Member Materials

Member Handbook

Your Member Handbook is your go-to guide to Healthy Blue benefits. Read it to find out about:

Your benefits and how to use them.
How to choose a primary care provider (PCP).
Where to go to for help after hours.
Who to call when you have questions.
Your rights and responsibilities as a Healthy Blue member.

Member Handbook — English

Member Handbook — Spanish

Member Handbook Change Control Log — English

Member Handbook Change Control Log — Spanish

Other Important Documents

Pharmacy: Comprehensive Drug List — English
Comprehensive Drug List — Spanish
Common Over-the-Counter Medicines — English
Common Over-the-Counter Medicines — Spanish
CarelonRx Reimbursement Form — English
CarelonRx Reimbursement Form — Spanish
Medical Appeals: Appeal Request Form — English
Appeal Request Form — Spanish
Appeal Representative Form — English
Appeal Representative Form — Spanish
Pharmacy Appeals: Appeal Request Form — English
Appeal Request Form — Spanish
Appeal Representative Form — English
Appeal Representative Form — Spanish
Medical Grievances: Grievance Request Form — English
Grievance Request Form — Spanish
Grievance Representative Form — English
Grievance Representative Form — Spanish
Pharmacy Grievances: Grievance Request Form — English
Grievance Request Form — Spanish
Grievance Representative Form — English
Grievance Representative Form — Spanish
Quality Improvement Program: Quality Improvement Program — English
Quality Improvement Program — Spanish
Personal Health Assessments (PHA): Personal Health Assessment for Adults — English
Personal Health Assessment for Children — English
Personal Health Assessment for Adults — Spanish
Personal Health Assessment for Children — Spanish
Preventive Health Guidelines: Preventive Health Guidelines — English
Preventive Health Guidelines — Spanish
Healthy Living Newsletters: Summer 2024 Newsletter
2023 Documents: 2023 Evidence of Coverage (EOC) - English
2023 Evidence of Coverage (EOC) - Spanish
2023 Member Appeals Request Form
2023 Member Appeals Representative Form - English
2023 Member Appeals Representative Form - Spanish
2023 Member Grievance Form
2023 Fraud Referral Form

Member Handbook

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Other Important Documents