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Forms & Resources

If you're looking for benefit details, pharmacy or prescription drug information, or need to report a potential concern, you’re in the right place. Elite Health Plan provides the tools and resources you need to stay informed and supported.

Notice of Availability (NOA)
Non-Discrimination Notice - English
Non-Discrimination Notice - Spanish
Member Rights and Responsibilities - English
Member Rights and Responsibilities - Spanish
Direct Reimbursement Claim Form
Election Period Attestation - Spanish
Election Period Attestation - English
California Advanced Directive Form - English
California Advanced Directive Form - Spanish
Disenrollment Rights and Responsibilities - English
Disenrollment Rights and Responsibilities - Spanish
Medicare Disaster Policy - English
Medicare Disaster Policy - Spanish

FAQ

Find answers to questions about your drug coverage.

Find Care

Locate providers and facilities near you.

List of Covered Drugs

Check drug coverage, prior authorization, quantity limits, and alternatives.

Report an Issue

Tell us about a problem so we can review and resolve it.

Already a Member?

Contact Elite Health Plan Member Services

800-958-1129 (TTY - 711)

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