Members
Getting care
Knowing how to understand, use and manage your health benefits is important. When you know how to use your health coverage, you’ll get the best treatment at the best cost, all while making the most of the benefits available to you.
Finding care and costs
Choose from quality doctors and hospitals that are part of your plan with our find care tool. We’ll help you find who you need, and give you estimates for treatment based on provider’s claims history, health plan benefits and your claims history..
Find care and costsGetting care from the right place
There are many places to find care, but which place gives you the best care for your situation? Learn how to save on healthcare costs by understanding where to go for care.
Choose a PCPSeeing a doctor from home
Virtual care allows you to see a doctor or other healthcare provider from the comfort of your own home. Your plan includes Virtual Health, which you can use for nonemergency situations.
More about Virtual HealthWorking with a case manager
Case and chronic condition management services are available to you. When a case manager calls, it’s part of an effort to get you helpful information to better manage your health. Learn more about case and chronic condition management.
Achieving better mental health
Behavioral health is a critical part of your overall health and wellbeing. Your health plan includes Lucet, a behavioral health service that can help you achieve better mental health and clarity. Call 877-801-1159 or the number on the back of your member ID card for 24/7 support.
Behavioral Health resourcesHaving a baby
Special Delivery, our maternity health program, is available to expecting mothers. Learn more about the how to register for Special Delivery, and how the program can help you.
More about Special DeliveryDiabetes Care
Diabetes Care gives you tools, free supplies and a personal health coach to help you improve your health and your A1c. Watch the video to learn about the program and how to register.
Diabetes support tools
Health Programs
A set of health programs for you to manage your specific needs, included in addition to your health plan benefits.
View health programs
InterQual® 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.
View guidelines