Individual Plan Descriptions - California Healthy Families - State of ...

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1-800-750-4776 Monday–Thursday: 8:00 a.m.–6:00 p.m. Friday: 9:30 a.m.–6:00 p.m. English, Spanish and Tagalog. Other languages available through interpreter services. Why Choose Health Plan of San Mateo (HPSM)? Choose HPSM and get the health care you need from the community doctors, clinics, and hospitals you know! HPSM has operated locally in San Mateo County since 1987. We work with most of the local doctors and hospitals in the area and chain and independent pharmacies. Our doctors speak several languages, understand your culture, and are close to your home or work. If you choose HPSM, the Community Provider Plan in San Mateo County, your monthly premium will be less than if you choose another Healthy Families Plan in the county. Healthy Families monthly premiums are based on income and family size. The range is $4 to $21 per child per month to a maximum of $63 per month for all children in a family. How the Plan Works Every HPSM Healthy Families member chooses a Primary Care Physician (PCP). Your child’s PCP takes care of most of your child’s health care needs. If there is an emergency, call your child’s PCP anytime, including nights and weekends. We can help you find the right PCP. You can change your child’s PCP as often as once a month. If needed, your child’s PCP will refer you to one of HPSM’s specialists. Members can get family planning and prenatal care without a referral. If your child needs medicine, the doctor will write a prescription. Once your child enrolls you will receive a packet with membership information including a Member ID card. You should carry this card with you to all your child’s doctor appointments and to pharmacies to get your child’s prescriptions. What if I have a Question about HPSM? If you have any questions or need assistance, please call HPSM’s Member Services Representatives at 1-800-750-4776 or 1-650-616-2133. How to Choose To become an HPSM Healthy Families member, write HPSM in the space provided on the form. At HPSM, we fight to make a different in our community-to turn our vision of better health for everyone, into a reality. 166 The Healthy Families Program Handbook - September 2012
Toll Free 1-866-294-IEHP (4347) 1-800-720-4347 for TTY users Call 8 a.m. to 6 p.m. Monday – Friday English & Spanish + 140 other languages IEHP offers you a discounted rate – Save up to $108 a year with IEHP! Riverside and San Bernardino counties Why choose Inland Empire Health Plan? IEHP has the highest Healthy Families enrollment in Riverside and San Bernardino Counties! And more families choose us for great features like these: • Choose IEHP, the Community Provider Plan in Riverside and San Bernardino counties, and you will pay less than if you choose another Healthy Families Plan in Riverside and San Bernardino counties. Pay a monthly premium of $4 to $21 per child per month (up to a maximum of $63 for all eligible children in the family). • 24-Hour Nurse Advice Line: Can’t reach your doctor at night? Call our nurse for help…seven days a week, including holidays. • Most Medical Services are Near You: Saves you time. IEHP has many doctors, specialists, hospitals and pharmacies (includes big chains like Walmart, Rite-Aid, CVS and Walgreens) for you to choose from. • Commendable Accreditation: IEHP earned a “Commendable” Accreditation status for the Healthy Families Program from the National Committee for Quality Assurance (NCQA). NCQA awards this status to IEHP for our well-established programs for service and clinical quality for our Members. How the Plan Works Getting Care for Your Child You choose a Primary Care Doctor who will handle most of your child’s care. When a specialist is needed, your child’s Doctor will work with the medical group to find the best specialist care options. Show the IEHP I.D. Card It’s your child’s pass to covered services – like a doctor’s visit or medicine. How to Choose On the Healthy Families application, write IEHP in the space provided. For plan code, write #1013. Need help filling out the form? Call IEHP at 1-866-94-IEHP (4347). If you need help, call HFP at 1-800-880-5305. The call is free. 167
Page 1: Individual Plan Descriptions 153
Page 4 and 5: 156 Exclusive Provider Organization
Page 6 and 7: 1-800-530-2899 Monday - Friday, 8 a
Page 8 and 9: 1-877-814-1861 Call toll free 8 a.m
Page 10 and 11: 162 1-800-224-7766 24 hours a day,
Page 12 and 13: Multilingual Customer Service Call
Page 16 and 17: Toll Free: 1-800-464-4000 Mon.-Fri.
Page 18 and 19: 1-888-4LA-CARE (1-888-452-2273) Cal
Page 20 and 21: 2008 172 PARTNERSHIP HEALTHPLAN OF
Page 22 and 23: Toll Free: 1-800-260-2055 / 1-800-7
Page 24 and 25: 1-888-849-8440 8 a.m. to 6 p.m., Mo
Page 26 and 27: DeltaCare USA 800-422-4234 7:00 a.m
Page 28 and 29: 1-888-584-5830 8 a.m. to 6 p.m., Mo
Page 30 and 31: Call toll-free: 1-800-805-8000 8:30
Page 32 and 33: Customer Service 1-800-880-3080 Cal
Page 34 and 35: Notes 186 The Healthy Families Prog
Page 42: Notes 194 The Healthy Families Prog

Individual Plan Descriptions - California Healthy Families - State of ...

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