New West Medicare Plan Forms
Enrollment
Medicare beneficiaries may enroll in New West Medicare PPO or New West Medicare Enhanced PPO through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at www.medicare.gov. For more information contact New West Health Services at 1-888-873-8049. TTY/TDD users call 1-888-290-3658.
Print and mail applications directly to:
New West Health Services
PO Box 668
Kalispell, MT 59903
Attn: Medicare Enrollment
Medicare Eligible persons can only enroll in a New West Medicare plan during specific times of the year, please contact Customer Service for details.
2010 Materials
2010 Medicare Sales Presentation
2010 Annual Notice of Change for New West Medicare
See how our plans will change from 2009 to 2010.
2010 Evidence of Coverage
This document contains a complete list of your benefits, premiums and cost sharng for the New West Medicare PPO & New West Medicare Enhanced PPO Plans.
2010 LIS Premium Summary Table
If you receive extra help from the Social Security Administration, this document will show you what your premiums will be for 2010.
2010 Summary of Benefits
Provides information on your benefits, premiums, and cost sharing in the the New West Medicare PPO & New West Medicare Enhanced PPO Plans. It doesn't list every service that we cover or list every limitation or exclusion.
2010 Provider & Pharmacy Directory
See a list of our network providers and pharmacies. For the most current information see the “find a provider” box on the top right hand side of this page.
2010 New West Medicare (PPO) Comprehensive Formulary
2010 New West Medicare Enhanced (PPO) Comprehensive Formulary
General Materials & Links
Medicare Appeal Rights
Important information on how to appeal a decision about your coverage.
Notice of Privacy Practices
Your legal rights on how your medical information can be shared and how it is protected.
Service Area Listing
New West Health Services' Medicare Service Area Counties in Montana. Our service area will not change for 2010.
Service Area Map
Check the map to see if your county is in our service area.
Automatic Premium Payment - EFT or Credit Card Option
Learn how to use direct debit from your checking account or a credit card to make monthly premium payments.
How to Obtain the Number of Grievances, Appeals, and Exceptions Filed with Our Plan
How to Request Information about New West Health Services
You have the right to obtain information about New West. Learn how to access our financial information, pharmacy information and more.
How to file a Grievance
If you have problems with a New West Health Services Medicare plan involving customer service, medical decisions or quality of care it is your right to file a grievance. Learn the reasons for filing a grievance and the process here.
Medical Prior Authorization Instructions
Learn how to obtain authorization for prescription drugs and/or healthcare services you may need that require prior authorization. See your Evidence of Coverage to determine which services need prior authorization.
Services Requiring Prior Authorization in 2010
Medicare Appointment of Representative Form
You have the right to elect someone to help you with your claims and discuss your coverage. If you need this assistance, this form tells you how to make that arrangement.
Using plan and non-plan providers to get services covered by New West Medicare
Learn why using plan providers saves you money.
Physical Address:
New West Health Services
130 Neill Ave
Helena, MT 59601
New West Health Services
2132 Broadwater Ave., Unit A-1
Billings, MT 59102
New West Health Services
1203 Hwy 2 West, Suite #45
Kalispell, MT 59901-6071
Note: (H2701_NW#135-09-09) CMS Approval Date: 10-13-2009
Last updated on 06-14-2010
New West has over 4,600 providers in our network.
Medicare beneficiaries may enroll in New West Medicare PPO or New West Medicare Enhanced PPO through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at http://www.medicare.gov
or
Choose a plan below. Enter your zip code and click the “Submit” button. For more information contact New West Health Services. Please call:
(888) 873-8049
or
(888) 290-3658 (TTY/TDD)