Medicare Documents and Forms | Members

2026 Benefits and Coverage

2026 Sentara Community Complete (HMO D-SNP) - Annual Notice of Changes
PDF, 280 KBLast Updated: 10/31/2025
PDF, 280 KBLast Updated: 10/31/2025
2026 Sentara Community Complete Select (HMO D-SNP - Annual Notice of Changes
PDF, 286 KBLast Updated: 10/01/2025
PDF, 286 KBLast Updated: 10/01/2025
2026 Sentara Community Complete Select (HMO D-SNP) - Summary of Benefits
PDF, 2 MBLast Updated: 10/01/2025
PDF, 2 MBLast Updated: 10/01/2025
2026 Sentara Community Complete (HMO D-SNP) - Summary of Benefits
PDF, 888 KBLast Updated: 10/01/2025
PDF, 888 KBLast Updated: 10/01/2025
2026 Sentara Community Complete (HMO D-SNP) - Evidence of Coverage
PDF, 2 MBLast Updated: 10/15/2025
PDF, 2 MBLast Updated: 10/15/2025
2026 Sentara Community Complete Select (HMO D-SNP) - Evidence of Coverage
PDF, 2 MBLast Updated: 10/15/2025
PDF, 2 MBLast Updated: 10/15/2025
2026 Sentara Community Complete Select (HMO D-SNP) - Summary of Benefits Spanish
PDF, 2 MBLast Updated: 11/06/2025
PDF, 2 MBLast Updated: 11/06/2025
2026 Sentara Community Complete (HMO D-SNP) - Summary of Benefits Spanish
PDF, 1 MBLast Updated: 11/06/2025
PDF, 1 MBLast Updated: 11/06/2025

2025 Benefits and Coverage

2025 Sentara Community Complete (HMO D-SNP) - Annual Notice of Changes
PDF, 447 KBLast Updated: 10/04/2024
PDF, 447 KBLast Updated: 10/04/2024
2025 Sentara Community Complete (HMO D-SNP) - Evidence of Coverage
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Community Complete (HMO-DSNP) - Summary of Benefits
PDF, 2 MBLast Updated: 02/21/2025
PDF, 2 MBLast Updated: 02/21/2025
2025 Sentara Community Complete Select (HMO D-SNP) - Annual Notice of Changes
PDF, 427 KBLast Updated: 10/03/2024
PDF, 427 KBLast Updated: 10/03/2024
2025 Sentara Community Complete Select (HMO D-SNP) - Evidence of Coverage
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Community Complete Select (HMO-DSNP) - Summary of Benefits
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Annual Notice of Changes
PDF, 444 KBLast Updated: 12/12/2024
PDF, 444 KBLast Updated: 12/12/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Evidence of Coverage - Central/Halifax
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Evidence of Coverage - Hampton Roads
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Evidence of Coverage - Northern Virginia
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Evidence of Coverage - Northern Virginia - Spanish
PDF, 1 MBLast Updated: 11/29/2024
PDF, 1 MBLast Updated: 11/29/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Evidence of Coverage - Roanoke/Alleghany
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Summary of Benefits - Central/Halifax
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Summary of Benefits - Hampton Roads
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Summary of Benefits - Northern VA
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) - Summary of Benefits - Roanoke/Alleghany
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Engage - Lung (HMO C-SNP) - Evidence of Coverage
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Engage - Lung (HMO C-SNP) - Summary of Benefits - Hampton Roads
PDF, 2 MBLast Updated: 10/15/2024
PDF, 2 MBLast Updated: 10/15/2024
2025 Sentara Medicare Prime (HMO) - Annual Notice of Change - Southside
PDF, 404 KBLast Updated: 10/14/2024
PDF, 404 KBLast Updated: 10/14/2024
2025 Sentara Medicare Prime (HMO) - Evidence of Coverage - Peninsula
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Prime (HMO) - Evidence of Coverage - Southside
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Salute (HMO) - Summary of Benefits
PDF, 2 MBLast Updated: 10/03/2024
PDF, 2 MBLast Updated: 10/03/2024
2025 Sentara Medicare Salute (HMO) - Annual Notice of Changes
PDF, 330 KBLast Updated: 10/03/2024
PDF, 330 KBLast Updated: 10/03/2024
2025 Sentara Medicare Salute (HMO) - Evidence of Coverage
PDF, 964 KBLast Updated: 10/15/2024
PDF, 964 KBLast Updated: 10/15/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Change - Southside
PDF, 395 KBLast Updated: 10/14/2024
PDF, 395 KBLast Updated: 10/14/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Central/Halifax
PDF, 406 KBLast Updated: 10/03/2024
PDF, 406 KBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Northern VA
PDF, 405 KBLast Updated: 10/03/2024
PDF, 405 KBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Northern VA Spanish
PDF, 378 KBLast Updated: 10/29/2024
PDF, 378 KBLast Updated: 10/29/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Peninsula
PDF, 397 KBLast Updated: 10/14/2024
PDF, 397 KBLast Updated: 10/14/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Roanoke/Alleghany
PDF, 413 KBLast Updated: 10/03/2024
PDF, 413 KBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Annual Notice of Changes - Southwest Crosswalk
PDF, 403 KBLast Updated: 10/03/2024
PDF, 403 KBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Central/Halifax
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - North Carolina
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Northern Virginia
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Northern Virginia - Spanish
PDF, 1 MBLast Updated: 11/29/2024
PDF, 1 MBLast Updated: 11/29/2024
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Peninsula
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Roanoke/Alleghany/Southwest
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Evidence of Coverage - Southside
PDF, 1 MBLast Updated: 06/03/2025
PDF, 1 MBLast Updated: 06/03/2025
2025 Sentara Medicare Value (HMO) - Summary of Benefits - Central/Halifax
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Value (HMO) - Summary of Benefits - North Carolina
PDF, 2 MBLast Updated: 10/03/2024
PDF, 2 MBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Summary of Benefits - Northern Virginia
PDF, 2 MBLast Updated: 10/03/2024
PDF, 2 MBLast Updated: 10/03/2024
2025 Sentara Medicare Value (HMO) - Summary of Benefits - Roanoke/Alleghany/Southwest
PDF, 2 MBLast Updated: 10/14/2024
PDF, 2 MBLast Updated: 10/14/2024
2025 Sentara Medicare Value/Prime (HMO) - Summary of Benefits - Peninsula
PDF, 2 MBLast Updated: 10/03/2024
PDF, 2 MBLast Updated: 10/03/2024
2025 Sentara Medicare Value/Prime (HMO) - Summary of Benefits - Southside
PDF, 2 MBLast Updated: 10/03/2024
PDF, 2 MBLast Updated: 10/03/2024
Non-renewal letter for Salute members
PDF, 157 KBLast Updated: 10/22/2025
PDF, 157 KBLast Updated: 10/22/2025
Non-renewal letter for Value, Prime, and C-SNP members
PDF, 157 KBLast Updated: 10/22/2025
PDF, 157 KBLast Updated: 10/22/2025

2025 Prescription Drugs and Formularies

2025 Over-the-Counter (OTC) Product Catalog
PDF, 681 KBLast Updated: 01/16/2025
PDF, 681 KBLast Updated: 01/16/2025
2025 Sentara Community Complete Select (HMO D-SNP) Prescription Drug Formulary
PDF, 7 MBLast Updated: 11/24/2025
PDF, 7 MBLast Updated: 11/24/2025

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Please note that revision dates are on the front page of each directory.

Other Documents

2025 Sentara Medicare Star Ratings-DSNP
PDF, 114 KBLast Updated: 12/05/2024
PDF, 114 KBLast Updated: 12/05/2024
2025 Sentara Medicare Star Ratings-DSNP Spanish
PDF, 130 KBLast Updated: 10/30/2024
PDF, 130 KBLast Updated: 10/30/2024
2025 Sentara Medicare Star Ratings-NC
PDF, 114 KBLast Updated: 10/30/2024
PDF, 114 KBLast Updated: 10/30/2024
2025 Sentara Medicare Star Ratings-VA
PDF, 102 KBLast Updated: 12/05/2024
PDF, 102 KBLast Updated: 12/05/2024
2025 Sentara Medicare Star Ratings-VA Spanish
PDF, 105 KBLast Updated: 10/30/2024
PDF, 105 KBLast Updated: 10/30/2024
2026 Sentara Medicare Star Ratings-DSNP
PDF, 114 KBLast Updated: 10/27/2025
PDF, 114 KBLast Updated: 10/27/2025
2026 Sentara Medicare Star Ratings-DSNP Spanish
PDF, 151 KBLast Updated: 10/27/2025
PDF, 151 KBLast Updated: 10/27/2025
2026 Sentara Medicare Star Ratings-Partial DSNP
PDF, 103 KBLast Updated: 10/27/2025
PDF, 103 KBLast Updated: 10/27/2025
2026 Sentara Medicare Star Ratings-Partial DSNP Spanish
PDF, 139 KBLast Updated: 10/28/2025
PDF, 139 KBLast Updated: 10/28/2025