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Exhibit 5-1 Case Management Referral Form

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Owner: tyler

Version: 1.9

Last Updated: 04-19-2023 17:37

BCBSAZ Health Choice Pathway (HMO D-SNP) is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in BCBSAZ Health Choice Pathway (HMO D-SNP) depends on contract renewal. BCBSAZ Health Choice Pathway is a subsidiary of Blue Cross® Blue Shield® of Arizona.

Member Services can be reached at 1-800-656-8991, TTY 711, 8 a.m. to 8 p.m., 7 days a week. Member Services also has free language interpreter services available for non-English speakers.

Every year, Medicare evaluates plans based on a 5-star rating system.

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H5587_D36739PY24_M Accepted 09/30/23

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