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Medicare-Medicaid Plan) Member Handbook for 2019 H8452 OHMMC-1250 a Caresource Mycare Ohio (Medicare-Medicaid Plan

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Medicare-Medicaid Plan) Member Handbook for 2019 H8452 OHMMC-1250 a Caresource Mycare Ohio (Medicare-Medicaid Plan CareSource® MyCare Ohio (Medicare-Medicaid Plan) Member Handbook for 2019 H8452_OHMMC-1250 a CareSource MyCare Ohio (Medicare-Medicaid Plan) CareSource MyCare Ohio Member Handbook January 1, 2019 – December 31, 2019 Your Health and Drug Coverage under CareSource® MyCare Ohio (Medicare-Medicaid Plan) Member Handbook Introduction This handbook tells you about your coverage under CareSource MyCare Ohio through December 31, 2019. It explains health care services, behavioral health coverage, prescription drug coverage, and home and community based waiver services (also called long-term services and supports). Long-term services and supports help you stay at home instead of going to a nursing home or hospital. Key terms and their definitions appear in alphabetical order in the last chapter of the Member Handbook. This is an important legal document. Please keep it in a safe place. This plan, CareSource MyCare Ohio, is offered by CareSource. When this Member Handbook says “we,” “us,” or “our,” it means CareSource. When it says “the plan” or “our plan,” it means CareSource MyCare Ohio. ATTENTION: If you speak Spanish, language services, free of charge, are available to you. Call Member Services at 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. The call is free. ATENCIÓN: Si habla espanol, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-475-3163 (TTY: 1-800-750-0750 o 711), el lunes a viernes, 8 a.m. a 8 p.m. La llamada es gratis. You can get this document for free in other formats, such as large print, braille, or audio. Call our Member Services Department at 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. The call is free. To request this document in a language other than English or in an alternate format now and in the future, please call Member Services at 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. The call is free. If you have any problems reading or understanding this handbook or any other CareSource MyCare Ohio information, please contact Member Services. We can explain the information or provide the information in your primary language. We may have the information printed in certain other languages or in other ways. If you are visually or hearing impaired, special help can be provided. If you have questions, please call CareSource MyCare Ohio at 1-855-475-3163 (TTY: 1-800­ 750-0750 or 711), Monday – Friday 8 a.m. – 8 p.m. If you need to speak to your Care Manager, ? please call 1-866-206-7861, 24 hours a day, 7 days a week. These calls are free. For more information, visit CareSource.com/MyCare. 1 CareSource MyCare Ohio MEMBER HANDBOOK Chapter 1: Getting started as a member Table of Contents Chapter 1: Getting started as a member ............................................................................................ 3 Chapter 2: Important phone numbers and resources ....................................................................... 15 Chapter 3: Using the plan’s coverage for your health care and other covered services .................... 26 Chapter 4: Benefits Chart ................................................................................................................. 46 Chapter 5: Getting your outpatient prescription drugs through the plan ............................................ 93 Chapter 6: What you pay for your Medicare and Medicaid prescription drugs ................................ 111 Chapter 7: Asking us to pay a bill you have gotten for covered services or drugs .......................... 117 Chapter 8: Your rights and responsibilities ..................................................................................... 122 Chapter 9: What to do if you have a problem or complaint (coverage decisions, appeals, complaints) .................................................................................................................................... 147 Chapter 10: Changing or ending your membership in our MyCare Ohio Plan ................................ 213 Chapter 11: Definitions of important words ..................................................................................... 220 Disclaimers CareSource® MyCare Ohio (Medicare-Medicaid) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. Coverage under CareSource MyCare Ohio qualifies as minimum essential coverage (MEC). It satisfies the Patient Protection and Affordable Care Act’s (ACA) individual shared responsibility requirement. Please visit the Internal Revenue Service (IRS) website at www.irs.gov/Affordable-Care-Act/Individuals-and-Families for more information on the individual shared responsibility requirement for MEC. You may have to pay for some services and you need to follow certain rules to have CareSource MyCare Ohio pay for your services. If you have questions, please call CareSource MyCare Ohio at 1-855-475-3163 (TTY: 1-800­ 750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. If you need to speak to your Care Manager, ? please call 1-866-206-7861, 24 hours a day, 7 days a week. These calls are free. For more information, visit CareSource.com/MyCare. 2 CareSource MyCare Ohio MEMBER HANDBOOK Chapter 1: Getting started as a member Chapter 1: Getting started as a member Introduction This chapter includes information about CareSource MyCare Ohio, a health plan that covers all your Medicare and Medicaid services. It also tells you what to expect as a member and what other information you will get from CareSource MyCare Ohio. Key terms and their definitions appear in alphabetical order in the last chapter of the Member Handbook. Table of Contents A. Welcome to CareSource MyCare Ohio .......................................................................................... 5 B. Information about Medicare and Medicaid ..................................................................................... 5 B1. Medicare ................................................................................................................................. 5 B2. Medicaid ................................................................................................................................. 5 C. Advantages of this plan .................................................................................................................6 D. CareSource MyCare Ohio’s service area....................................................................................... 7 E. What makes you eligible to be a plan member? ............................................................................ 9 F. What to expect when you first join a health plan ............................................................................ 9 G. Your care plan ............................................................................................................................. 10 H. CareSource MyCare Ohio monthly plan premium ........................................................................ 10 I. The Member Handbook ............................................................................................................... 10 J. Other information you will get from us ......................................................................................... 11 J1. Your CareSource MyCare Ohio Member ID Card .................................................................. 11 J2. New Member Letter ............................................................................................................... 11 J3. Provider and Pharmacy Directory .......................................................................................... 12 J4. List of Covered Drugs ............................................................................................................ 13 J5. Member Handbook Supplement or “Waiver Handbook” ......................................................... 13 J6. The Explanation of Benefits ................................................................................................... 13 If you have questions, please call CareSource MyCare Ohio at 1-855-475-3163 (TTY: 1-800­ 750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. If you need to speak to your Care Manager, ? please call 1-866-206-7861, 24 hours a day, 7 days a week. These calls are free. For more information, visit CareSource.com/MyCare. 3 CareSource MyCare Ohio MEMBER HANDBOOK Chapter 1: Getting started as a member K. How to keep your membership record up to date ........................................................................ 13 K1. Privacy of your personal health information (PHI).................................................................. 14 If you have questions, please call CareSource MyCare Ohio at 1-855-475-3163 (TTY: 1-800­ 750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. If you need to speak to your Care Manager, ? please call 1-866-206-7861, 24 hours a day, 7 days a week. These calls are free. For more information, visit CareSource.com/MyCare. 4 CareSource MyCare Ohio MEMBER HANDBOOK Chapter 1: Getting started as a member A. Welcome to CareSource MyCare Ohio CareSource MyCare Ohio, offered by CareSource, is a Medicare-Medicaid Plan. A Medicare- Medicaid Plan is an organization made up of doctors, hospitals, pharmacies, providers of long-term services and supports, and other providers. It also has Care Managers and care teams to help you manage all your providers and services. They all work together to provide the care you need. CareSource
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