MEMBER HANDBOOK - BMC HealthNet Plan
MEMBER HANDBOOK - BMC HealthNet Plan
MEMBER HANDBOOK - BMC HealthNet Plan
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Over-the-counter medications ................................... 13<br />
Pediatric doctors .......................................................... 9<br />
Pharmacy ...................................................................... 2<br />
Post-stabilization .......................................................... 4<br />
Pregnancy ................................................................... 15<br />
Prenatal care ............................................................... 15<br />
Prescription medication coverage ............................ 13<br />
Preventive care ........................................................... 13<br />
Preventive Pediatric Healthcare ................................ 16<br />
Screening and Diagnosis (PPHSD)<br />
Primary Care Provider (PCP) ....................................... 1<br />
Prior-Authorization ...................................................... 22<br />
Privacy practices ........................................................ 27<br />
Privacy complaint ....................................................... 30<br />
Protected Health Information (PHI) ........................... 11<br />
Provider Directory ......................................................... 1<br />
Questions ...................................................................... 1<br />
Referrals ........................................................................ 4<br />
Responsibilities ........................................................... 21<br />
Rights ........................................................................... 20<br />
Services .............. (covered) see Covered Services list<br />
Services not covered ...........see Covered Services list<br />
Special healthcare needs ............................................ 1<br />
Specialty care ............................................................... 4<br />
Substance abuse services (including detoxification).. 10<br />
Transportation assistance .......................................... 12<br />
urgent Care .................................................................. 10<br />
Web site ....................................... See bottom of pages<br />
Well-child care ............................................................ 16<br />
39<br />
<strong>BMC</strong> <strong>HealthNet</strong> <strong>Plan</strong> Member Services Department<br />
8:00 a.m. – 6:00 p.m., (Eastern Time) Monday-Friday 1.888.566.0010 (English and other languages) • 1.888.566.0012<br />
(en Español) • 1.866.765.0055 (TTY/TDD for hearing impaired) • 1.800.421.1220 (relay operator for hearing impaired) •<br />
1.888.217.3501 (Behavioral Health: mental health and substance abuse questions 24 hours a day/7 days a week managed by<br />
Beacon Health Strategies) • 1.888.727.9441 (Behavioral Health TTY/TDD for hearing impaired) • 1.800.973.6273 (Nurse Advice<br />
Line) • Web Site www.bmchp.org • www.beaconhealthstrategies.org (Behavioral health)<br />
MassHealth Customer Service<br />
8:00 a.m. – 5:00 p.m., Monday-Friday<br />
1.800.841.2900 • 1.800.497.4648 (TTY/TDD for hearing impaired)
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