I'm in an Employer Group

New Members

After signing up please watch your mail for a letter containing a My-Chart Activation code. You will need this activation code to create an account.

If you have not received this letter please call customer service at  844-262-1560.

Viewing your claims

Claims information and benefit usage are available to view online through My-Chart.

Looking for your card?

Looking for a way to access your ID card?  You can get your ID card on your phone or other mobile device through our partner, the University of Utah Health Plans, who will be processing our claims in 2020.

Just search for the University of Utah Health Plans in your app store.  The login is your ID number.  The pin is the last four digits of your ID number.

Introducing

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Employer

You choose! Online, Phone, Or Mail

Available in all 50 states and Washington DC

Medical forms, school and work release notes available

All visit notes can be shared with your Primary Care Provider (PCP)

All information is stored on encrypted servers inside encrypted databases; this system is HIPAA compliant

Send it by mail

Please make checks payable to MHC, and mail to the address below:

LB 410035

Mountain Health Cooperative

PO Box 35145

Seattle WA 98124-5145

Express Mail payments:

Lockbox Services-#410035

18035 Sperry Dr

Tukwila, WA 98188-4750

Find a Provider

Montana Health CO-OP offers two provider networks—Connected Care and Access Care—that correspond with our insurance plans of the same names. Check to see if your preferred providers are “in-network” based on which type of plan you are considering or have purchased already. In-network doctors and hospitals will save you more money.

Connected Care

Network Provider Finder for all types of providers

Includes doctors and hospitals

across the state

Employer Group Network

Providers Outside of Montana, Idaho, and Utah

Includes doctors and hospitals across the state

Report Changes to Your Group Leader

Life moves quickly—make sure your insurance is keeping up. Examples of life event changes include marriage, divorce, birth, adoption, a change in salary or a change of address.

If you enrolled directly through MHC

Email Portal

You can log into your online account to process changes: https://marketplace.mhc.coop/ehpportal/eapp/login

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Download the change form and email, mail or fax in.

Use the email portal to securely return the change form.  If you haven’t used the Email Portal before, you will need to register your email address in order to send encrypted emails to Montana Health CO-OP. Click on the “Email Portal” button to begin.

Pharmacy

If you need assistance with your pharmacy benefits please contact Pharmacy Customer Service at 855-885-7695. They are available 24 hours, seven days a week, 365 days a year.

Pharmacy Network

Prescription Drug List

Use the buttons below to access the 2019, and 2020 online searchable drug lists for individual and small group coverage.  

You can also download a PDF of this list. You can search on your computer by clicking  CTRL-F.

Prescription Mail Order Services 

Did you know you could have your medications delivered to your home and save money? Instead of driving to the pharmacy and standing in line, consider having your prescriptions delivered right to your door. 

If Interested here are your next steps:

Step 1:  Go to https://www.novixus.com/

Step 2: Set up a profile using the Rx information off your member benefits card

Step 3: Once your web profile is set up, call Novixus at 1-877-668-4987. Novixus will gather your doctor’s information and contact your doctor for you. Novixus will then set up your prescription on 90-day mail order.

It’s just that easy.

Need to obtain prior authorization or request a drug coverage exception?

Specialty Pharmacy Program

What is a specialty drug?

Specialty medications are generally prescribed to treat complex and/or chronic conditions, such as multiple sclerosis, hepatitis C and rheumatoid arthritis.

 

These medications may be taken by mouth, injection or infusion and have special handling or storage requirements and may not be stocked by retail pharmacies.

Specialty medications that require professional services for administration are usually covered under your medical benefit plan.

Coverage for self-administered specialty medications is provided through your pharmacy benefit plan. 

How to access

Your plan may require you to get self-administered specialty drugs through MHC's preferred specialty pharmacy or another in-network specialty pharmacy.

 

Specialty medications are designated as Tier 4 medications in MHC'S list of covered drugs (formulary). Certain Tier 4 specialty medications require prior authorization, and your provider may submit a coverage request by using our existing medication prior authorization form or by calling UUHP Pharmacy Customer Service at 866-236-5936.

Drug List Abbreviations and Terms 

For each drug on our lists, find additional information and requirements including: 

Tier: The numbers refer to drug copay tiers. Tier 0 drug copays are waived under the Affordable Care Act. Tier 1 drugs have the lowest copay and are typically generics. For Tier 2 drugs you will have a mid-range copay. For Tier 3 drugs you will have a high copay. Tier 4 drugs are specialty drugs.

PA, Preauthorization: Pre-authorization helps encourage safe, cost-effective use of prescription drugs by requiring a "prior authorization" request from your physician before the drug will be covered. If PA appears in the Requirements column, the drug requires pre-authorization from your physician before the drug will be covered. 

QL, Quantity Limits: QL stands for quantity limits. If QL appears in the requirements column, the drug may be covered by your plan, but only up to a certain quantity or limit. If you need quantities higher than the limit shown, have your provider fax a preauthorization request to us.

SP, Specialty Drug: SP stands for specialty or biotech drug. In most cases, specialty drugs are required to be filled at a designated specialty pharmacy. Check your member handbook or Summary of Benefits to find the specialty drug copay amount or deductible amount. 

ST, Step Therapy: SP stands for Step Therapy, a program that requires you to try a lower-cost alternative medication ("Step 1 Drugs") before using the more expensive ("Step 2") medication. If it is medically necessary for you to use a Step 2 medication as initial therapy, your provider can submit an exception request to us. 

 
 
At the Pharmacy
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is your new Pharmacy Benefit Manager. The CO-OP worked with industry experts to design this program, helping you balance cost, convenience, and
quality for your prescriptions starting June 1st, 2020.

Your RealRx pharmacy benefits will begin on June 1, 2020. You will
receive a new benefits ID card and pharmacy information before the
transition date. If you have any questions along the way, please contact
Pharmacy Customer Service at 855-885-7695.

Introducing

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Vision Exam Reimbursement

Did you know that your eyes can be a key indicator of your overall health? 
 
This is why MHC has added an adult vision exam reimbursement to
 your 2020 medical plan and we have worked to keep it as simple as possible. 

 

Here’s how it works….

 

  • You pick your provider

    • Helpful hint: Please check with your provider regarding the cost of the exam ahead of time to make the most of the $60 reimbursement

  • Go to your appointment and pay direct – make sure you get a copy of your receipt

    • Helpful hint: The receipt should include one of the following standard vision exam codes: 92002, 92004, 92012, 92014, 92015, Z13.5, Z00.00, Z00.01

 

  • Submit your receipt along with the claim form, located at www.mhc.coop, to MHC. For your convenience, we provide three ways for you to submit:

 

  • Mail to University of Utah Health Plans, PO Box 45180, Salt Lake City, UT 84145-0180;

  • Fax to 801-281-6121 Attn: Member Reimbursement; or

  • Email to memberservice@mhc.coop

 

  • MHC will reimburse you up to $60 for the eye exam – reimbursement will be mailed to you within 15 business days of receipt

 

Vision Coverage

Vision coverage is included without additional charge for all enrolled children under 18.

Adult vision coverage is available as a stand-alone plan administered by VSP.  VSP is a national leader in vision and eye-care benefits offering vision insurance with plans designed to save you money on doctor visits and eyewear.

 

Doctor on Demand

At a Glance:

US Based and Board Certified Doctors, Psychologists and Psychiatrists

Low copay of $20 per visit

Offered for all MHC plans

No appointment needed for Medical visits, but appointments may be scheduled for your convenience

Appointments are required for Psychology or Psychiatry visits and can be done on the mobile app or website

Available in all 50 states and Washington DC

Medical forms, school and work release notes available

All visit notes can be shared with your Primary Care Provider (PCP)

All information is stored on encrypted servers inside encrypted databases; this system is HIPAA compliant

To Get Started:

To access Doctor On Demand, download the app (iTunes or Google Play) or visit www.doctorondemand.com

Open the app and follow on screen instructions to register

Once registered, select “See a Medical Doctor Now” (you will need to enable the app to access your location)

Follow on-screen instructions to enter your symptoms, allergies and medications in to the app

If you do not have a mobile device and would like to use your laptop or PC, then you can do so by using our web app. To
register, please visit us at: https://patient.doctorondemand.com/. All you'll need is a webcam and the Google Chrome
browser.

If you don't have the Google Chrome browser installed, you can download & install it from this link:
https://www.google.com/intl/en-US/chrome/browser/.

If you have any additional questions, feel free to call Doctors on Demand directly at 1-800-997-6196. The Member
Support team would be happy to assist you!

FAQ's:

For Frequently Asked Questions, click here to learn more.

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Mountain Health CO-OP does not discriminate based on race, color, national origin, disability, age, sex, gender, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

 

Contact Us with Questions About Coverage