Availity Portal

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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

View requirements for Local Plan and BlueCard Out-of-Area members.

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Open Access POS Plans

PW_E180128

Rx Option BG Plans – Benefit Summaries (effective 1/1/2018)

OAP5 500/100 BG 
OAP5 500/90 BG 
OAP5 500/80 BG 
OAP5 1K/90 BG 
OAP5 1K/80 BG 
OAP5 1.5K/90 BG 
OAP5 1.5K/80 BG 
OAP5 2.5K/100 BG 
OAP5 2.5K/80 BG 
OAP5 3.5K/100 BG 
OAP5 3.5K/80 BG 
OAP5 3.5K/70 BG 
OAP5 5K/100 BG 
OAP5 5K/80 BG 
OAP5 5K/70 BG 
OAP9 2.5K/80 BG 
 
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