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Helpful Information

CMS Forms

Appointment of Representative Form CMS-1696
Request for a Medicare Prescription Drug Coverage Determination for Enrollees

Tribute Health Plan of Oklahoma HMO-SNP is a Health Plan with a Medicare Contract. Enrollment in
Tribute Health Plan of Oklahoma HMO-SNP depends on contract renewal.                          

H3708_TRIBWEBCY18_0418 Approved

Tribute Health Plans and associated names are proud offerings of Oklahoma Superior Select, Inc.

Copyright © 2016 Tribute Health Plans

This Page Was Updated: August 8, 2018
Site Updated: August 8, 2018

Tribute Health Plan of Oklahoma HMO-SNP
909 S. Meridian Ave, Suite 425  |  Oklahoma City, OK 73108
Toll-free: 1-866-583-4649 (TTY 711)  |  8am – 8pm | 7 days a week