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Resource Library


Summary of Benefits

Download a complete summary of benefits for the Premier Plan (HMO) and Freedom Plan (HMO POS)

Evidence of Coverage

These booklets give you the details about your Medicare health care and prescription drug coverage from Jan.1 – Dec. 31, 2023. It explains how to get coverage for the health care services and prescription drugs you need.

Premier Plan (HMO)

Freedom Plan (HMO POS)

Provider Directory

This directory provides a list of Ochsner Health Plan’s current network providers for Ascension, East Baton Rouge, East Feliciana, Iberville, Jefferson, Lafourche, Livingston, Orleans, St. Charles, St. John the Baptist, St. Tammany, and West Baton Rouge parishes in Louisiana.

Ochsner Health Plan Freedom (HMO POS) members may use Point-of-Service (POS) providers that are outside of our network for an additional cost. Out-of-network/noncontracted providers are under no obligation to treat Ochsner Health Plan members, except in emergency situations. Please call our member services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Dental Information

LIS Premium Summary Form

Pharmacy Directory

This directory provides a list of Ochsner Health Plan ’s in-network pharmacies available in Louisiana, updated as of October 2022. For more recent information or other questions, please contact Ochsner Health Plan by phone or leverage the contact us form.


This document is a partial formulary and includes only some of the drugs covered by
Ochsner Health Plan.

Additional Information About Prescription Drugs

Prescription Drug Member Portal: Ochsner Health Plan offers online tools to help you make informed choices regarding your formulary and copay options. You’ll need your Ochsner Health Plan ID card to register. Click on the link to visit the MedImpact member portal. Once you register, you can sign into your account to: Check drug prices, View benefit highlights, and View prescription history:

Over the Counter Catalog

You may need over-the-counter health and wellness products, but they may be hard to budget for. To help, your health plan offers an over-the-counter benefit that allows you to purchase some of these products and have them shipped to your home.

Member Request For Reimbursement Forms

These forms are to be used to request reimbursement for out-of-pocket expenses.

Vendor Contact Sheet

As an Ochsner Health Plan member, you get additional benefits. Please call the vendors
directly for information or call Members Services at 1-833-674-2112 (TTY:711).

Network Fitness Centers

To search for additional fitness centers in our network by city, zip code, full address and parish:
Here is a list of Ochsner Fitness Centers in our network:

Ochsner Fitness Center-Downtown
701 Poydras Street
Suite 1300
New Orleans, LA 70139-7727

Ochsner Fitness Center-Harahan
1200 S. Clearview Parkway
Suite 1200
Harahan LA 70123-2335

Ochsner Fitness Center-Heritage Plaza
111 Veterans Memorial Boulevard
Suite 475
Metairie LA, 70005-3064

Request for Enrollment

This is an individual enrollment request for to enroll in a medicare advantage plan (part C)

Notice Of Non-Discrimination

Notice Of Privacy Practices

Filing A Complaint

If you find the information we provided prior to enrollment misleading or unclear, you can file a complaint with Medicare. If your complaint is related to a sales agent, please provide the agent’s name if possible.

To file a complaint with Medicare, call 1-800-MEDICARE or visit Medicare's grievance/coverage determination page on Medicare.gov at this link: https://www.medicare.gov/MedicareComplaintForm/home.aspx

1-800-MEDICARE is available 24 hours a day, 7 days a week, except some federal holidays. TTY users can call 1-877-486-2048.

Provider Manual

The Provider Manual is a resource for participating providers of Ochsner Health Plan.

Emergency Disaster Policy


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