The information at the links below is intended for use by those that provide health care services to members.

Our Medical & Drug Policies and Coverage Determinations Guidelines  are tools we use to help us administer health benefits under your plan. Please consult your benefit plan document to find out what services are covered under your plan.

These policies and guidelines are not medical advice. You should always consult with your physician or other health care provider about your medical care and treatment.

For information on your medical care by condition, search by Area of the Body or Condition.

Our Reimbursement Policies  are one factor that determines how physicians and other health care providers are paid. More information about these policies and guidelines are available at the links above.

If you received a letter saying your coverage request was denied, and MCG guidelines were used to make the decision, you can view the MCG guidelines here.