We want to make sure you know that we do all we can to make sure your health care and services are available to you. The Health Plan recommends contacting your doctor's office first if you suspect you might be sick. We also encourage our members to use the telephone to get the health care you need. The Health Plan is working with Medicaid and your doctors to make sure this is available to you.
You can stay well and stop the spread of the disease by following these simple steps:
- Wash your hands often with soap and water for at least 20 seconds
- Use hand sanitizers when you cannot wash your hands
- Avoid touching your eyes, nose or mouth with your hands
- Stay home when you're sick
- Cover your coughs and sneezes with a tissue and throw it away
- Clean frequently touched surfaces
For more information about symptoms, what to do if you are sick, and how to protect yourself, visit our COVID-19 information page.
The Health Plan's practice guidelines and criteria for medical necessity are based on well-supported clinical evidence. These guidelines or criteria are reviewed and updated on a regular basis or when new scientific evidence is published. They are available to our members or potential members upon request. Based on these guidelines, The Health Plan makes decisions including:
- Utilization Management
- Enrollee Education
- Coverage Services
- Other Areas
In addition to the links to this information on our website, you can call our Customer Service Department at 1.888.613.8385 (TTY: 711) to request a printed copy or ask any questions or concerns. Our customer service representatives can also assist you with any of the following topics related to your coverage:
- Specialty care and other benefits, not provided by the PCP
- Mental health and non-emergency transportation are covered benefits available through Medicaid
- Benefits covered by The Health Plan
- How and where to access emergency care and post-stabilization services
- Providing benefit information in an alternative language or format due to special needs such as vision, read impairments, or language translation difficulties. Translation services are available at no cost for members.