Medicare Advantage plan documents
For your convenience, below are important forms and documents to help you easily manage your health coverage.
Summary of Benefits
2026 Summary of Benefits — updated 10/1/2025
2025 Summary of Benefits — updated 11/25/2024
Evidence of Coverage and Outline of Coverage
The Evidence of Coverage (EOC) is a complete description of your Medicare Advantage plan coverage and your rights as a member. It explains your benefits, premiums, and cost-sharing; conditions and limitations of coverage; and plan rules.
After you've joined the plan, you will receive the Evidence of Coverage in the mail. This is a legal document that should be kept in a safe place.
2026 Evidence of Coverage — updated 10/1/2025
2025 Evidence of Coverage — updated 5/20/2025
2026 AmeriHealth Medigap Outline of Coverage
- AmeriHealth Medigap Outline of Coverage — effective 1/1/2026
2025 AmeriHealth Medigap Outline of Coverage
- AmeriHealth Medigap Outline of Coverage — effective 4/1/2025
Annual Notice of Changes
2026 Annual Notice of Changes (ANOC) — updated 10/1/2025
2025 Annual Notice of Changes (ANOC) — updated 10/1/2024
- AmeriHealth Medicare Core PPO
- AmeriHealth Medicare Enhanced PPO
- AmeriHealth Medicare Secure PPO
- AmeriHealth Medicare Ultimate PPO
Covered non-Medicare dental codes
Select your plan below to view a list of covered preventive/comprehensive non-Medicare dental codes.
Y0041_H5361_AH_125392_M_2026
Website last updated: 8/15/2025