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Guide to using your policy

Read our Quick Start Guide to learn the basics of using your insurance policy.

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Coverage policy

Find out which procedures are covered by your policy using this search tool.

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The BlueCard® program

Make sure your healthcare needs are met when traveling or living outside of Arkansas.

View BlueCard

Case management services

These services can help qualifying members navigate the healthcare system, lower costs and maximize their benefits.

Visit case management

Coverage policy and pre-certification/pre-authorization

Find out which procedures are covered by your policy or if your procedure requires prior authorization.

View coverage details

Value-based care programs

Value-based care initiatives reward physicians for positive health outcomes and coordinating care. Find out more about programs like Patient-Centered Medical Homes (PCMH) or the Comprehensive Primary Care initiative (CPC, CPC+) and other programs using the value-based care model.

View value-based care

Your EOB

For some claims, you will receive an EOB once they are processed.

View sample EOB

InterQual® Coverage Policy Guidelines

The InterQual® guidelines are used by our utilization management team to help assess whether a given medical condition and known or represented circumstances of a case support medical service(s) as the most appropriate treatment, or whether the medical condition/circumstances presented could be appropriately addressed with an alternative treatment. Use the self-registration tool at the link to create a login and view the criteria. Individuals without an email address should contact the plan to receive the criteria information via mail.

View Guidelines