AllMemberMembersProviders

Members Handbook – Machine Readable

This is the machine-readable version of the 2026 Member Handbook.

Medical, Behavioral and SUD Prior Authorization Form

Medication Management Referral Form

Pharmacy Prior Authorization Criteria

Pharmacy Prior Authorization Criteria outlines requirements and clinical criteria for medications requiring prior authorization, supporting consistent review and approval decisions for covered pharmacy services.

Professionally Administered Drug (PAD) Prior Authorization Form

Pharmacy Prior Authorization Grid

NOABD FAQs (Spanish)

Encuentre respuestas a preguntas frecuentes sobre determinaciones adversas de beneficios.

NOABD FAQs

Find answers to frequently asked questions about adverse benefit determinations.

UHA Complaint Form (Spanish)

Utilice este formulario para enviar una queja por escrito a Umpqua Health.

UHA Complaint Form

Use this form to submit a written complaint to Umpqua Health.

HRSN Nutrition Service Request Form

Use this form to request nutrition assistance services.

HRSN Housing Service Request Form

Use this form to request housing assistance services.