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Plan benefits & forms

Medicare plans have many different details and forms, so we’ve organized everything together into one convenient place.

SEHP Aetna Medicare Advantage plan options

You can review the SEHP Aetna Medicare Advantage plan options comparison flyer and follow the simple steps indicated to choose Aetna® medical and prescription drug coverage. To enroll , visit the State of Kansas Employee Health Plan Member Portal. See a word or term that you don’t know? Check our glossary.

 

 

2021 Plan information

 

Liberty Medicare Extended Service Area (ESA) PPO Plans

There are three Liberty Plans offered. Refer to your member ID card for your plan name.

Summary of Benefits – SOK 2021 MAPD Liberty High Rx - English (PDF)

Summary of Benefits – SOK 2021 MAPD Liberty Standard Rx - English (PDF)

Summary of Benefits – SOK 2021 MAPD Liberty Low Rx- English (PDF)

Annual Notice of Change (ANOC) – SOK 2021 MAPD Liberty Plans - English (PDF)

 

Elite Medicare Extended Service Area (ESA) PPO Plans

There are three Elite Plans offered. Refer to your member ID card for your plan name.

Summary of Benefits – SOK 2021 MAPD Elite High Rx - English (PDF)

Summary of Benefits – SOK 2021 MAPD Elite Standard Rx - English (PDF)  

Summary of Benefits – SOK 2021 MAPD Elite Low Rx - English (PDF)

Annual Notice of Change (ANOC) – SOK 2021 MAPD Elite Plans - English (PDF)

 

Freedom Medicare Extended Service Area (ESA) PPO Plans

There are three Freedom Plans offered. Refer to your member ID card for your plan name.

Summary of Benefits – SOK 2021 MAPD Freedom High Rx - English (PDF)

Summary of Benefits – SOK 2021 MAPD Freedom Standard Rx - English (PDF)

Summary of Benefits – SOK 2021 MAPD Freedom Low Rx - English (PDF)  

Annual Notice of Change (ANOC) – SOK 2021 MAPD Freedom Plans- English (PDF)

 

Formulary, Star Rating and Evidence of Coverage

Formulary (list of covered drugs) - High, Standard, and Low Rx Plans - English (PDF)

Star Rating - English (PDF)

You can request a copy of your Evidence of Coverage if you need one.

Review your Evidence of Coverage (EOC), SEHP enrollment booklet or visit the Kansas Department of Health and Environment website  to learn about comprehensive plan details, and your rights and responsibilities.

 

Find Medicare forms

 

See below for helpful resources for managing your plan and how to get started with common requests.

 

 

File claims & reimbursement requests

Give someone permission to manage your care

Manage your medications

Exceptions, appeals & grievances

Additional information

We're here to help

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