Evidence of Coverage
The Evidence of Coverage document gives you the details of your Medicare health benefits.
This document explains your benefits and rights—including medical and prescription drug coverage, services, and extra benefits as a member of a Martin's Point Generations Advantage plan. It applies to the following plan years: January 1–December 31, 2025 and January 1–December 31, 2026.
Use this document to learn about the following:
- Your plan premium and cost sharing;
- Your medical and prescription drug benefits;
- How to file a complaint if you are not satisfied with a service or treatment;
- How to contact us if you need assistance; and,
- Other protections required by Medicare law.
2025 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2025 - Prime [PDF]
Plan ID: H5591-015-001 | Maine Counties: Lincoln, Oxford, Piscataquis, Somerset, Waldo | New Hampshire Counties: Belknap, Carroll, Coos, Grafton
Evidence of Coverage 2025 - Prime [PDF]
Plan ID: H5591-015-002 | Maine Counties: Aroostook, Franklin, Hancock, Knox, Penobscot, Washington
Evidence of Coverage 2025 - Prime [PDF]
Plan ID: H5591-006-001 | Maine Counties: Cumberland, York
Evidence of Coverage 2025 - Prime [PDF]
Plan ID: H5591-006-002 | Maine Counties: Androscoggin, Kennebec, Sagadahoc
2026 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2026 - Prime [PDF]
Plan ID: H5591-006-001 | Maine Counties: Cumberland and York
Evidence of Coverage 2026 - Prime [PDF]
Plan ID: H5591-006-002 | Maine Counties: Androscoggin, Kennebec, Sagadahoc
Evidence of Coverage 2026 - Prime [PDF]
Plan ID: H5591-016 | Maine Counties: Lincoln, Oxford, Piscataquis, Somerset, Waldo
Evidence of Coverage 2026 - Prime [PDF]
Plan ID: H5591-017 | Maine Counties: Aroostook, Franklin, Hancock, Knox, Penobscot, Washington
2025 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2025 – Select (LPPO) [PDF]
Plan ID: H1365-001 | Maine Counties: Androscoggin, Aroostook, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, Washington, York | New Hampshire Counties: Cheshire, Coos, Hillsborough, Merrimack, Rockingham, Strafford, Sullivan
2026 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2026 – Select (LPPO) [PDF]
Plan ID: H1365-001 | Maine Counties: Androscoggin, Cumberland, Kennebec, Sagadahoc, York
Evidence of Coverage 2026 – Select (LPPO) [PDF]
Plan ID: H1365-005 | Maine Counties: Aroostook, Franklin, Hancock, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Somerset, Waldo, Washington
2025 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2025 – Value Plus (HMO-POS) [PDF]
Plan ID: H5591-009 | Maine Counties: All
2026 Evidence of Coverage (EOC) by Plan ID / County
The Value Plus (HMO-POS) plan has been terminated for 2026 and no Evidence of Coverage is available.
2025 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2025 – Access (LPPO) [PDF]
Plan ID: H1365-004-002 | New Hampshire Counties: Belknap, Carroll, Coos, Grafton
Evidence of Coverage 2025 – Access (LPPO) [PDF]
Plan ID: H1365-004-003 | New Hampshire Counties: Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, Sullivan
2026 Evidence of Coverage (EOC) by Plan ID / County
The Access (LPPO) plan has been terminated for 2026 and no Evidence of Coverage is available.
2025 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2025 – Alliance (HMO) [PDF]
Plan ID: H5591-003 | Maine Counties: All | New Hampshire Counties: All
2026 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2026 – Alliance (HMO) [PDF]
Plan ID: H5591-003 | Maine Counties: All
2026 Evidence of Coverage (EOC) by Plan ID / County
Evidence of Coverage 2026 – Essential (HMO-POS) [PDF]
Plan ID: H5591-018 | Maine Counties: All