What You Need to Know About Our ACA Plans
This page serves as a quick links landing page designed to help you navigate our site and find helpful information about how our plans work and our claims policies.
We've selected nine topics we feel are important. Under each topic, we've included a brief description of what the topic is about and links to pages where you'll actually find the information.
Medical necessity and prior authorization timeframes and enrollee responsibilities
Check out these pages for an explanation of what prior authorization is and why you need it for some of your medical or dental services, or prescription drugs. Also, it explains what could happen if a member doesn't get prior authorization and the time frame for a decision.
Drug exceptions timeframes and enrollee responsibilities
Check out these pages for an explanation of the internal and external exceptions process for members to request drugs their plan doesn't cover. Also, you'll find information about the timeframes for these decisions, how to complete the application and how the review process works.
- How to request a review for your coverage of a prescription drug
- PPO Coverage Request Form
- HMO Prior Authorization Callback Form
- External review for approval of a drug