Request a printed copy of an Evidence of Coverage, Provider Directory or Prescription Drug Guide

Fill out the form below to request a copy of our printed Evidence of Coverage, Bilingual Provider Directory or Prescription Drug Guide for a specific CarePlus benefit plan and service area/county. In order to receive the right document, please enter the contract and plan benefit package (PBP) number for the plan you’re interested in. An example is, H1019-123.

Here are steps to find the contract and Plan Benefit Package PBP or plan number on the CarePlus plan page:

  1. Go to
  2. Enter your ZIP code to find a plan.
  3. Browse the list of plans for your ZIP code.
  4. View the name of the plan, such as "CareOne PLUS (HMO)".
  5. Locate the contract and PBP number underneath the name of the plan as shown in the image.

For immediate access to the most up-to-date information, we recommend using our online searchable directory.

We’re collecting your name and mailing address only to send you the materials you’re requesting. Your contact information will not be used for any other purpose.

Required All fields are required.

Required Please choose the printed materials you would like to receive in the mail.

CarePlus is an HMO plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal.

The formulary, pharmacy and/or provider networks may change at any time. You will receive notice when necessary.