Florida 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) H8225 - 001 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Reward (HMO) H8225 - 002 Escambia, Santa Rosa, and Walton
Ascension Complete St. Vincent's Secure (HMO) H8225 -003 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Secure (HMO) H8225 - 004 Escambia, Santa Rosa, and Walton
Ascension Complete St. Vincent's Access POS H8225-007 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Access POS H8225-008 Escambia, Santa Rosa, and Walton

For HMO D SNP Members:

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent's DSNP H8225 - 005 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart DSNP H8225 - 006 Escambia, Santa Rosa, and Walton

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:

For HMO Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent's Reward (Jacksonville) H8225 - 001 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Reward (Pensacola) H8225 - 002 Escambia, Santa Rosa, and Walton
Ascension Complete St. Vincent's Secure (Jacksonville) H8225 - 003 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Secure (Pensacola) H8225 - 004 Escambia, Santa Rosa, and Walton
Ascension Complete St. Vincent's Access POS (HMO POS) H8225 - 007 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Access POS H8225 - 008 Escambia, Santa Rosa, and Walton

For HMO D SNP Members:

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent's DSNP (HMO D-SNP) H8225 - 005 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart DSNP (HMO D-SNP) H8225 - 006 Escambia, Santa Rosa, and Walton

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:

Plan Name CMS # County Annual Notice of Changes (ANOC)
Ascension Complete St. Vincent's Reward (HMO) H8225 - 001 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Reward (HMO) H8225 - 002 Escambia, Santa Rosa, and Walton
Ascension Complete St. Vincent's Secure (HMO) H8225 -003 Baker, Clay, Duval, and Nassau
Ascension Complete Sacred Heart Secure (HMO) H8225 - 004 Escambia, Santa Rosa, and Walton

If you have any questions please, contact Member Services.