Your Evidence of Coverage (EOC) tells you how to get your Medicare medical care and covered medications through your plan. It explains your rights and responsibilities as a member, what is covered and what you pay as a member of your plan.
Members receive a copy of their EOC annually. We encourage you to read through it to understand how your plan works and what services are available.
For more information or questions, please contact us.
| No Drug Coverage | with Rx Coverage | with Enhanced Rx Coverage | Optional Comprehensive Dental Benefit |
|---|---|---|---|---|
| ||||
Freedom Basic (Cost) | Evidence of Coverage | Not offered | Not offered | Not offered |
Freedom Vital (Cost) | Evidence of Coverage | Evidence of Coverage | Not offered | Evidence of Coverage Rider |
Freedom Balance (Cost) | Evidence of Coverage | Evidence of Coverage | Not offered | Evidence of Coverage Rider |
Freedom Ultimate (Cost) | Evidence of Coverage | Evidence of Coverage | Evidence of Coverage | Evidence of Coverage Rider |
| ||||
Wisconsin Freedom Basic (Cost) | Evidence of Coverage | Not offered | Not offered | Not offered |
Wisconsin Freedom Ultimate (Cost) | Evidence of Coverage | Evidence of Coverage | Not offered | Not offered |
| ||||
| Evidence of Coverage | |||