Member Resources
Access Member Tools and Resources
Medical Care
- Find a Provider. Search for in-network providers, specialists, facilities.
- Find a Dentist. Visit our partner website for Saint Alphonsus Health Plan Dental to find in-network dentists.
- Find a Routine Vision and Eyewear Provider. Visit our partner website for Saint Alphonsus Health Plan Vision to find in-network vision providers.
- Find a SilverSneakers Location. Visit the SilverSneakers website to find a location near you or access online classes.
Pharmacy
- Find a Pharmacy. Search for in-network pharmacies.
- Formulary (Drug List). See a list of all plan-covered drugs.
- Formulary (Drug List) Search Tool. View plan-covered drugs and estimate your drug costs.
- Prior Authorization Criteria. See a list of drugs that require prior authorization.
Additional Resources
- Member Portal. Go to our secure portal to view your claims and eligibility information, healthy living tips, news and more.
- Member Forms. Find copies of commonly used forms.
- MCG Portal. View the criteria used by the plan to support a medical determination.
- Please refer to the CMS website for the most current applicable National Coverage Determination (NCD)/ Local Coverage Determination (LCD)/Local Coverage Article (LCA)/CMS Online Manual System/Transmittals.
Learn More About Your Benefits
- 24-7 Nurse Advice Line
- Acupuncture
- Cash Back
- Dental Benefits
- Fitness Benefit
- Flexible Benefit Card
- Healthy Living Programs
- Hearing Benefits
- Meals after Hospital Stay
- Member Rewards
- Over-the-Counter (OTC) Benefits
- Prescription Drug Benefits
- Transportation
- Travel Benefit
Review Plan Policies
- Fraud, Waste and Abuse
- Member Rights and Responsibilities
- Long Term Acute Care Hospital (LTACH) Reviews