print page email page Home For Members Evidence of Coverage Evidence of Coverage If you would like us to mail you an Evidence of Coverage, please fill out and submit this form: * Required fields First Name * Last Name * Address * Address 2 City * State * (please select) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Member ID (if a current member) 2023 Prime - Evidence of Coverage 2023 Complete - Evidence of Coverage 2023 Special - Evidence of Coverage 2023 Silver - Evidence of Coverage 2023 Platinum - Evidence of Coverage Language: English Spanish If you would like to speak with a representative from Health Partners Medicare to discuss plan options, please provide your phone number. Telephone By providing my phone number, I agree to allow Health Partners Medicare to contact me with information related to its health plans, products, benefits, services and/or educational information related to health care. Submit
