Alabama Plan Benefit Materials


This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent's Reward (HMO) H4343- 001 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Reward (HMO) H4343- 002 Mobile county
Ascension Complete St. Vincent's Secure (HMO) H4343-003 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Secure (HMO) H4343- 004 Mobile county

For HMO D SNP Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent's DSNP (HMO D-SNP) H4343- 005 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence DSNP (HMO D-SNP) H4343- 006 Mobile county

For PPO Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent's Access Plus (PPO) H7556- 001 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete St. Vincent's Access (PPO) H7556- 002 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Access Plus (PPO) H7556- 003 Mobile County
Ascension Complete Providence Access (PPO) H7556- 004 Mobile county

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent's Reward (HMO) H4343- 001 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Reward (HMO) H4343- 002 Mobile county
Ascension Complete St. Vincent's Secure (HMO) H4343-003 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Secure (HMO) H4343- 004 Mobile county

For HMO D SNP Members:

Plan Name CMS # County Evidence of Coverage
(EOC)
Ascension Complete St. Vincent's DSNP (HMO D-SNP) H4343- 005 Bibb, Blount, Jefferson, Shelby, St. Clair
Ascension Complete Providence DSNP (HMO D-SNP) H4343- 006 Mobile

For PPO Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent's Access Plus (PPO) H7556- 001 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete St. Vincent's Access (PPO) H7556- 002 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Access Plus H7556- 003 Mobile County
Ascension Complete Providence Access (PPO) H7556- 004 Mobile County

This booklet will tell you about changes to your plan’s costs and benefits for the coming year. Please select the document for your plan and county:

For HMO Members:

Plan Name CMS # County Annual Notice of Changes (ANOC)
Ascension Complete St. Vincent's Reward (HMO) H4343- 001 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Reward (HMO) H4343- 002 Mobile county
Ascension Complete St. Vincent's Secure (HMO) H4343-003 Bibb, Blount, Jefferson, Shelby and St. Clair counties
Ascension Complete Providence Secure (HMO) H4343- 004 Mobile county

If you have any questions please, contact Member Services.