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Evidence of Coverage
A full description of your benefits for all Qualified Health Plans, including requirements for getting services covered.
Schedule of Benefits
A schedule of your benefits (SOB) and the costs of services based on your plan type. If you need a paper copy, please call us at 855-833-8120 (TTY: 711) to request one, free of charge.
Treatment Cost Estimator
You can now estimate costs for common procedures using our Treatment Cost Estimator. This tool shows you the costs covered by your health plan and the portion you would pay based on your plan benefits. This information will help you work with your doctor to make informed decisions about your treatment plan.
Log in to the Member Portal to see treatment costs.
You can also call us at 855-833-8120 (TTY: 711) for a cost estimate, or print the Cost Estimate Worksheet to fill out with your provider. Once the form is completed, you or your provider will need to send it to us for a cost estimate.
If you qualify as an American Indian/Native Alaskan you may be eligible to have your cost share (deductible, copay and coinsurance) waived if you:
- Have an income that is at or below federal standards for cost-share waivers; or
- Are using a qualified Indian health care Provider for your healthcare services – in which case cost share may be waived when obtaining services from that Provider.
Some procedures or services require prior authorization, or prior approval, from us. You or your doctor may confirm if the service requires a prior authorization by checking our Medical Procedure Code Lookup Tool or our Supplies and Services Code Lookup Tool.
We're always working to improve the quality of our services for members. If you're interested in learning more, you can read our Quality Improvement Work Plan Evaluation.