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:

Plan Name	CMS #	County	Summary of Benefits
Ascension Complete St. Vincent's Reward (HMO)	H8225 - 001	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Summary of Benefits, H8225-001 - English (PDF) Summary of Benefits, H8225-001 - Spanish (PDF)
Ascension Complete Sacred Heart Reward (HMO)	H8225 - 002	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Summary of Benefits, H8225-002 - English (PDF) Summary of Benefits, H8225-002 - Spanish (PDF)
Ascension Complete St. Vincent's Secure (HMO)	H8225 -003	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Summary of Benefits, H8225-003 - English (PDF) Summary of Benefits, H8225- 003 - Spanish (PDF)
Ascension Complete Sacred Heart Secure (HMO)	H8225 - 004	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Summary of Benefits, H8225-004 - English (PDF) Summary of Benefits, H8225-004 - Spanish (PDF)

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)	H8225 - 001	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Evidence of Coverage, H8225-001 - English (PDF)
Ascension Complete Sacred Heart Reward (HMO)	H8225 - 002	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Evidence of Coverage, H8225-002 - English (PDF)
Ascension Complete St. Vincent's Secure (HMO)	H8225 -003	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Evidence of Coverage, H8225-003 - English (PDF)
Ascension Complete Sacred Heart Secure (HMO)	H8225 - 004	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Evidence of Coverage, H8225-004 - English (PDF)

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, Escambia, Nassau and Santa Rosa counties	Annual Notice of Changes, H8225-001 - English (PDF)
Ascension Complete Sacred Heart Reward (HMO)	H8225 - 002	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Annual Notice of Changes, H8225-002 - English (PDF)
Ascension Complete St. Vincent's Secure (HMO)	H8225 -003	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Annual Notice of Changes, H8225-003 - English (PDF)
Ascension Complete Sacred Heart Secure (HMO)	H8225 - 004	Baker, Clay, Duval, Escambia, Nassau and Santa Rosa counties	Annual Notice of Changes, H8225-004 - English (PDF)

Your current plan may have an over-the-counter benefit that allows you to purchase over-the-counter (OTC) health and wellness products. This catalog includes a list of over-the-counter items that you can order to be directly mailed to your home. Check the catalog for item limits.

Ordering is easy! Just follow the steps listed on your plan's catalog.

Over-the-Counter Catalog - English / Spanish (PDF)

Member Newsletter, Summer 2020

Plan Name	CMS #	County	Summary of Benefits
Ascension Complete St. Vincent's Reward (Jacksonville)	H8225 - 001	Baker, Clay, Duval and Nassau counties	Summary of Benefits, H8225-001 - English (PDF) Summary of Benefits, H8225-001 - Spanish (PDF)
Ascension Complete Sacred Heart Reward (Pensacola)	H8225 - 002	Escambia and Santa Rosa counties	Summary of Benefits, H8225-002 - English (PDF) Summary of Benefits, H8225-002 - Spanish (PDF)
Ascension Complete St. Vincent's Secure (Jacksonville)	H8225 -003	Baker, Clay, Duval and Nassau counties	Summary of Benefits, H8225-003 - English (PDF) Summary of Benefits, H8225-003 - Spanish (PDF)
Ascension Complete Sacred Heart Secure (Pensacola)	H8225 - 004	Escambia and Santa Rosa counties	Summary of Benefits, H8225-004 - English (PDF) Summary of Benefits, H8225-004 - Spanish (PDF)

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

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

If you have questions please, contact Member Services.

Florida Plan Benefit Materials

Summary of Benefits

Evidence of Coverage (EOC)

Annual Notice of Changes (ANOC)

Optional Benefit Individual Enrollment Form

Optional Supplemental Benefits Flyer

Over-the-Counter Benefits

Member Newsletter

Florida Plan Benefit Materials

Summary of Benefits

Evidence of Coverage (EOC)

Annual Notice of Changes (ANOC)

Over-the-Counter Benefits

Optional Supplemental Benefits Flyer

Brochures, Flyers and Inserts