Medi-Cal Member Handbook - LA Care Health Plan
Medi-Cal Member Handbook - LA Care Health Plan
Medi-Cal Member Handbook - LA Care Health Plan
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Drugs/medications<br />
Prescription drugs and over-the-counter drugs on<br />
the Anthem Blue Cross formulary are covered.<br />
You can learn more about this in the “Pharmacy<br />
benefits: How do I get prescription drugs?”<br />
section of this handbook.<br />
Durable medical equipment (DME)<br />
DME is medical equipment used repeatedly (over<br />
and over again) by a person who is ill or injured.<br />
These items are ordered by your doctor.<br />
Examples include:<br />
Apnea monitors<br />
<strong>Medi</strong>-<strong>Cal</strong> <strong>Member</strong> <strong>Handbook</strong> / Benefit Year 2010-2011<br />
Blood glucose monitors, including<br />
monitors for the visually impaired, for<br />
insulin dependent, non-insulin dependent,<br />
and gestational diabetes<br />
Insulin pumps and all related supplies<br />
Nebulizer machines<br />
Orthotics (shoe inserts)<br />
Ostomy bags<br />
Oxygen and oxygen equipment<br />
Prosthesis<br />
Pulmo-Aides and related supplies<br />
Spacer devices for metered-dose inhalers<br />
Tubing and related supplies<br />
Urinary catheters and related supplies<br />
Emergency services<br />
Emergency services are covered 24 hours a day,<br />
seven (7) days a week, anywhere. Emergency<br />
care is a service that a member reasonably<br />
believes is necessary to stop or relieve:<br />
Sudden serious illnesses or symptoms<br />
Injury or conditions requiring immediate<br />
diagnosis and treatment<br />
Emergency services and care include ambulance,<br />
medical screening, examination, and evaluation<br />
by a doctor or appropriate personnel. Emergency<br />
services include both physical and psychiatric<br />
emergency conditions, and active labor. You can<br />
learn more about these in the “Emergency care:<br />
How do I get care in an emergency?” section of<br />
this handbook.<br />
Family planning<br />
Family planning services are provided to<br />
members of child-bearing age to help them<br />
choose the number and spacing of children. These<br />
services include all methods of birth control<br />
approved by the Food and Drug Administration<br />
(FDA). You may receive family planning services<br />
and FDA-approved contraceptives from any<br />
health care provider licensed to provide these<br />
services.<br />
Examples of family planning providers include:<br />
Your PCP doctor<br />
Clinics<br />
Certified Nurse Midwives and Certified<br />
Nurse Practitioners<br />
OB/GYN specialists (doctors who specialize<br />
in female reproductive health care)<br />
<strong>Plan</strong>ned Parenthood clinics<br />
Family planning services also include counseling<br />
and surgical procedures for the termination of<br />
pregnancy (called an abortion). Please call<br />
Anthem Blue Cross to find out more.<br />
Many of our doctors who provide family planning<br />
services are also OB/GYN specialists. Women<br />
may pick a PCP doctor from a list of family<br />
planning clinics located near them. <strong>Cal</strong>l Anthem<br />
Blue Cross for a copy of this list.<br />
Women have the right to family planning services<br />
given by a family planning provider who is not in<br />
16<br />
Anthem Blue Cross Customer <strong>Care</strong> Center toll-free 1-888-285-7801<br />
L.A. <strong>Care</strong> <strong>Health</strong> <strong>Plan</strong> <strong>Member</strong> Services Department toll-free 1-888-839-9909
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