Members
Getting care
Find care
Search for a doctor you've seen or find a new one in your network using the Find Care tool.
Find careChoosing a PCP
At the time of enrollment, you must select a primary care provider (PCP). Your Member ID card will list the PCP you select. Each covered member of your family also must select a PCP.
Choose a PCPVirtual Health
For nonemergencies, state-licensed, board-certified physicians (including pediatricians) are available online – around the clock and around the world. When you can’t get to the doctor, expert healthcare is available from anywhere – 24/7/365.
More about Virtual HealthStay in network
A common (and costly) mistake people make is visiting doctors or other healthcare providers who are not in their insurance company's network.
How to stay in networkPrior authorization
Sometimes prior authorization is needed to protect your health. Other times it may be needed to protect you from expensive tests or treatments when there are other, less expensive options available. Find out which services might require prior authorization.
Learn about prior authorizationBlue Distinction Centers
Find out which hospitals demonstrate superior capabilities in specialty care procedures, such as bariatric surgery, cardiac care, hip replacement and more.
View Blue Distinction CentersTotal Care
Total Care recognizes doctors that focus on health care instead of sick care. Total Care is coordinated, patient-focused and, in many cases, more affordable healthcare.
Learn more about Total CareValue-based care programs
Value-based care initiatives reward physicians for positive health outcomes and coordinating care. Find out more about programs like Patient-Centered Medical Homes (PCMH) or the Comprehensive Primary Care initiative (CPC, CPC+) and other programs using the value-based care model.
View value-based careInterQual® Coverage Policy Guidelines
The InterQual® guidelines are used by our utilization management team to help assess whether a given medical condition and known or represented circumstances of a case support medical service(s) as the most appropriate treatment, or whether the medical condition/circumstances presented could be appropriately addressed with an alternative treatment. Use the self-registration tool at the link to create a login and view the criteria. Individuals without an email address should contact the plan to receive the criteria information via mail.
Please consult your provider for applicable policies and/or criteria.