Member Handbook, Provider Directory, Preferred Drug List and Forms

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.  

Manuals

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)

Forms

• Notification of Pregnancy (NOP) Form (PDF)
• PCP Change Form (PDF) 
• Traditional Healing Benefit Form (PDF)
• Grievance/Appeal Form (PDF) 
• Authorized Representative Designation Form (PDF)