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Request Plan Materials

For the most up-to-date information, you can find a provider, pharmacy and drug online, as well as your Evidence of Coverage booklet:

To have a printed copy mailed to you, please fill out the form below. All fields are required unless otherwise noted.

First Name

Last Name

Middle Initial

Street Address

Apartment/Building/Suite

City

State Code

Zip Code

Phone Number

Select Plan Year*

Provider Directory

Pharmacy Directory

Drug Formulary

Evidence of Coverage

Requesting this information does not obligate you to enroll nor allow Alignment Health Plan to enroll you in one of our health plans.

Page last updated on 11/12/2019 | Y0141_21079EN