Member Handbook, Provider Directory, Preferred Drug List, Forms, and Policies

Here are links to the manuals, forms, and policies available to you.

Manuals

• Member Handbook - English (PDF)
• Member Handbook - Spanish (PDF)
• Provider Directory (PDF) - Updated April 2021
• Preferred Drug List

Member Forms

• Primary Care Provider (PCP) Change Form (PDF) - Coming Soon
• Designation of Authorized Representative Form (PDF)

Pregnancy Forms

• Notification of Pregnancy (NOP) Form (PDF)

Policies

• Utilization Management Policy (PDF) - Coming Soon
• Opioid Misuse Prevention Program Policy (PDF) - Coming Soon
  
• Opioid Misuse Prevention Lock-In Policy (PDF)
• In Lieu of Services (ILOS) Policy (PDF)

Any documents and items offered in electronic format can be requested in paper format. To request a document in paper format, please contact Member Services at 1-833-552-3876 (TTY: 711).

Once you have completed your request, the paper format item(s) will be mailed within 7 business days from the date of the request.