2024 Evidence of Coverage – Samaritan Advantage Valor See the complete details and documentation about this plan, including what is covered and what you pay.
2024 Evidence of Coverage – Samaritan Advantage Premier See the complete details and documentation about this plan, including what is covered and what you pay.
2024 Evidence of Coverage – Samaritan Advantage Premier Plus See the complete details and documentation about this plan, including what is covered and what you pay.
2024 Prior Authorization List – Samaritan Advantage Plans Learn what medical services, procedures, supplies and equipment require authorization before being covered.
2024 Enrollment Form – Advantage Plans Use this form to enroll in a Samaritan Advantage plan for 2024.
2024 Summary of Benefits – Advantage Valor Use this summary to compare plan premiums, cost shares, benefits and more.
2024 Summary of Benefits – Advantage Premier & Premier Plus Plans Use this table to compare plan premiums, cost shares, benefits and more.
2023 Quantity Limit Criteria – Premier & Premier Plus Plans See the medication quantity limits for this plan.
2023 Step Therapy Criteria – Advantage Premier & Premier Plus Plans Understand which drugs require starting with one drug before a different option can be prescribed.
2023 Prior Auth Criteria – Premier & Premier Plus Plans Understand the criteria used for medications that require prior authorization.
