For Members / Pennsylvania

Jefferson Health Plans Special (HMO-SNP)

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Summary of Benefits

The Summary of Benefits provides information on key features and coverage of our plans. You can find details on benefits, limitations, premiums, copays and deductibles.

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Annual Notice of Changes

Each year we alert our members to the important changes for their plan the following year through our Annual Notice of Changes.

Evidence of Coverage

This document describes in detail the health care benefits covered by each of our health plans, how the plans work, prescription drug coverage, and associated costs.

Request a printed copy

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Updated 10/1/2024

Drug List

Learn about the generic and brand-name drugs covered by Jefferson Health Plans in our formulary.

Request a printed copy.

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Need help with expenses in 2024?

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Need to Change Your Plan?


For a personalized evaluation, visit our online enrollment site and enter your ZIP code. Then click the “View Plans” button.


Learn more about Jefferson Health Plans


View our Star Rating sheet.


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Page last updated: 10/1/2024 - Y0170_MCE‐220S05‐4991_M