Resources, tools, and tips
How to use your plan wisely
Understanding preapproval (preauthorization)
Preapproval (also called preauthorization) confirms that a service you’re having will be covered for benefits.
In most cases, members don’t need to do anything – your doctor will take care of getting preapproval. Once in a while, you may need to work with the doctor to arrange for preapproval; for example, if you’re getting care from a non-contracted doctor in another state.
Alternatives to the ER
Emergency rooms save lives – that's what they're for. But if you're dealing with a less threatening issue, getting care doesn't have to take so long or cost so much. You have choices, even when you need care right away.
Switching to Medicare coverage
The GIC will contact you about Medicare coverage when you’re retiring at age 65 or older.
Have you moved?
If you have moved, you must provide the GIC with your new home address.
Hope for the best, but prepare anyway
We all hope to never face a health crisis that leaves us too ill to make our own care decisions. But sometimes, a crisis can happen anyway. Advance care planning lets you take the common sense step of communicating your wishes now in case you aren’t able to make your own care decisions later.
Health assessment with personalized recommendations
Take the Wellpoint health assessment to find out how healthy you are and get customized suggestions to improve your health.
Hospital safety and comparison tools
For Total Choice, PLUS, and Community Choice members
Leapfrog is a nonprofit organization committed to helping consumers make informed healthcare decisions.
Find out about – and compare – hospital safety records
For Medicare Extension members
Medicare collects information about the quality of care for thousands of providers, hospitals, and other medical facilities.
Member and Provider Urgent Appeals
This notification is to encourage and remind members and providers that the preferred method for Urgent Appeals is by phone or fax as this is the fastest method for your urgent appeal to be handled.
What if my situation is urgent?
You’ll need to ask for an expedited appeal. Your situation is urgent if:
Your life, health or ability to regain maximum function is in jeopardy (danger), or
In your doctor’s opinion, your pain can’t be controlled while you wait for a standard appeal review to be finished.
An expedited appeal must be filed before services are provided or while services are ongoing. This means you can’t ask for an expedited appeal after services have already been provided.
How do I file an expedited appeal?
You can mail your request, but it’s best if you call Member Services at the phone number on your ID card. Or, fax your request to 866-273-3692 so we can handle it fast.
How long does an expedited appeal review take?
We’ll do a review and give you a decision within 72 hours of receiving the request. We’ll let you know the decision by phone. We’ll also send it to you in writing.