Member Handbook - Los Angeles County Department of Health ...
Member Handbook - Los Angeles County Department of Health ...
Member Handbook - Los Angeles County Department of Health ...
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Medi-Cal <strong>Member</strong> <strong>Handbook</strong> / Benefit Year 2006-2007• Cervical cancer screening test.• Cancer clinical trials. If you have cancer, youmay be able to be part <strong>of</strong> a cancer clinicaltrial. A cancer clinical trial is a research studywith cancer patients to find out if a new cancertreatment or drug is safe and treats amember’s type <strong>of</strong> cancer. The cancer clinicaltrial must meet certain requirements, whenreferred by your Community <strong>Health</strong> Plan doctoror treating provider. The cancer clinicaltrial must have a meaningful potential to benefityou and must be approved by one <strong>of</strong> thefollowing: the National Institute <strong>of</strong> <strong>Health</strong>(NIH), FDA, U.S. <strong>Department</strong> <strong>of</strong> Defense orthe U.S. Veteran’s Administration. If you arepart <strong>of</strong> an approved cancer clinical trial,Community <strong>Health</strong> Plan will provide coveragefor all routine patient care cost related to thecancer clinical trial.If you have a life threatening or debilitatingcondition or were eligible but denied coveragefor a cancer clinical trial, you have the right torequest an Independent Medical Review(IMR) on the denial. This is talked about inthe section, “Complaints: What should I do ifI am unhappy?” in this handbook.Diabetic Services• Medical equipment• Prescription drugs• Diabetes-related supplies:o Blood glucose monitors and blood glucosetesting stripso Blood glucose monitors designed to assistthe visually impaired for insulin dependent,non-insulin dependent and gestational diabeteso Insulin pumps and all related necessary supplieso Ketone urine testing stripso Lancets and lancet puncture deviceso Pen delivery systems for the administration<strong>of</strong> insulino Podiatric devices to prevent or treat diabetes-relatedcomplicationso Insulin syringeso Visual aids, excluding eyewear, to assist thevisually impaired with proper dosing <strong>of</strong> insulin• Training and health education for selfmanagement• Family education for self-managementDoctor Office Visits• All routine visits, exams, treatments, shots andCHDP visits are provided by your doctor.• Services received from specialist visits.• Any CHDP services from school-based programsor the <strong>Los</strong> <strong>Angeles</strong> <strong>County</strong> <strong>Department</strong><strong>of</strong> <strong>Health</strong> Services. There is more informationabout the Child <strong>Health</strong> Disability PreventionProgram (CHDP) under “More benefits: Whatother services can I get?” in this handbook.You can also call CHDP at 1-800-993-2437.Drugs/Medications• Prescription drugs and over-the-counter drugson the Community <strong>Health</strong> Plan formulary arecovered. This is talked about in the section,“Pharmacy Benefits: How do I get prescriptiondrugs?” in this handbook.Durable Medical Equipment (DME)DME is medical equipment used repeatedly (overand over again) by a person who is ill or injured.These items are ordered by your doctor.• Apnea monitors• Blood glucose monitors, including monitorsfor the visually impaired for insulin depend-13Community <strong>Health</strong> Plan <strong>Member</strong> Services <strong>Department</strong> toll-free 1-800-475-5550L.A. Care <strong>Health</strong> Plan <strong>Member</strong> Services <strong>Department</strong> toll-free 1-888-4LA-Care or 1-888-452-2273
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