State of Oklahoma Group Retirees Member Materials
GENERATIONS STATE OF OKLAHOMA GROUP RETIREES PLAN MEMBER MATERIALS, FORMS, RESOURCES & GUIDELINES
Learn more about your Generations State of Oklahoma Retiree Plan and benefits. Download the latest member materials below. All materials shown are available in printed versions. If you need a printed version, please contact Customer Care and a copy will be mailed to you.
Member Newsletter
2021 Plan
Drug Formulary, Pharmacy Prior Authorization and Step Therapy Information
Summary of Benefits
Evidence of Coverage (EOC)
Annual Notice of Changes (ANOC)
Enrollment Forms
- 2021 OMES EGID Application for Medicare Advantage Prescription Drug (MA-PD) Plan
- OMES EGID Application for Retiree/Vested/Non-Vested/Defer Insurance Coverage Form
Provider Directory
- Plan Year 2021 Provider Directory (for a current listing, click here.)
Pharmacy Documents, Links and Resources
- Medicare Part D Prescription Claim Form
- 2021 Pharmacy Search Tool
- Prescription Drug Mail Order Form
- Prescription Drug Transition Policy
- Medicare Therapy Management (MTM) Program Information
- Utilization Management Program
- Request for Medicare Prescription Drug Appeal (Redetermination) Form
- Request for Medicare Prescription Drug Coverage Determination Form
- Use the above Coverage Determination Form for Exceptions, Prescription Drug Prior Authorization, Quantity Limits, Step Therapy, and Reimbursements.
- Over the Counter Benefit
Please note when ordering OTC items online, you should not enter the “01” located at the end of your GlobalHealth member ID number. If the “01” is entered, the member ID number will not be recognized.- Over the Counter Benefit – Place Order (Coming 01/01/2021)
- 2021 Over the Counter Benefit FAQs
- 2021 Over the Counter Benefit Catalog (Updated 10/01/2020)
2020 Plan
Drug Formulary, Pharmacy Prior Authorization and Step Therapy Information
Summary of Benefits
Evidence of Coverage (EOC)
- Plan Year 2020 Evidence of Coverage (Generations State of Oklahoma Group Retirees) (Updated 10/15/2019)
Annual Notice of Changes (ANOC)
Enrollment Forms
- 2020 OMES EGID Application for Medicare Advantage Prescription Drug (MA-PD) Plan
- OMES EGID Application for Retiree/Vested/Non-Vested/Defer Insurance Coverage Form
Provider Directory
- Plan Year 2020 Provider Directory (for a current listing, click here.)
Pharmacy Documents, Links and Resources
- Medicare Part D Prescription Claim Form
- 2020 Pharmacy Search Tool
- Prescription Drug Mail Order Form
- Prescription Drug Transition Policy
- Medicare Therapy Management (MTM) Program Information
- Utilization Management Program
- Request for Medicare Prescription Drug Appeal (Redetermination) Form
- Request for Medicare Prescription Drug Coverage Determination Form
- Over the Counter Benefit
Please note when ordering OTC items online, you should not enter the “01” located at the end of your GlobalHealth member ID number. If the “01” is entered, the member ID number will not be recognized.
Additional Documents, Links and Resources
- Plan Year 2020 Medicare Star Ratings (Updated 10/15/2019)
- Plan Year 2021 Medicare Star Ratings (Updated 10/19/2020)
- Non-Discrimination Notice
- Get information about Extra Help to pay your plan premium or prescriptions (LIS)
- Your Rights and Responsibilities as a Member of Generations Medicare Advantage plan, offered by GlobalHealth
- Assistance During a Disaster
- Advance Directive Information
- CMS Website's Best Available Evidence (BAE) Page
- Appointment of Representative Form
- Release of Information Form
- Privacy Notice
- 2019 Creditable Coverage Notice
- 2020 Creditable Coverage Notice
Click here for member materials prior to 2020.