ADDITIONAL RESOURCES

Member Rights & Responsibilities

Grievances & Appeals

Authorization Request Form

Getting Care During A Disaster

Appoint A Representative

Prescription Reimbursement Form

Medical Reimbursement Form

Medical Determination Form

Preservice Appeal Form

Dental Reimbursement Form

Vision Reimbursement Form

Over-the-Counter Catalog

Over-the-Counter Form

Personal Health Information (PHI) Release Form

Substance Use Disorder (PHI) Release Form