Provider Manual
The Provider Manual has everything you need to know about member benefits, coverage, and provider guidelines. Click the link below to view or save a copy.
- Resources / Materials
- Medicare-Medicaid Plan
- For Providers
- Health Library
-
Pharmacy
- List of Drugs (Formulary)
- Drug Transition Policy
- Prior Authorization, Step Therapy and Quantity Limits
- Coverage Determinations and Redeterminations for Drugs
- Medication Therapy Management
- Drug Quality Assurance
- Mail Order Service
- Specialty Pharmacy
- Out of Network Pharmacies
- Find a Doctor or Pharmacy
- Frequently Asked Questions
- COVID-19