Find information on using your benefits, reimbursements, and key plan documents and forms to help you make the most of your health plan.
Find key documents and forms, including reimbursement forms.
When you are enrolled as a member of Martin’s Point Generations Advantage you will receive an Annual Notice of Change (ANOC) document. Learn more or download a copy of your plan's ANOC document below.
The Evidence of Coverage document provides the details of your Medicare health benefits, services, and prescription drug coverage as a member of Martin's Point Generations Advantage from January 1 – December 31, 2025. It explains how to get coverage for the health care services and prescription drugs you need.
The Evidence of Coverage document provides the details of your Medicare health benefits, services, and prescription drug coverage as a member of Martin's Point Generations Advantage from January 1 – December 31, 2026. It explains how to get coverage for the health care services and prescription drugs you need.
Eligible purchases must be made in 2025. Submit claims by April 30, 2026.
Submit online:
Or by mail:
2026 form coming soon.
Note: Do not use this form if eyewear was purchased after cataract surgery — use the Medical Services form below.
For covered medical services you received from a provider or facility, including eyewear purchased after cataract surgery.
For out-of-pocket payments of Part D formulary prescription drugs. Do not use any other forms for prescription drug claims.
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Explore added benefits and programs for screenings, therapy drugs, personalized care management, and more.
For information on these benefits, please visit the Pharmacy & Part D Coverage and Extra Benefits hub pages.
Take your Health Risk Assessment—an online questionnaire to help you understand your health/health risks, and guide you toward being as healthy as possible.
To take the HRA (at no additional charge) you must first have an online portal account. Log in with your portal username and password or click “Register” if this is your first time logging in. When prompted, enter your Generations Advantage member ID number and follow the instructions. This website will allow only you to see your results anytime.
If you don’t have internet access or have questions, call us at 1-877-659-2403 (TTY: 711) and leave a message. We will return your call within two business days.
You can find the Health Risk Assessment here:
Your free* annual flu shots can be administered at participating pharmacies** as well as by your primary care provider. Shots covered include quadrivalent, trivalent, trivalent (high dose), and intradermal.
If you don’t show your Generations Advantage member ID card when you get your flu shot, you will pay the full cost at the pharmacy and submit a form to us for reimbursement.
Flu Shot Reimbursement Form [PDF]
If your pharmacist has problems sending your claim to us, they should call our Part D Pharmacy Help Desk at 1-800-364-6331.
*Influenza (flu) vaccines are covered under your Medicare Part B benefit through your Generations Advantage plan.
**The Vaccine Pharmacy Network is offered through our relationship with our pharmacy benefit manager, CVS Caremark. Pharmacy network may change on January 1 of each year. Other pharmacies are available in our network.
For detailed coverage information, visit:
At Martin's Point, we’ve partnered with LifeStation to offer peace of mind and security through advanced medical alert devices. Whether you’re eligible for our Covered Medical Benefit (Alliance plan members only) or looking to take advantage of our value-added discount (available to all other plan members), LifeStation ensures you're always connected when it matters most.
For Martin's Point Generations Advantage Alliance plan members, this benefit offers fully covered medical alert devices. You'll receive 24/7 monitoring with no out-of-pocket costs for shipping, activation, or monthly fees (valued at $13.95–$18.95 per month). Covered devices include:
Spousal coverage and product warranties are also included at no additional charge.
How to Use Your Covered Medical Benefit:
What’s Covered:
Generations Advantage plan members receive 25% discounts on medical alert devices through LifeStation. Please note, this is a value-added discount, not a covered plan benefit.
The following plans include this value-added discount:
2025: Access, Select, Prime, and Value Plus | 2026: Prime, Essential, and Select
How to Use Your Value-Added Discount:
What’s Covered:
Devices & Pricing:
Once enrolled in either option, LifeStation® makes it easy to manage your service and get support when you need it. Call LifeStation® Customer Service at 1-800-998-2400 for troubleshooting or to explore device add-ons.
The Part B Step Therapy requirement encourages members to try less costly but usually just as effective ‘preferred’ drugs before the plan covers another ‘preferred’ drug. For example, if Drug A (preferred) and Drug B (non-preferred) treat the same medical condition, the plan may require you to try Drug A first. If Drug A does not work for the member, the plan will then cover Drug B.
Step therapy is not required for members who have used a non-preferred drug within the last 365 days, but authorization is required. To see list of preferred and non-preferred step therapy drugs please see:
2025 Part B Step Therapy Drug List [PDF]
2026 Part B Step Therapy Drug List [PDF] - COMING SOON
Colorectal cancer screenings save lives. All screenings have a $0 copay when you go to an in-network provider. Ask your primary care provider which screening and schedule is right for you. We cover these screenings more frequently for people at high risk for colorectal cancer.
For detailed coverage information, refer to your Evidence of Coverage document:
As a Martin’s Point Generations Advantage member, you are eligible to receive free, personalized care management.
Our care managers can help you:
Sign up for a dedicated medical or behavioral health care manager who will help you succeed at leading a healthy, active, and full life.
Martin’s Point care management programs are entirely voluntary. You can choose not to participate or to stop participating in the program at any time. If you have immediate concerns regarding your health, please contact your doctor. Always consult your health care provider before making any lifestyle changes. Only your doctor can diagnose and treat a medical condition.
For detailed coverage information, visit:
Eligible members have the option to purchase nutritionally balanced, refrigerated, and ready-to-eat meals that are delivered by Mom’s Meals directly to your home.
Eligibility: This is available for plan members with congestive heart failure (CHF) or end-stage renal disease (ESRD) post-discharge or post-surgery, or for members with CHF or ESRD who indicate need and meet objective screening criteria.
Benefit Details:
Alliance (HMO) Plan Members: In addition, Alliance members have a separate meal benefit:
Place your order online or by phone using code MPGA to activate the offer:
Online: MomsMeals.com/MPGA
Phone: 1-877-347-3438
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Additional plan details including third-party vendor information, state resources, grievance support, and more.
Gain insight into how we determine the medical necessity for treatments and services, ensuring you receive care that meets established medical standards. This knowledge supports your health care journey with us, aligning with Medicare's guidelines.
For detailed clinical coverage criteria, visit:
Your Maximum Out-of-Pocket limit is the most you will pay for covered medical services in a fiscal year. Once you reach your Maximum Out-of-Pocket limit, you will no longer pay cost shares for those services. Here’s what you need to know:
To check if you’ve hit your limit, contact Member Services at 1-866-544-7504. They can confirm your status and provide a Maximum Out-of-Pocket letter upon request, which can be shown at your doctor's office to confirm that you no longer need to pay cost shares.
If you’ve met your Maximum Out-of-Pocket limit, call Member Services at 1-866-544-7504 to request your letter. If you haven’t met the limit, a letter will not be generated.
We connect you directly with trusted partners, making it easier than ever to manage your benefits. From exclusive discounts to personalized support, our vendors are here to help you get the most out of your membership. Direct access to the services and solutions you need. Explore what’s available and take control of your health and wellness today!
For detailed third-party vendor information, visit:
At Martin’s Point, we are committed to providing our members a fair and timely process for resolving any complaints or disputes. We encourage Martin’s Point Generations Advantage members to contact us with questions, concerns, or problems related to any benefits or service.
Please call us at 1-866-544-7504 (TTY: 711), 8am–8pm, seven days a week from October 1–March 31, and Monday through Friday the rest of the year, to discuss your concerns.
For detailed information, visit:
As part of the 21st Century Cures Act regulations, the Centers for Medicare and Medicaid (CMS) policy now requires that systems be put in place to make it easier for you to see your important health data. Under the systems, you’ll be able to:
For detailed information, visit: