Forms

• Appointment of Personal Representative
• Denver Parks & Recreation Membership
• Pharmacy Prior Auth Request (PAR) / Exception Request Form
• Authorization to Use and Disclose PHI
• Medicare Member Reimbursement
• Prescription Drug Coverage Determination Request
• Coordination of Benefits

Documents

• Star Ratings
• LIS Summary Table
• Request Provider Pharmacy Directory Hardcopy
• Advance Directive / Living Will

Links

• Affirmative Statement About Incentives
• LIS Premium Subsidy
• Medicare Exceptions, Grievances and Appeals
• Best Available Evidence
• Medicare Disenrollment
• Medical Prior Authorization List
• Glossary
• Medicare Enrollment Instructions
• Member Rights & Responsibilities