Rules For Getting Care

A Few Things to Keep in Mind When Using Your Health Coverage

There are a few guidelines you must follow to get your health coverage. These were created to make sure that every member gets the right amount of care to address their health needs.

  • You must use doctors that we have relationships with - Typically, you must get care from doctors and hospitals that are in our network, which means that we have an agreement with these providers to offer you care. See a list of available doctors and hospitals.

  • You may need approval before getting certain care - Some services such as procedures, medications, or visits to doctors outside our network require approval from us before you can get them. This is sometimes called “prior authorization”. Covered services that need advanced approval are marked in your 2021 Summary of Benefits document in bold. You can also view some of the policies* we use when making these decisions, or you can call us with any questions.

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