Banner Medicare Advantage Prime HMO | 2022 Plan Materials

Coverage Year: January 01, 2022 to December 31, 2022

The materials and links below provide you with information related to your plan benefits and coverage. Contact our Customer Care Center if you need further assistance.

Plan Materials | 2022

The 2022 Annual Notice of Changes (ANOC) booklet tells about the changes between plan benefit years 2021 and 2022. Please find your county below to review some changes to the plan's costs and benefits.

Applicable Counties: Maricopa, Pinal

Annual Notice of Changes (001) | English

Annual Notice of Changes (001) | Español

Applicable County: Pima

Annual Notice of Changes (002) | English

Annual Notice of Changes (002) | Español

The 2022 Evidence of Coverage booklet gives you the details about your Medicare health care and prescription drug coverage from January 1, 2022 – December 31, 2022. It explains how to get coverage for the health care services and prescription drugs you need. This is an important legal document.

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare or TTY users call 1-877-486-2048 (24 hours a day/seven days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

If you have any questions, please call our Customer Care Center at (877) 874-3930, (TTY users should call 711), from 8 a.m. to 8 p.m., seven days a week.

Explore 2022 plan details to see if it is right for you. Use the 2022 Pharmacy and Medication Search Tool or view the documents (PDFs) below. Our most current version of medications and pharmacies will always be updated online.

Please Note: For 2022 plan benefits and coverage, Banner Medicare Rx will partner with Express Scripts, Inc. (ESI) as our pharmacy benefit manager (PBM).

Online Pharmacy and Medication Search Tool

Check medication prices, see what pharmacies are in-network, and find out what medications are covered.

Comprehensive Formularies (List of Covered Drugs)

Our network of more than 5,000 providers is committed to understanding your medical history and partnering with you to develop a health care roadmap to support your health and lifestyle objectives.

If you need assistance identifying a provider that’s right for you, please call (833) 516-1007, TTY 711, 8 a.m. to 8 p.m., Monday - Friday to speak with a licensed sales agent.

2022 Provider Directories

Maricopa and Pinal Counties

Pima, Santa Cruz, and Yuma Counties

2022 Dental Directory

Counties: Maricopa, Pima, Pinal, Santa Cruz, Yuma

2022 Pharmacy Directory

Counties: Maricopa, Pima, Pinal, Santa Cruz, Yuma

This is a summary of drug and health services covered by Banner Medicare Advantage Prime HMO (January 1, 2022 - December 31, 2022).