CALIFORNIA - Pacificare Health Systems

If your newborn has not been discharged from the
hospital, is being followed by the Case Management
or is receiving acute institutional or noninstitutional
care at the time of your request, a change in your
newborn’s Primary Care Physician or Participating
Medical Group will not be effective until the first day of
the second month following the newborn’s discharge
from the institution or termination of treatment. When
PacifiCare’s Case Management is involved, the Case
Manager is also consulted about the effective date of
your requested Physician change for your newborn.
You can learn more about changing Primary Care
Physicians in Section 4. Changing Your Doctor or
Medical Group. (For more about adding a newborn to
your coverage, see Section 8. Member Eligibility.)
Does your group or Hospital restrict any
reproductive services?
Some Hospitals and other Providers do not provide
one or more of the following services that may
be covered under your plan contract that you or
your Family Member might need: family planning;
contraceptive services, including emergency
contraception; sterilization, including tubal ligation at
the time of labor and delivery; Infertility treatments;
or abortion. You should obtain more information
before you enroll. Call your prospective doctor,
medical group, independent practice association, clinic
or call the PacifiCare Health Plan Customer Service
department at 1-800-624-8822 or 1-800-442-8833
(TDHI) to ensure that you can obtain the health care
services that you need.
If you have chosen a Participating Medical Group
that does not provide the family planning benefits
you need, and these benefits have been purchased by
the University of California, please call our Customer
Service department.
Getting Started:
Your Primary Care Physician
Questions? Call the Customer Service Department at 1-800-624-8822. 7
PART A