Due to scheduled maintenance, our phone lines and secure portals will be unavailable Saturday, July 24th from 7am – 7pm. We apologize for any inconvenience and thank you for your patience.
View the Benefit and Cost-sharing Summary for your plan level. These summaries give you information about the costs you have to pay for covered services.
Please note: For certain services, your provider will need to ask us for a prior authorization before sending you to get those services. Your provider knows when and how to ask us for prior authorization if it is required.
Direct Bronze 2900 Direct Bronze 3550 with Coinsurance Direct Catastrophic Direct ConnectorCare I Direct ConnectorCare II Direct ConnectorCare III Direct Gold 1000 Direct Gold 2000 Direct Platinum Direct Silver 2000 Direct Silver 2000 HSA Direct Silver 2000 II Direct Silver 2500 with Coinsurance
For a list of covered benefits, see the covered services section of the Member Handbook 2021 | 2020 | 2019 (for members effective Jan. 1, 2019 - June 30, 2019) | 2019 (for members effective July 1, 2019, and after).
Additional Information
Consumer narrative justification document