Plan Documents & Benefit Information

Questions? Contact Customer Service at (855) 645-8448

Member Benefits & Programs

Plan Documents and Materials

Below you'll find our enrollment form that you can print out, complete and mail to Memorial Hermann Advantage. Mail your completed form to:

Memorial Hermann Medicare Advantage Enrollment
PO Box 19909
Houston, Texas 77224

Enrollment Form 2024 — HMO (English) / (Spanish)

Here at Memorial Hermann Advantage, we strive to provide our members with the most accurate Provider Directories. If you need help finding a network provider, please call Customer Service: (855) 645-8448 (TTY 711) or click here to access our online searchable directory. If you would like a Provider Directory mailed to you, you may call the number above, or request one here.

Aquí en Memorial Hermann Advantage nos esforzamos por ofrecer a nuestros miembros los Directorios de Proveedores más precisos. Si necesitas ayuda para encontrar un proveedor dentro de la red, llama al: (855) 645-8448 (TTY 711) O visita aquí para acceder a nuestro directorio de búsqueda online. Si deseas recibir por correo un Directorio de Proveedores, puedes llamar al número indicado más arriba o solicitar uno en el sitio web aquí.

Benefit Information

Coming Soon

Dental benefits under the Memorial Hermann Medicare Advantage plans are provided by Liberty Dental Plan®. Please review your plan’s Evidence of Coverage (EOC) to ensure you fully understand the dental benefits offered with your specific plan, or view specific dental fees here.

Members can use their flexible card to cover costs associated with supplemental benefits including Vision, Hearing, Over-the-Counter products and Grocery where applicable. (D-SNP plans and those who have been enrolled in Case Management and approved by a Case Manager will receive a grocery benefit) Click here for more information.

Available for all Memorial Hermann Advantage Plans, members are provided an annual allowance for vision and eyewear equipment. Click here for more information on the hearing and vision benefit. 

Available for all Memorial Hermann Advantage Plans, Modivcare manages routine non-emergency medical transportation (NEMT) for Memorial Hermann Health Plan members. For more information on the transportation benefit, click here.

Available for all Memorial Hermann Advantage Plans, Mom’s Meals® provides members with meals post-discharge of an in-patient hospitalization stay. For more information about using this benefit click here, please call our customer service team at (855) 645-8448 (TTY 711)

Available for all Memorial Hermann Advantage Plans, the Over-The-Counter (OTC) benefit provides members with a quarterly allowance for OTC products. For more information on the OTC benefit, click here.

Our plan allows for reimbursements of certain claims. Please download the form below, complete it and follow the submission directions.

Member Reimbursement Medical Claim Form

The Medicare Program rates all health and prescription drug plans each year, based on a plan's quality and performance. Medicare Star Ratings help you know how good a job our plan is doing. You can use these Star Ratings to compare our plan's performance to other plans.

Medicare Stars Rating 2024 - HMO (English) / (Spanish)

Appointment of Representative (AOR) Form (English) / (Spanish)
This form confirms your request for a particular person to act as your representative in connection with a claim.

For information on how to Authorization to Disclose Protected Health Information, visit our Privacy Page.

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