The Care N’ Care Evidence of Coverage includes detailed information about your coverage. This legal document addresses any conditions associated with the receipt or use of benefits and potential for contract termination, as well as rights and responsibilities upon disenrollment. You can search the document for specific words or topics by holding the CTRL key while pressing "F" on your keyboard.

Quality Assurance
The Care N’ Care Evidence of Coverage includes information about our quality assurance policies and procedures. You can find information regarding drug management programs such as utilization management (prior authorizations, quantity limits, step therapy and generic substitutions) and medication therapy management. Within the EOC, quality assurance policies can be found beginning in section 2.

Medication Therapy Management
The Care N’ Care Medication Therapy Management program is available at no cost for members who meet specific criteria. Members who have multiple medical conditions, who are taking certain prescription drugs or who have high drug costs may be eligible for the program. More information can be found in section 2 of the EOC or by contacting Care N’ Care Customer Service.

Contract Termination and Member Rights
Care N’ Care has a contract with the Centers for Medicare & Medicaid Services (CMS) that may be renewed each year. However, either Care N’ Care or CMS can decide to end the contract at any time. If we leave the Medicare program, we will notify you in writing. If this situation occurs, your membership in our Plan will end, and you will have to enroll in another Medicare Advantage Plan with prescription drug coverage to continue receiving prescription drug benefits. More information can be found in the Care N’ Care EOC beginning in section 6.

You can learn more about how and why to submit coverage determinations, organization determinations, appeals and grievances by viewing the Care N' Care Evidence of Coverage (Sections 4 and 5) or by clicking on the individual topics below.

H6328_MR0022WEBv2_CMS11/3/2008