Everything you need to know about Neighborhood INTEGRITY (Medicare-Medicaid Plan) is just a click away.
2019 Plan Documents
Annual Notice of Changes
Click below to download the full list of benefit changes for 2019.
- 2019 Annual Notice of Changes [PDF, English]
- 2019 Annual Notice of Changes [PDF, Portuguese]
- 2019 Annual Notice of Changes [PDF, Spanish]
Provider/Pharmacy Directory
Click below to find a provider, specialist, hospital or pharmacy near you.
- Provider/Pharmacy Directory [PDF, English]
- Last Updated 3/5/19
- Provider/Pharmacy Directory [PDF, Portuguese] – Coming soon
- Provider/Pharmacy Directory [PDF, Spanish] – Coming soon
To see a list of our pharmacies, you can search our Pharmacy Locator
Member Handbook (Evidence of Coverage)
Click below to get detailed information about your coverage with Neighborhood INTEGRITY.
- Member Handbook [PDF, English]
- Member Handbook [PDF, Portuguese]
- Member Handbook [PDF, Spanish]
List of Covered Drugs (Formulary)
Click below to download the full list of covered drugs under this plan.
- Formulary Foreword [PDF, English], Formulary [English]
- Last Updated 4/1/19
- Formulary Foreword [PDF, Portuguese], Formulary [Portuguese]
- Last Updated 4/1/19
- Formulary Foreword [PDF, Spanish], Formulary [Spanish]
- Last Updated 4/1/19
Click below for a list of Durable Medical Equipment Supplies limited at pharmacies.
- Durable Medical Equipment List [PDF, English]
- Durable Medical Equipment List [PDF, Portuguese]
- Durable Medical Equipment List [PDF, Spanish]
Summary of Benefits
Click below for a summary of benefits available under the Neighborhood INTEGRITY plan.
- Summary of Benefits [PDF, English]
- Summary of Benefits [ PDF, Portuguese]
- Summary of Benefits [PDF, Spanish]
Multi-Language Insert
Click below for interpreter services available to you.
- Multi-Language Insert [PDF]
Sample ID Card
Click below to see a sample Neighborhood INTEGRITY member ID card
- ID Card Sample [PDF]
2019 Member Forms
Appointment of Representative (AOR) Form
This form is used to appoint an individual to act as your representative. You can name another person to ask for a coverage decision or make an appeal. If you want a friend, relative, lawyer or another person to be your representative, this form will give the person permission to act for you. You must give us a copy of the signed form.
Request for Drug Determination Form
Use this form to request a decision on a request for a Part D drug with Neighborhood INTEGRITY.
Enrollee Grievance Request Form
Use this form if you would like to notify Neighborhood of a complaint or grievance.
Enrollee Appeal Request Form
Use this form to file an appeal of an adverse decision.
Request for Redetermination of Part D Denial Form – Coming Soon
Use this form if a Part D drug has been denied and you believe it should be covered.
Member Reimbursement Form for Part D Drugs
Member Reimbursement Form for Part D Drugs – Spanish
Member Reimbursement Form for Part D Drugs – Portuguese
Use this form to request reimbursement if you paid the full cost of a prescription from one of our Network pharmacies.
Have questions?
Please call us at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.
Neighborhood Health Plan of Rhode Island is a health plan that contracts with both Medicare and Rhode Island Medicaid to provide the benefits of both programs to enrollees.
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call Member Services at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.
ATENCIÓN: Si usted habla Español, servicios de asistencia con el idioma, de forma gratuita, están disponibles para usted. Llame a Servicios a los Miembros al 1-844-812-6896 (TTY 711), de 8 am a 8 pm, de lunes a viernes, de 8 am a 12 pm los Sábados. En las tardes de los Sábados, domingos y feriados, se le pedirá que deje un mensaje. Su llamada será devuelta dentro del siguiente día hábil. La llamada es gratuita.
ATENÇÃO: Se você fala Português, o idioma, os serviços de assistência gratuita, estão disponíveis para você. Os serviços de chamada em 1-844-812-6896 TTY (711), 8 am a 8 pm, de segunda a sexta-feira; 8 am a 12 pm no sábado. Nas tardes de sábado, domingos e feriados, você pode ser convidado a deixar uma mensagem. A sua chamada será devolvido no próximo dia útil. A ligação é gratuita.
Our plan can also give you materials in Spanish and Portuguese and in formats such as large print, braille, or audio. Call Neighborhood INTEGRITY Member Services to make a standing request to receive your materials now and in the future, in your requested language or alternate format. Call Neighborhood INTEGRITY Member Services to make a standing request to receive your materials now and in the future, in your requested language or alternate format.
Last Updated January 25, 2019, 3:54 pm
H9576_WebMaterials CMS Approved 12/18/18