Personal Comp Member Handbook - CareFirst BlueCross BlueShield

ContentsYour Member ID Card ........................................................................................................... 1When You Need Care .............................................................................................................2■ Medical Records ■ Scheduling Appointments ■ Canceling Appointments■ Preventive Care Benefits ■ Well Child Care ■ Adult Physical Exams ■ Medical Emergencies ■ FirstHelp®■ Mental Health, Alcohol Abuse and Drug Abuse Benefits ■ Coverage When Traveling■ Receiving Health Care Outside of the CareFirst BlueCross BlueShield Service Area■ Pre-Existing Conditions ■ ExclusionsCareEssentials ......................................................................................................................... 7■ Prevention ■ Vitality Newsletter ■ Get Healthy with My Care First■ Great Beginnings Program for Expectant Mothers ■ Preventive Services Guidelines■ Utilization Management ■ Hospital Care ■ Disease Management ■ Case ManagementHealth Savings Account Plan ............................................................................................... 11Claims, Enrollment Changes & Payments .......................................................................... 14■ Coordination of Health Care Benefits ■ Subrogation and Workers’ Compensation■ Paying for your Health Care Coverage ■ Personal and Enrollment Changes ■ Filing Claims■ Explanation of Health Care Benefits StatementAdditional CareFirst Benefits ............................................................................................... 20■ Your Dental Benefits ■ Your Vision Benefits ■ Save Money with the Discount Drug ProgramDiscount Program ................................................................................................................ 22■ Discounts on Alternative Therapies and Wellness ServicesAppeals Process .................................................................................................................... 25Member Rights and Responsibilities ................................................................................... 26Portability ............................................................................................................................. 27Confidentiality ...................................................................................................................... 28Frequently Asked Questions ................................................................................................ 29Definition of Terms .............................................................................................................. 30Index ...................................................................................................................................... 31ii