Welcome! We are happy to have you as a member. We know that health insurance can be confusing, so the following are tools that should help you get the care you need from us.
- Looking for a provider in our network? Search our provider directory.
- Need to choose a Primary Care Provider (PCP)? If you don’t already have one who is in our network, we urge you to choose a PCP as soon as possible. To select or change your PCP call Member Services toll free at 1-866-261-1286 | TTY:711 or contact your Care Coordinator at [email protected].
- Want to find out if the medications you take are covered by your plan? Learn more about your pharmacy benefit and view our Formularies (list of covered medications) on our Pharmacy page.
How to join Empower:
Am I eligible?
Empower Healthcare Solutions is a Provider-Led Arkansas Shared Savings Entity (PASSE) serving Medicaid beneficiaries in Arkansas with developmental disabilities or complex behavioral health needs.
You will be given an assessment by the Arkansas Department of Human Services to identify your unique care needs. Based on your assessment, you will be assigned to a PASSE to get the care and services you need.
How to enroll with Empower
Once you’re assigned to a PASSE, you may voluntarily choose a new PASSE within the first 90 days of enrollment. If you choose to stay with the PASSE you’re assigned to, the next time you can change your PASSE is:
- During open enrollment or
- If there is cause to make a change. Cause for changing your PASSE includes:
- You move out of state
- Your PASSE is sanctioned
- Your PASSE does not cover the services you request due to moral or religious reasons
- Poor quality of care
- You cannot access covered services or providers experienced with your care needs
Have questions about your eligibility or want to request a change?
Call the Arkansas Department of Human Services (DHS), Beneficiary Support Center at
1-501-682-1001 (TTY 1-501-682-8933).
Our Utilization Management Procedures
Utilization management (UM), sometimes called utilization review, is the evaluation of the medical necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities under your health plan.
- Empower covers medically necessary Medicaid Services.
- Most routine services, such as a visit with a PCP or specialist, do not need a prior authorization (PA). You may need a PA for certain procedures or surgeries, exceptions to the formulary (drug list), and requests for services outside of our provider network.
- When you do need a PA, your provider makes the request for you. You do not need to contact Empower about this.
- If you are admitted to a hospital, the facility must tell Empower Healthcare Solutions.
- We offer Care Coordination services to all Empower members. This ensures that you receive appropriate and timely care.
Find complete utilization management information in your Member Handbook.