Member Handbook, Provider Directory, Preferred Drug List and Forms
Here are links to the manuals and forms available to you.
- Member Handbook (PDF)
- Provider Directory (PDF)
- Preferred Drug List (PDF)
- Care Coordination Contact List (PDF)
- Notification of Pregnancy (NOP) Form (PDF)
- PCP Change Form Coming Soon
- Traditional Healing Benefit Form (PDF)
- Grievance/Appeal Form (PDF)
- Authorized Representative Designation Form (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 1-844-543-8996 (TTY: 711).
Once you have completed your request, the paper format item(s) will be mailed within 5 business days from the date of the request.