Request For Appeal Of Medicare Prescription Drug Denial Page 4

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Amerigroup STAR+PLUS MMP (Medicare-Medicaid Plan) is a health plan that contracts with
both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.
You can get this information for free in other languages. Call 1-855-878-1784
(TTY: 711) Monday through Friday from 8 a.m. to 8 p.m. local time. The call is free.
Usted puede obtener esta información gratuitamente en otros idiomas. Llame al
1-855-878-1784 (TTY: 711) de lunes a viernes de 8 a.m. a 8 p.m. hora local. La llamada es
gratuita.

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