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Medicaid Member Handbook

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Medicaid Member Handbook medicaid member handbook P.O. Box 30192 Salt Lake City, UT 84130-0192 800-538-5038 selecthealth.org Dear Member: Thank you for choosing SelectHealth. You will receive or may have already received a Medicaid ID Card from the state. Please carry this card with you. You will be asked to show it each time you get care or fill a prescription. We encourage you to choose a primary care provider (PCP). Seeing a PCP can help you stay healthy and lower your healthcare costs. Please call Member Services to tell us who you prefer. If you need help finding a doctor, call SelectHealth Member Advocates. They can help you find the closest doctors and schedule appointments for you. To contact Member Advocates, call 800-515- 2220 weekdays, from 7:00 a.m. to 8:00 p.m., and Saturdays, from 9:00 a.m. to 2:00 p.m. You can also find doctors by visiting selecthealth.org/findaprovider. If you do not have a PCP on file, we will pick one in your area for you. If you have questions, call Member Services at 855-442-3234 weekdays, from 7:00 a.m. to 8:00 p.m., and Saturdays, from 9:00 a.m. to 2:00 p.m. TTY users should call 711. Sincerely, Russ Elbel Medicaid Program Director SelectHealth Fair Treatment Notice � SelectHealth complies with Federal civil rights laws. ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने We do not discriminate or treat you differently because of your race, color, national origin, age, तपार्इंको निम्ति भाषा सहायतासेवाहरू निःशुल्क रूपमा disability, or sex. उपलब्ध छ । SelectHealth: 1-800-538-5038 मा फोन We provide free: गर्नुहोस्। > � Aid to those with disabilities to help them FAKATOKANGA’I: Kapau ‘oku ke lea fakatonga, communicate with us, such as sign language ko e kau fakatonu lea te nau tokoni atu ta’etotongi, interpreters and written information in pea te ke lava ‘o ma’u ia. Telefoni ki he SelectHealth: other formats (large print, audio, electronic formats, other). 1-800-538-5038. > � Language help for those whose first language ОБАВЕШТЕЊЕ: Ако говорите српски језик, is not English, such as Interpreters and member materials written in other languages. услуге језичке помоћи доступне су вам бесплатно. Позовите SelectHealth: 1-800-538-5038. For help, call SelectHealth Member Services at 1-800-538-5038 (TTY Users: 711) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari If you feel you’ve been treated unfairly, call kang gumamit ng mga serbisyo ng tulong sa wika SelectHealth 504/Civil Rights Coordinator at nang walang bayad. Tumawag sa SelectHealth: 1-844-208-9012 (TTY Users: 711) or the Compliance Hotline at 1-800-442-4845 (TTY Users: 711). You 1-800-538-5038. may also call the Office for Civil Rights at 1-800-368-1019 (TTY Users: 1-800-537-7697). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen Language Access Services zur Verfügung. Rufnummer: SelectHealth: 1-800-538-5038. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a ВНИМАНИЕ: Если вы говорите на русском языке, SelectHealth: 1-800-538-5038. то вам доступны бесплатные услуги переводчика. Позвоните SelectHealth: 1-800-538-5038 注意：如果您使用繁體中文，您可以免費獲得語 ةدعاسملا تامدخ نإف ،ةيبرعلا ثدحتت تنك اذإ :ةظوحلم :言援助服務。請致電 SelectHealth ةكرشب لصتا .ناجملاب كل رفاوتت ةيوغللا 。 .1-800-538-5038 SelectHealth: 1-800-538-5038. CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số សម្គាល់៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ SelectHealth: 1-800-538-5038. សេវាជំនួយផ្នែកភាសា ដោយមិនគិតថ្លៃ 주의 한국어를 사용하시는 경우 언어 지원 គឺអាចមានសំរាប់ អ្នក។ សូមទូរស័ព្ទមក : , SelectHealth: 1-800-538-5038 서비스를 무료로 이용하실 수 있습니다. ។ SelectHealth: 1-800-538-5038. ATTENTION : si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. 번으로 전화해 주십시오 . Contactez SelectHealth: 1-800-538-5038. Díí baa akó nínízin: Díí saad bee yáníłti’go Diné 注意事項：日本語を話される場合、無料の言語 Bizaad, saad bee áká’ánída’áwo’dęʹęʹ’, t’áá jiik’eh, éí 支援をご利用いただけます。SelectHealth: ná hólǫʹ, kojį’ hódíílnih SelectHealth: 1-800-538-5038. 1-800-538-5038. まで、お電話にてご連絡くださ い。 © 2017 SelectHealth. All rights reserved. 203540 03/17 PHONE NUMBERS AND CONTACT INFORMATION FOR SELECTHEALTH � Member Services Phone: 855-442-3234 � Hours: Weekdays, from 7:00 a.m. to 8:00 p.m., and � Saturdays, from 9:00 a.m. to 2:00 p.m. TTY/TDD � users, please call 711. � SelectHealth Member Advocates® Phone: 800-515-2220 � Hours: Weekdays from 7:00 a.m. to 8:00 p.m. and � Saturdays, from 9:00 a.m. to 2:00 p.m. � Behavioral Health AdvocatesSM Phone: 800-876-1989 � Hours: Weekdays from 8:00 a.m. to 6:00 p.m. � Care Management Phone: 800-442-5305, option 2 � Hours: Weekdays, from 8:00 am. to 5:00 p.m. � SelectHealth Healthy Beginnings® Phone: 866-442-5052, option 1 � Hours: Weekdays, from 8:00 a.m. to 5:00 p.m. � Restriction Program Phone: 800-442-5305, option 2 � Pharmacy Services Phone: 800-442-3129 � Hours: Weekdays, from 7:00 a.m. to 8:00 p.m., and � Saturdays from 9:00 a.m. to 3:00 p.m. � Appeals Phone: 844-208-9012 � Hours: Weekdays, from 8:00 a.m. to 5:00 pm � Intermountain Health Answers® Phone: 844-501-6600 (24/7 Nurse Advice Line) SelectHealth Website selecthealth.org OTHER IMPORTANT PHONE NUMBERS � Utah Poison Control: Phone: 800-222-1222 Hours: 24 hours a day; 7 days a week UNI CrisisLine: Phone: 801-587-3000 Hours: 24 hours a day; 7 days a week SELECTHEALTH MEDICAID MEMBER HANDBOOK SELECTHEALTH 2018 Medicaid Member Handbook PHONE NUMBERS AND CONTACT INFORMATION FOR STATE MEDICAID � Medicaid Health Program Rep. (HPR) Phone: 866-608-9422 � Medicaid Information Line Phone: 800-662-9651 � Hours: Weekdays, from 8:00 a.m. to 5:00 p.m. � Medicaid Hotline Phone: 800-662-9651 � Hours: Weekdays, from 8:00 a.m. to 5:00 p.m. � Pregnancy Risk Line Phone: 800-822-2229 � All phone calls are free and confidential � Hours: Weekdays, from 8:00 a.m. to 5:00 p.m. � Medicaid Website medicaid.utah.gov Glossary of Abbreviations CHEC Children’s Health Evaluation and Care CHIP Children’s Health Insurance Program DAAS Division of Aging and Adult Services DWS Department of Workforce Services EOB Explanation of Benefits HPR Medicaid Health Program Representative MBS Medicaid Benefit Summary PCP Primary Care Provider/Doctor PHI Protected Health Information PMHP Prepaid Mental Health Plan OTC Over-the-Counter For your reference, write down the name and phone number for your doctor and your child/children’s doctor. Primary Care Doctor (PCP): Name Phone Child’s Doctor: Name Phone SELECTHEALTH MEDICAID MEMBER HANDBOOK SELECTHEALTH 2018 Medicaid Member Handbook Medicaid member handbook � Table of Contents � PHONE NUMBERS AND CONTACT INFORMATION FOR SELECTHEALTH ......................I � PHONE NUMBERS AND CONTACT INFORMATION FOR STATE MEDICAID .................. II � TABLE OF CONTENTS ........................................................................................................ V � WELCOME ............................................................................................................................ 1 � Your Name, Address, and Phone Number .......................................................................................1 � LANGUAGE SERVICES ........................................................................................................ 1 � How Can I Get Help in other Languages? .......................................................................................1 � RIGHTS AND RESPONSIBILITIES ....................................................................................... 1 � What are My Rights? ............................................................................................................................1 � What are My Responsibilities? .........................................................................................................2 � Ending Your Membership ....................................................................................................................2 � Cancellation .............................................................................................................................................3 � Medical Policies ......................................................................................................................................3 � CONTACTING MY MEDICAID PLAN ...................................................................................3 � Who Can I Call When I Need Help? ..................................................................................................3 � MEDICAID BENEFITS ..........................................................................................................3 � How Do I Use My Medicaid Benefits? ..............................................................................................3 � What Does My Utah Medicaid Card Look Like? ...........................................................................3 � Can I View My Medicaid Benefits Online? ..................................................................................... 4 � FINDING A PROVIDER ....................................................................................................... 4 � What is a Primary Care Provider? ................................................................................................... 4 � How Do I Choose a Primary Care Provider? ................................................................................. 4 � How Can I Change My Primary Care Provider? ........................................................................... 4 � SELECTHEALTH MEMBER ADVOCATES ............................................................................5
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