Plan Benefit Materials | Trillium Advantage

Plan Materials and Forms

 

Listed below are some documents that may be helpful at different times during your membership. 

This booklet gives you a summary of costs and coverage in your plan. 

Please select the document for your plan and county:

For HMO D-SNP Members:

Plan Name CMS# County  Summary of Benefits
Trillium Advantage Dual
(HMO D-SNP)
H2174-001

Lane county

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:

For HMO D-SNP Members:

Plan Name CMS# County  Evidence of Coverage (EOC)
Trillium Advantage Dual
(HMO D-SNP)
H2174-001

Lane county

If you were enrolled in Trillium Medicare Advantage last year, 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:

For HMO D-SNP Members:

Plan Name CMS# County  Annual Notice of Changes (ANOC)
Trillium Advantage Dual
(HMO D-SNP)
H2174-001

Lane county

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

Ordering is easy. Just follow the steps in your plan's catalog.