Senior Care Plus
Document Request Form
Please complete and submit the form below and the selected documents will be mailed to you. Please allow 7-10 days to receive your requested documents.
First / Last name
Member Number (From Your ID Card)
Your Plan Name (From your ID Card)
Clear choice
Renown Preferred Plan
Essential Plan
Extensive Duals Plan
Patriot Plan
Select Plan
Complete Plan
Enriched Duals Plan
Washoe County Retiree Plan
Email address
Address
Please send me the documents I select via
Physical Mail – You will receive hard copies of the documents selected in the mail
Email - You will receive an email with links to download the selected documents
Which document YEAR would you like to receive?
Clear choice
I would like to receive the CURRENT YEAR documents.
I would like to receive NEXT YEAR’S documents (only available October through December for the following year).
Documents You Would Like to Receive (select all that apply)
*Important: Printed directories are typically not the most up-to-date. To view current directories please visit
seniorcareplus.com/directories/
Evidence of Coverage for Your Plan
Provider Directory For Your Plan
Formulary / Pharmacy Directory
Over-the-Counter Catalog
Member Handbook with Benefits at a Glance
Summary of Benefits for Your Plan
Annual Notice of Change for your Plan
Right Of Access Form
Optional Language Choices (if available)
Spanish Language Versions
Verification
SUBMIT FORM
Please wait...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20