Plan Details

Each plan's Member Services can help you: find a doctor, learn about benefits, access services, file a complaint about a provider or appeal a denied service. All plans have a 24 hour Nurse Hotline to help you figure out if you need to go to the emergency room or learn about health issues. All health plans allow unlimited visits to in-network doctors, as needed.

All of the health plans have special programs to help members with chronic illness such as asthma, congestive heart failure, diabetes, hepatitis C, HIV, obesity and sickle cell anemia. If they do not have a program in place that fits your needs, they will work with you to create one. They also have programs for pregnant women with a high risk of problems during pregnancy and delivery.

Dental exams and cleanings twice a year, fillings, extractions, periodontal therapy, and x-rays $750 total benefit per year*

Eye exam (No co-pay)
Glasses covered in full* (once a year)

All health plans will set up a ride for members who don’t have a way to get to medical appointments. Stop at the pharmacy after your appointment to get medications.

All of the health plans offer rewards for healthy behaviors. Unless otherwise noted, rewards are available once a year per member in the form of a reward debit card or gift card.

$30 for all well visits from 2 to 15 months
$10 for yearly well visits ages 2 and up

$10 for yearly well visits ages 2 and up

$10 for STI screening (chlamydia, gonorrhea and HIV test)

$20 for all: dilated eye exam, and blood tests for LDL, A1C and kidney disease screenings for members diagnosed with diabetes

$5 for a flu shot

Certified pain management coaches help address chronic pain for members in care management.

Start Smart for Your Baby

Up to $110 for prenatal visits ($10 each)

$50 for a postpartum visit

$30 for completing a Notice of Pregnancy form
Free pack-and play crib with safe sleep kit
NICU Care Kit for members in need*

Start Smart for Your Baby Kit with helpful info and items for new moms. Free access to Start Smart mobile app

All health plans offer sponsorships and/or mini-grants for community organizations and members in need.*

There are no copays for children, pregnant women, family planning supplies, members in the hospital, members of a home and community based waiver, women who have Medicaid due to breast or cervical cancer, members getting hospice services, Native American or Alaska Native members. For others, if the medicine is: 
$10 or less = $0.50 copay
$10.01 - $25 = $1 copay
$25.01 - $50 = $2 copay
Over $50 = $3 copay

Available with a prescription and co-pay.

Raising Well program guides you in helping your child be healthy by eating right and being active.

Members age 21+ receive one hearing exam and one set of hearing aids every two years.

*Please contact the health plan for eligibility requirements and details for this benefit.