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Benefits Documents for Slidell Memorial Hospital

These summaries of your benefit plan include coverage information and your deductible, copayment and coinsurance amounts.

Consumer Choice
2022 Summary of Benefits and Coverage (SBC)

Consumer Choice OOA
2022 Summary of Benefits and Coverage (SBC)

High Plan
2022 Summary of Benefits and Coverage (SBC)

High Plan OOA
2022 Summary of Benefits and Coverage (SBC)

Standard Plan
2022 Summary of Benefits and Coverage (SBC)

Standard Plan OOA
2022 Summary of Benefits and Coverage (SBC)


Other Customer Forms

Our forms are updated regularly. Please use the most current form to avoid delays in processing. Read each form carefully for special instructions and/or submission information.

Authorized Delegate Form

Other Coverage Questionnaire

Health Insurance Claim Form

Continuity of Care Request

BlueCard International Claim

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