2019 Member Materials

You can get this information for free in other languages. Call 1-888-522-1298 (TTY: 711). The call is free. You can also ask for this information in other formats, such as audio CD, Braille or large print.

List of Covered Drugs (Formulary)

Below are our Formulary documents in eleven languages.

- List of Covered Drugs – English (pdf)
 
- List of Covered Drugs – Spanish (pdf)
 
- List of Covered Drugs – Chinese (pdf)
 
- List of Covered Drugs – Korean (pdf)
 
- List of Covered Drugs – Armenian (pdf)
 
- List of Covered Drugs – Russian (pdf)
 
- List of Covered Drugs – Tagalog (pdf)
 
- List of Covered Drugs – Vietnamese (pdf)
 
- List of Covered Drugs – Farsi (pdf)
 
- List of Covered Drugs – Khmer/Cambodian (pdf)
 
- List of Covered Drugs – Arabic (pdf)
Member Handbook

Below are our Member Handbook documents in eleven languages.

 
- Member Handbook – English (pdf)
 
- Member Handbook – Spanish (pdf)
 
- Member Handbook – Chinese (pdf)
 
- Member Handbook – Korean (pdf)
 
- Member Handbook – Armenian (pdf)
 
- Member Handbook – Russian (pdf)
 
- Member Handbook – Tagalog (pdf)
 
- Member Handbook – Vietnamese (pdf)
 
- Member Handbook – Farsi (pdf)
 
- Member Handbook – Khmer/Cambodian (pdf)
 
- Member Handbook – Arabic (pdf)
Provider/Pharmacy Directory

Below are our Provider/Pharmacy Directory documents in eleven languages.

Provider, Facility and Pharmacy Directory Vol. 1

The Provider, Facility and Pharmacy Directory Vol. 1 has the location and contact information you need to select an in-network Primary Care Provider, Vision Provider, Dental Provider, Mental Health Provider, Hospital, Pharmacy and more.

- Provider, Facility and Pharmacy Directory Vol. 1 – English (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Spanish (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Chinese (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Korean (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Armenian (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Russian (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Tagalog (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Vietnamese (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Farsi (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Khmer/Cambodian (pdf)
 
- Provider, Facility and Pharmacy Directory Vol. 1 – Arabic (pdf)

Specialist Directory Vol. 2

The Specialist Directory Vol. 2 has the location and contact information you need to select an in-network specialty care provider such as: Allergists, Cardiologists, Podiatrists, Proctologists, and more.

- Specialist Directory Vol. 2 – English (pdf)
 
- Specialist Directory Vol. 2 – Spanish (pdf)
 
- Specialist Directory Vol. 2 – Chinese (pdf)
 
- Specialist Directory Vol. 2 – Korean (pdf)
 
- Specialist Directory Vol. 2 – Armenian (pdf)
 
- Specialist Directory Vol. 2 – Russian (pdf)
 
- Specialist Directory Vol. 2 – Tagalog (pdf)
 
- Specialist Directory Vol. 2 – Vietnamese (pdf)
 
- Specialist Directory Vol. 2 – Farsi (pdf)
 
- Specialist Directory Vol. 2 – Khmer/Cambodian (pdf)
 
- Specialist Directory Vol. 2 – Arabic (pdf)
Dental Benefits Guide

Below are our Dental Benefits Guide documents in eleven languages.

- Dental Benefits Guide – English (pdf)
 
- Dental Benefits Guide – Spanish (pdf)
 
- Dental Benefits Guide – Chinese (pdf)
 
- Dental Benefits Guide – Korean (pdf)
 
- Dental Benefits Guide – Armenian (pdf)
 
- Dental Benefits Guide – Russian (pdf)
 
- Dental Benefits Guide – Tagalog (pdf)
 
- Dental Benefits Guide – Vietnamese (pdf)
 
- Dental Benefits Guide – Farsi (pdf)
 
- Dental Benefits Guide – Khmer/Cambodian (pdf)
 
- Dental Benefits Guide – Arabic (pdf)

 

H8258_15129_2019CMC
CMS Pending
Updated 10/03/2018

 

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