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  • Coverage Documents

Coverage documents
Coverage documents explain what your plan contract includes and/or does not include, how to access care, what services require preauthorization, and more.

Go to Health plan coverage and cost information, and click on Coverage documents.

  • Briefly discusses symptoms and possible causes of abdominal pain, such as peptic ulcer disease, indigestion, appendicitis, and stomach flu. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses the common causes of nausea and vomiting, including stomach illnesses, infections, health conditions, and medicines. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common skin changes and possible causes including infection, health conditions, and medicines. Includes info on skin cancer. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common causes of finger, hand, or wrist injuries from sports, hobbies, or work-related issues, including sudden injuries and those caused by overuse. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common causes of arm injuries from sports, hobbies, and work-related issues, including sudden injuries and those caused by overuse. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses eye problems, including watery eyes, drainage, eyelid problems and problems related to health conditions. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses causes of eye injuries, including sports, work activities, recreational activities, and foreign objects. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses causes of facial problems, including skin conditions and infections, and health conditions with facial symptoms. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common nail changes and possible causes for nail problems, including infection, injury, health conditions, and medicines. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses groin problems and injuries. Looks at acute injuries, hernias, and rashes and at groin problems in children. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses conditions, such as gout, pinched nerve, bursitis, tennis elbow, and golfer's elbow, that may cause elbow problems. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses causes of coughs, including common cold, bronchitis, pneumonia, asthma, GERD, COPD, choking, and chemicals in the air. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common scalp problems and possible causes, including hair loss, infections, sores, and damage from hair products. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses the hip joint and various causes of hip problems in children, including problems from birth (congenital), conditions causing inflammation, and infections. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses the hip joint and various causes of hip injuries, including overuse injuries, fractures, and dislocations. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses the hip joint and various causes of hip problems, including pain with movement or weight bearing, conditions causing inflammation, and infections. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses common problems from body piercings, including infection, problems with jewelry, torn skin, and scarring. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Guides through decision to stop driving because of age. Discusses how aging affects the ability to drive and when it is time to stop driving. Offers other transportation options. Includes an interactive tool to help you make your decision.
  • Briefly discusses toothache, its symptoms, and possible causes. Also describes gum disease, including gingivitis and periodontal disease. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Briefly discusses the hip joint and various causes of hip injuries in children, including muscle strains, fractures, and dislocations. Offers interactive tool to help decide when to seek care. Also offers home treatment tips.
  • Guides you through decision to use active surveillance for men who have low-risk and for some men who have medium-risk localized prostate cancer. Lists reasons for and against active surveillance. Includes interactive tool to help you make your decision.
  • Topic guides reader through decision to get a pacemaker for heart rate problems. Provides general overview of what pacemakers are and what heart problems can be helped with pacemakers. Lists benefits and possible complications of getting a pacemaker.
  • Guides you through the decision to have an angiogram. Explains why the test is done and what it can show. Discusses why you might or might not want to have the test. Lists risks and benefits. Includes interactive tool to help you decide.
  • Topic guides reader through decision to get an ICD for heart rhythm problems. Provides general overview of what ICDs are and what heart rhythm problems can be helped with ICDs. Lists benefits and possible complications of getting an ICD.
  • Guides you through the decision to have angioplasty when you have stable angina. Lists benefits and risks of angioplasty and medical therapy. Explains why lifestyle changes are still important. Includes interactive tool to help you with your decision.
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