CommunityCare HMO
Individual & Family PlansEffective January 1, 2019CommunityCare HMOHealth coverage for individuals and familiesAvailable from Health Net of California, Inc. (Health Net) through Covered California Health Net quality meetsHMO affordabilityOur CommunityCare plans are HMO plans,which are easy to use and help makehealth care affordable! They come with theCommunityCare HMO Network – doctors,specialists and other providers you seewhen you need care.
The CommunityCare HMO Care KeyKnow where to go when you need care. This Care Key will help you understand and find the options that come with everyCommunityCare HMO plan.Use When you need For things like Contact infoYour primarycare physician(PCP)Routine and preventive care,and referrals to specialistsAnnual wellness exams,general medical careYour PCP’s name and numberare on your Health Net ID card.CommunityCareHMO NetworkprovidersCare from specialists andother providers; requires PCPreferral1Matters of dermatology,cardiology, orthopedics,psychology, etc.1Log in to your account atwww.myhealthnetca.com tofind providers in the Health NetCommunityCare HMO individualplan provider network.TeladoctelehealthservicesHealth information, diagnosesand prescriptions by phone,Web or Teladoc mobile appfor non-emergency medicalsituations or when your PCP’soffice is closed2Sinus problems, upperrespiratory infections,allergies, bronchitis, pinkeye,etc.Nurse AdviceLine24/7/365 advice by phonefrom a registered nurse2Urgent health concerns andcare for minor injuries andillnesses like fevers and the flu1-800-893-5597(TTY: 711)Urgent carecentersSame-day treatment fornon-emergency illnesses orinjuries2Minor sprains, earaches, colds,back pain, etc.Visit www.myhealthnetca.comand click on Find a Doctor tosearch for locations near you.1-800-Teladoc (1-800-835-2362)Set up your account atwww.teladoc.com/hn.1Self-referrals2Goare allowed for obstetrician and gynecological services, and reproductive and sexual health care services.immediately to the nearest emergency room or call 911 if you have an emergency.Remember: Use the CommunityCare HMO Network for all covered services.If you need a specialist, your PCP will refer you to one. There is no coverage forout-of-network services except for emergency care, urgent care and servicesapproved by Health Net.1
The care you need, the extras you wantCommunityCare HMO comes with valuable extras. They’re all designedto help you get the most out of your health coverage.Discover a network ofhealth care professionalsHaving a primary care physician (PCP) is justthe beginning. Your doctor is one of manyHealth Net CommunityCare HMO providersin your region. If you need a specialist, yourPCP will refer you to one. Find all of thephysicians and facilities that come with thishealth plan at www.myhealthnetca.com.Find support for healthy habitsGet on track for good with ourone-on-one, over-the-phone coachingsessions. Quit For Life helps smokers kickthe habit. And our health coaches can helpyou with weight and fitness goals. You caneven track your progress online! Use Active&Fit DirectEvery CommunityCare HMO healthplan comes with Active&Fit Direct1 – fitnesscenter memberships for less! For just 25a month (plus a 25 enrollment fee andapplicable taxes), you can choose from9,600 participating centers andYMCAs nationwide. Learn more atwww.activeandfitdirect.com/Fitness/HealthNet.1 MembersLean on myStrengthGive your emotional health someTLC. Take care of your whole self withmyStrength, a Health Net programdevoted to helping you manage depression,anxiety and stress. Learn more atwww.mystrength.com/hnwell. 50 Get a 50 gift for investing inyour healthComplete a Health Risk Questionnaire(HRQ) in 2019 and share it with yourCommunityCare HMO PCP during yourannual preventive care exam. Then login to your online Health Net account andfollow the instructions. We’ll send you a 50 gift certificate, valid with hundredsof popular retailers!must be 18 or older to participate. There is a 3-month commitment required. The Active&Fit Direct Program is providedby American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). The Active&Fit logo isa trademark of ASH and used with permission.2
It’s still important to have health coverageWe know you have options when it comes to having health coverage.But investing in health coverage is more than just a good idea. So trustyour good sense! Help protect your health and your finances with aHealth Net Individual & Family Plan. Our CommunityCare HMO canhelp give you priceless peace of mind!Looking for financial assistance?You might be able to get help paying for some of the costs that go with having this kind ofhealth coverage. There are two types of financial assistance available: premium assistance andcost-sharing reductions. Find out if you qualify by visiting www.CoveredCA.com.Where to findCommunityCare HMORegion 14Kern County1Through Covered California, Health Netoffers six different types of CommunityCareHMO plans in parts of Southern and CentralCalifornia. You can enroll in any of ourPlatinum, Gold or Silver CommunityCareHMO plans if you are in one of the areaslisted here. So you can choose the right fit foryou, your family and your budget.1Partialcounty – not all ZIP codes available.3 ways to enrollWhen you’re ready to sign up forHealth Net CommunityCare HMOhealth coverage, we’re here tohelp make it easy. Choose themethod that works best for you!123Region 15Los Angeles County: ZIP codes starting with906–912, 915, 917, 918, 935Region 16Los Angeles County: ZIP codes not in Region 15Region 17Riverside1 and San Bernardino1 countiesRegion 18Orange CountyRegion 19San Diego County Call the Health Net salesteam at 1-877-609-8711. Go to www.CoveredCA.com. Visit a broker or a Covered Californiacertified enrollment counselor.3
CommunityCare HMO plans and your share of costsThe amounts shown here are what you would pay for the services you use, depending on the plan you choose.With Gold 80 CommunityCare HMO, for example, your cost for a doctor office visit is 30.Reminder! Your share of costs is in addition to the monthly premium you pay for your health coverage.Platinum 90CommunityCare HMOGold 80CommunityCare HMOSilver 70CommunityCare HMODeductibleFor one person / For family 0 / 0 0 / 0 2,500 / 5,000Out-of-pocket maximumFor one person / For family 3,350 / 6,700 7,200 / 14,400 7,550 / 15,100Doctor office visit 15 30 401Teladoc consultationtelehealth services2 0 0 01Specialist 30 55 801Hospital stay 250 facility3 / 0 physician 600 facility3 / 0 physician20% facility / 20% physician1Outpatient surgery 100 facility / 25 physician 300 facility / 40 physician20%1Urgent care 15 30 401Emergency care4 150 facility / 0 physician 325 facility / 0 physician 350 facility1 / 0 physician1 5 / 15 / 25 15 / 55 / 75 15 / 55 / 80BenefitPrescription drugsTier 1 (most generics andlow-cost preferred brands) /Tier 2 (non-preferred genericsand preferred brands) /Tier 3 (non-preferred brands only)Prescription drug calendaryear deductible is 200 permember / 400 per familyThis is a summary only. The CommunityCare HMO disclosure has plan overviews with more details about what servicesare covered with our CommunityCare HMO plans. The deductible applies unless otherwise noted. Pediatric dental andvision services are covered until the last day of the month in which the child turns 19 years of age.1Yourmedical deductible does not apply to these services.2Should3Pernot replace regular doctor visits. Only telehealth services provided by Teladoc are covered.day, up to five days.4Youdo not pay the copayment if you are admitted to the hospital.4
CommunityCare HMO Enhanced Silver plans and your share of costsSome people qualify for extra help paying for the health services they use. Instead of paying 40 to visit the doctor,the cost could be as low as 5. The extra help comes with silver-level plans that are called Enhanced Silver. Individualswith an income between 138 percent and 250 percent of the federal poverty level qualify for Enhanced Silver.Silver 94CommunityCare HMOSilver 87CommunityCare HMOSilver 73CommunityCare HMODeductibleFor one person / For family 75 / 150 650 / 1,300 2,200 / 4,400Out-of-pocket maximumFor one person / For family 1,000 / 2,000 2,600 / 5,200 6,300 / 12,600Doctor office visit1 5 151 35Teladoc consultationtelehealth services2 01 01 01Specialist1 8 25 75Hospital stay10% facility / 10% physician1 15% facility / 15% physician1 20% facility / 20% physician1Outpatient surgery110%15%20%Urgent care1 5 15 35Emergency care1,3 50 facility / 0 physician 100 facility / 0 physician 350 facility / 0 physician 3 / 10 / 15 54 / 20 / 35 15 / 50 / 75BenefitPrescription drugsTier 1 (most generics andlow-cost preferred brands) /Tier 2 (non-preferred genericsand preferred brands) /Tier 3 (non-preferred brands only)Prescription drug calendaryear deductible is 50 permember / 100 per familyPrescription drug calendaryear deductible is 175 permember / 350 per familyThis is a summary only. The CommunityCare HMO disclosure has plan overviews with more details about what servicesare covered with our CommunityCare HMO plans. The deductible applies unless otherwise noted. Pediatric dental andvision services are covered until the last day of the month in which the child turns 19 years of age.1 Yourmedical deductible does not apply to these services.2Should3Younot replace regular doctor visits. Only telehealth services provided by Teladoc are covered.do not pay the copayment if you are admitted to the hospital.4Yourprescription drug calendar year deductible does not apply.5
Nondiscrimination NoticeNondiscriminationNoticeInaddition to the State ofCalifornia nondiscrimination requirements (as described in benefit discriminationInc. (Health Net) requirementscomplies with(asapplicablefederalcivil rightslaws andIn addition toHealththe Statedescribedin benefitcoveragedoesnot discriminate,excludepeople ortreatthemNet)differentlyon withthe basisof race,federalcolor, civilnationalorigin,documents),Health Netof California,Inc.(Healthcompliesapplicablerightslaws entity,sexualorientation,age,disability,orsex.does not discriminate, exclude people or treat them differently on the basis of race, color, national origin,ancestry,religion, marital status, gender, gender identity, sexual orientation, age, disability, or sex.Health Net: HealthProvidesNet:free aids and services to people with disabilities to communicate effectively with us, such as qualifiedlanguageinterpretersand writteninformationin otherformats (large effectivelyprint, accessibleelectronicformats, signProvidesfree aidsand servicesto peoplewith disabilitiesto communicatewith us,such as qualifiedotherformats).interpreters and written information in other formats (large print, accessible electronic formats,sign languageother formats). Providesfree language services to people whose primary language is not English, such as qualified interpretersinformationwrittenservicesin other andProvidesfree languagetolanguages.people whose primary language is not English, such as qualified interpreterswritten contactin otherHealthlanguages.If andyou informationneed these services,Net’s Customer Contact Center at:IndividualFamilyPlan (IFP)MembersOn Exchange/CoveredIf you need&theseservices,contactHealth Net’sCustomer Contact CaliforniaCenter at: 1-888-926-4988 (TTY: 711)Individual && xchange/CoveredExchange Y: 711)Individual & Family Plan (IFP) Applicants1-877-609-8711(TTY:711)Members Off Exchange 1-800-839-2172 (TTY: 711)GroupPlansthroughHealthNet1-800-522-0088(TTY: 711)(TTY: 711)Individual & Family Plan (IFP) Applicants1-877-609-8711GroupPlans 11)If you believethat HealthNet hasto provide theseor discriminated in another way based on oneofthe characteristicslistedNetabove,you cana grievanceby callingHealth Net’s CustomerContactCenteratIf youbelieve that Healthhas failedto fileprovidethese servicesor discriminatedin anotherway basedon onethenumberabove andlistedtellingthemyouyoucanneedfiling a grievance.Health Net’sNet’s CustomerCustomer ContactContact CenterCenter atisof thecharacteristicsabove,filehelpa grievanceby calling Healthavailableto helpyoufiletellinga grievance.Youneedcan helpalso filea grievanceby Healthmail, faxor emailat: Contact Center isthe numberaboveandthem youfilinga grievance.Net’sCustomeravailableto ofhelpyou file aInc.grievance.can also file a grievance by mail, fax or email at:Health NetCalifornia,AppealsYou& GrievancesPOBoxNet10348Healthof California, Inc. Appeals & GrievancesVanNuys,CAPO Box 10348 91410-0348Van Nuys,CA ation.Complaints@healthnet.com (Members) orFax: 1-877-831-6019(Applicants)Email: Member.Discrimination.Complaints@healthnet.com (Members)orIf your health problem is urgent, if you already filed a complaint with(Applicants)Health Net of California, Inc. and are notsatisfiedwith thedecisionor it hasmore thandays sincewithyou fileda complaintwith HealthIf your healthproblemis urgent,if beenyou alreadyfiled30a complaintHealthNet of California,Inc. Netand edsatisfied with the decision or it has been more than 30 days since you filed a complaint with Health Net of California,HealthCaremay submita complaintform by callingthe DMHCDesk at 1-888-466-2219Inc., youmay(DMHC).submit anYouIndependentMedicalReview/ComplaintFormwith theHelpDepartmentof ov/FileaComplaint.Health Care (DMHC). You may submit a complaint form by calling the DMHC Help Desk at 1-888-466-2219(TDD:1-877-688-9891)onlineat www.dmhc.ca.gov/FileaComplaint.Ifyou believeyou have orbeendiscriminatedagainst because of race, color, national origin, age, disability, or sex,youcanalso filecomplaint withagainstthe U.S.DepartmentHealthand HumanOfficeorforsex,CivilIf youbelieveyoua civilhave rightsbeen discriminatedbecauseof race,ofcolor,nationalorigin,Services,age, disability,RightsthewithOCRtheComplaintPortal, ,you can(OCR),also fileelectronicallya civil rightsthroughcomplaintU.S. DepartmentHealth and Human Services, Office for manServices,200 Independence Avenue SW, RoomRights (OCR), electronically through the OCR Complaint Portal, at F,HHHorBuilding,DC 20201,1-800-368-10191-800-537-7697).or by mailphone at:Washington,U.S. Departmentof Healthand Human(TDD:Services,200 Independence Avenue SW, Room509F, HHHformsBuilding,Washington,DC 20201, 1-800-368-1019 (TDD: 1-800-537-7697).Complaintare availableat laint forms are available at th Net of California, Inc. is a subsidiary of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. All rights reserved.FLY020471EP00 (6/18)Health Net of California, Inc. is a subsidiary of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. All rights reserved.6FLY020471EP00 (6/18)
EnglishNo Cost Language Services. You can get an interpreter. You can get documents read to you and some sent to youin your language. For help, call the Customer Contact Center at the number on your ID card or callIndividual & Family Plan (IFP) Off Exchange: 1-800-839-2172 (TTY: 711). For California marketplace,call IFP On Exchange 1-888-926-4988 (TTY: 711) or Small Business 1-888-926-5133 (TTY: 711).For Group Plans through Health Net, call 1-800-522-0088 (TTY: 711).Arabic يرجى التواصل مع ، للحصول على المساعدة الالزمة . ويمكننا أن نقرأ لك الوثائق بلغتك . يمكننا أن نوفر لك مترجم فوري . خدمات لغوية مجانية .)TTY: 711( 1-800-839-2172 : مركز خدمة العمالء عبر الرقم المبين على بطاقتك أو االتصال بالرقم الفرعي لخطة األفراد والعائلة )TTY: 711( 1-888-926-4988 : يرجى االتصال بالرقم الفرعي لخطة األفراد والعائلة عبر الرقم ، للتواصل في كاليفورنيا لخطط المجموعة عبر .)TTY: 711( 1-888-926-5133 أو المشروعات الصغيرة .)TTY: 711( 1-800-522-0088 يرجى االتصال بالرقم ،Health NetArmenianԱնվճար լեզվական ծառայություններ: Դուք կարող եք բանավոր թարգմանիչ ստանալ:Փաստաթղթերը կարող են կարդալ ձեր լեզվով: Օգնության համար զանգահարեք Հաճախորդներիսպասարկման կենտրոն ձեր ID քարտի վրա նշված հեռախոսահամարով կամ զանգահարեքIndividual & Family Plan (IFP) Off Exchange 1-800-839-2172 հեռախոսահամարով (TTY 711):Կալիֆորնիայի համար զանգահարեք IFP On Exchange՝1-888-926-4988 հեռախոսահամարով (TTY 711) կամ Փոքր բիզնեսի համար՝1-888-926-5133 հեռախոսահամարով (TTY 711): Health Net-ի Խմբային ծրագրերի համարզանգահարեք 1-800-522-0088 հեռախոսահամարով (TTY՝ ��康保險交易市場外的 Individual & Family Plan (IFP) �險交易市場的 IFP 專線 ）。如為透過 Health Net 聽障專線：711）。Hindiबिना शुल्क भाषा सेवाएं। आप ए्क दभु ाबषया प्ाप्त ्कर स्कते हैं । आप दसतावेजों ्को अपनी भाषा में पढ़वास्कते हैं । मदद ्के लिए, अपने आईडी ्काड्ड में ददए गए नंिर पर ग्ाह्क सेवा ्केंद्र ्को ्कॉि ्करें या वयबतिगतऔर फैलमिी पिान (आईएफपी) ऑफ एकसचेंज: 1-800-839-2172 )TTY: 711) पर ्कॉि ्करें । �रों ्के लिए, आईएफपी ऑन एकसचेंज 1-888-926-4988 )TTY: 711) या समॉि बिजनेस1-888-926-5133 )TTY: 711) पर ्कॉि ्करें । हे ल्थ नेट ्के माधयम से ग्ुप पिान ्के लिए1-800-522-0088 )TTY: 711) पर ्कॉि ्करें ।HmongTsis Muaj Tus Nqi Pab Txhais Lus. Koj tuaj yeem tau txais ib tus kws pab txhais lus. Koj tuaj yeem muaj ibtus neeg nyeem cov ntaub ntawv rau koj ua koj hom lus hais. Txhawm rau pab, hu xovtooj rau Neeg Qhua LubChaw Tiv Toj ntawm tus npawb nyob ntawm koj daim npav ID lossis hu rau Tus Neeg thiab Tsev Neeg QhovKev Npaj (IFP) Ntawm Kev Sib Hloov Pauv: 1-800-839-2172 (TTY: 711). Rau California qhov chaw kiabkhw, hu rau IFP Ntawm Qhov Sib Hloov Pauv 1-888-926-4988 (TTY: 711) lossis Lag Luam Me1-888-926-5133 (TTY: 711). Rau Cov Pab Pawg Chaw Npaj Kho Mob hla Health Net, hu rau1-800-522-0088 (TTY: ただくか、Individual & Family Plan (IFP) (個人・家族向けプラン)Off Exchange: 1-800-839-2172 (TTY: 711) ��IFP On Exchange 1-888-926-4988 (TTY: 711) または Small Business1-888-926-5133 (TTY: 711) までお電話ください。Health �1-800-522-0088 (TTY: 711) ាសាសោយឥតគិតថ្លៃ។ ��ត់។ �្នក។ េ្មាប់ជំនួយ េូ ��នងអតិ
1-888-926-5133 (TTY: 711) までお電話ください。Health �1-800-522-0088 (TTY: 711) ាសាសោយឥតគិតថ្លៃ។ ��ត់។ ្នក។ េ្មាប់ជំនួយ េូ ែលមានសៅសលើបណ័ ្ណ េមាគាល់ខួ នរបេ់លៃសោកអ្នក �កម្មវធិ ី Off ្ខណៈបុគគាល និង្ករុម្គរួសារ (IFP) តាមរយៈសលខ៖ 1-800-839-2172 (TTY: ��្ឋ California េូ �កម្មវធិ ី On Exchange របេ់គស្មាង IFP តាមរយៈសលខ1-888-926-4988 (TTY: 711) ��លខ 1-888-926-5133 (TTY: ��ករុមតាមរយៈ Health Net េូ �សលខ 1-800-522-0088 (TTY: 711)។Korean무료 언어 서비스입니다. 통역 서비스를 받으실 수 있습니다. 문서 낭독 서비스를 받으실 수 있으며일부 서비스는 귀하가 구사하는 언어로 제공됩니다. 도움이 필요하시면 ID 카드에 수록된 번호로고객서비스 센터에 연락하시거나 개인 및 가족 플랜(IFP)의 경우 Off Exchange:1-800-839-2172(TTY: 711)번으로 전화해 주십시오. 캘리포니아 주 마켓플레이스의 경우IFP On Exchange 1-888-926-4988(TTY: 711), 소규모 비즈니스의 경우 1-888-926-5133(TTY: 711)번으로전화해 주십시오. Health Net을 통한 그룹 플랜의 경우 1-800-522-0088(TTY: 711)번으로 전화해주십시오.NavajoDoo b33h 7l7n7g00 saad bee h1k1 ada’iiyeed. Ata’ halne’7g77 da [a’ n1 h1d7d0ot’88[. Naaltsoos da t’11sh7 shizaad k’ehj7 shich9’ y7dooltah n7n7zingo t’11 n1 1k0dooln77[. !k0t’4ego sh7k1 a’doowo[ n7n7zingoCustomer Contact Center hooly4h7j8’ hod77lnih ninaaltsoos nanitingo bee n44ho’dolzin7g77 hodoonihj8’bik11’ 47 doodago koj8’ h0lne’ Individual & Family Plan (IFP) Off Exchange: 1-800-839-2172 (TTY: 711).California marketplace b1h7g77 koj8’ h0lne’ IFP On Exchange 1-888- 926-4988 (TTY: 711) 47 doodagoSmall Business b1h7g77 koj8’ h0lne’ 1-888-926-5133 (TTY: 711). Group Plans through Health Net b1h7g77 47koj8’ h0lne’ 1-800-522-0088 (TTY: 711).Persian (Farsi) برای . می توانيد درخواست کنيد اسناد به زبان شما برايتان خوانده شوند . می توانيد يک مترجم شفاهی بگيريد . خدمات زبان بدون هزينه : به شماره IFP( Off Exchange) با مرکز تماس مشتريان به شماره روی کارت شناسايی يا طرح فردی و خانوادگی ، دريافت کمک 1-888-926-4988 شماره IFP On Exchange با ، برای بازار کاليفرنيا . ) تماس بگيريد TTY:711( 1-800-839-2172 برای طرح های گروهی از طريق . ) تماس بگيريد TTY:711( 1-888-926-5133 ) يا کسب و کار کوچک TTY:711(. ) تماس بگيريد TTY:711( 1-800-522-0088 با ،Health NetPanjabi (Punjabi)ਬਿਨਾਂ ਬਿਸੇ ਲਾਗਤ ਵਾਲੀਆਂ ਭਾਸਾ ਸੇਵਾਵਾਂ। ਤੁਸੀਂ ਇੱਿ ਦੁਭਾਸੀਏ ਦੀ ਸੇਵਾ ਹਾਸਲ ਿਰ ਸਿਦੇ ਹੋ। ਤੁਹਾਨੂੰ ਦਸਤਾਵੇਜ਼ ਤੁਹਾਡੀ ਭਾਸਾਬਵੱਚ ਪੜ੍ਹ ਿੇ ਸੁਣਾਏ ਜਾ ਸਿਦੇ ਹਨ। ਮਦਦ ਲਈ, ਆਪਣੇ ਆਈਡੀ ਿਾਰਡ ਤੇ ਬਦੱਤੇ ਨੰਿਰ ਤੇ ਗਾਹਿ ਸੰ ਪਰਿ ਿੇਂਦਰ ਨੂੰ ਿਾਲ ਿਰੋ ਜਾਂਬਵਅਿਤੀਗਤ ਅਤੇ ਪਬਰਵਾਰਿ ਯੋਜਨਾ )IFP) ਔਫ਼ ਐਿਸਚੇਂਜ ‘ਤੇ ਿਾਲ ਿਰੋ: 1-800-839-2172 (TTY: 711)। �ਲੇ ਸ ਲਈ, IFP ਔਨ ਐਿਸਚੇਂਜ ਨੂੰ 1-888-926-4988 )TTY: 711) ਜਾਂ ਸਮੌਲ ਬਿਜ਼ਨੇਸ ਨੂੰ1-888-926-5133 (TTY: 711) ‘ਤੇ ਿਾਲ ਿਰੋ। ਹੈਲਥ ਨੈੱਟ ਰਾਹੀਂ ਸਾਮੂਬਹਿ ਪਲੈ ਨਾਂ ਲਈ,1-800-522-0088 (TTY: 711) ‘ਤੇ ਿਾਲ ਿਰੋ।RussianБесплатная помощь переводчиков. Вы можете получить помощь переводчика. Вам могут прочитатьдокументы на Вашем родном языке. Если Вам нужна помощь, звоните по телефону Центра помощиклиентам, указанному на вашей карте участника плана. Вы также можете позвонить в отдел помощиучастникам не представленных на федеральном рынке планов для частных лиц и семей(IFP) Off Exchange 1‑800‑839‑2172 (TTY: 711). Участники планов от California marketplace: звонитев отдел помощи участникам представленных на федеральном рынке планов IFP (On Exchange) потелефону 1‑888‑926‑4988 (TTY: 711) или в отдел планов для малого бизнеса (Small Business) потелефону 1‑888‑926‑5133 (TTY: 711). Участники коллективных планов, предоставляемых черезHealth Net: звоните по телефону 1‑800‑522‑0088 (TTY: 711).SpanishServicios de idiomas sin costo. Puede solicitar un intérprete, obtener el servicio de lectura de documentos yrecibir algunos en su idioma. Para obtener ayuda, comuníquese con el Centro de Comunicación con el Clienteal número que figura en su tarjeta de identificación o llame al plan individual y familiar que no pertenece alMercado de Seguros de Salud al 1-800-839-2172 (TTY:8711). Para planes del mercado de seguros de salud deCalifornia, llame al plan individual y familiar que pertenece al Mercado de Seguros de Salud al
телефону 1‑888‑926‑5133 (TTY: 711). Участники коллективных планов, предоставляемых черезHealth Net: звоните по телефону 1‑800‑522‑0088 (TTY: 711).SpanishServicios de idiomas sin costo. Puede solicitar un intérprete, obtener el servicio de lectura de documentos yrecibir algunos en su idioma. Para obtener ayuda, comuníquese con el Centro de Comunicación con el Clienteal número que figura en su tarjeta de identificación o llame al plan individual y familiar que no pertenece alMercado de Seguros de Salud al 1-800-839-2172 (TTY: 711). Para planes del mercado de seguros de salud deCalifornia, llame al plan individual y familiar que pertenece al Mercado de Seguros de Salud al1-888-926-4988 (TTY: 711); para los planes de pequeñas empresas, llame al 1-888-926-5133 (TTY: 711).Para planes grupales a través de Health Net, llame al 1-800-522-0088 (TTY: 711).TagalogWalang Bayad na Mga Serbisyo sa Wika. Makakakuha kayo ng interpreter. Makakakuha kayo ng mgadokumento na babasahin sa inyo sa inyong wika. Para sa tulong, tumawag sa Customer Contact Center sanumerong nasa ID card ninyo o tumawag sa Off Exchange ng Planong Pang-indibidwal at Pampamilya(Individual & Family Plan, IFP): 1-800-839-2172 (TTY: 711). Para sa California marketplace, tumawag saIFP On Exchange 1-888-926-4988 (TTY: 711) o Maliliit na Negosyo 1-888-926-5133 (TTY: 711).Para sa mga Planong Pang-grupo sa pamamagitan ng Health Net, tumawag sa 1-800-522-0088 (TTY: 711).Thaiไม่มคี า่ บริการด้านภาษา คุณสามารถใช้ลา่ มได้ คุณสามารถให้อา่ นเอกสารให้ฟงั เป็ นภาษาของคุณได้ �ยเหลือ โทรหาศูนย์ลกู �ี มายเลขบนบัตรประจ าตัวของคุณ หรือโทรหาฝา่ �รัวของเอกชน(Individual & Family Plan (IFP) Off Exchange) ที่ 1-800-839-2172 (โหมด TTY: 711) ส �นีย โทรหาฝา่ �รัวของรัฐ (IFP On Exchange) ได้ท่ี 1-888-926-4988 (โหมด TTY: 711) หรือ ฝา่ l Business) ที่ 1-888-926-5133 (โหมด TTY: 711) ส าหรับแผนแบบกลุม่ ผ่านทาง Health Net โทร1-800-522-0088 (โหมด TTY: 711)VietnameseCác Dịch Vụ Ngôn Ngữ Miễn Phí. Quý vị có thể có một phiên dịch viên. Quý vị có thể yêu cầu được đọc chonghe tài liệu bằng ngôn ngữ của quý vị. Để được giúp đỡ, vui lòng gọi Trung Tâm Liên Lạc Khách Hàng theosố điện thoại ghi trên thẻ ID của quý vị hoặc gọi Chương Trình Bảo Hiểm Cá Nhân & Gia Đình (IFP) Phi TậpTrung: 1‑800‑839‑2172 (TTY: 711). Đối với thị trường California, vui lòng gọi IFP Tập Trung1‑888‑926‑4988 (TTY: 711) hoặc Doanh Nghiệp Nhỏ 1‑888‑926‑5133 (TTY: 711). Đối với các Chương TrìnhBảo Hiểm Nhóm qua Health Net, vui lòng gọi 1‑800‑522‑0088 (TTY: 711).CA Commercial On and Off-Exchange Member Notice of Language AssistanceFLY017549EH00 (12/17)9
Health Net Individual & Family Planswww.MyHealthNetCA.com1-877-609-8711 (TTY: 711)Click the link below to view the CommunityCare HMO plan disclosureCommunityCare HMO DisclosureHealth Net HMO health plans are offered by Health Net of California, Inc. Health Net of California, Inc. is a subsidiary of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc.Covered California is a registered trademark of the State of California. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.BRO024684EH00 (1/19)
With Gold 80 CommunityCare HMO, for example, your cost for a doctor office visit is 30. Reminder! Your share of costs is in addition to the monthly premium you pay for your health coverage. Benefit Platinum 90 CommunityCare HMO Gold 80 CommunityCare HMO Silver 70 CommunityCare HMO Deductib
Health Net of California Inc. (Health Net) CALIFORNIA INDIVIDUAL & FAMILY PLANS . Plan Overview – Silver 70 CommunityCare HMO. The Silver 70 HMO health plan utilizes the . CommunityCare HMO. provider network for covered beneits and services. CommunityCare HMO. is available through Co
The Silver 70 Off Exchange CommunityCare HMO health plan utilizes the CommunityCare HMO provider network for covered benefits and services. CommunityCare HMO is available directly through Health Net
Health Net of California, Inc. (Health Net) CommunityCare HMO . HEALTH-BOOSTING, LOW-PRICED HMOS WITH EXTRA FLEXIBILITY . CommunityCare HMO lets small business groups in L.A., Orange and San Diego counties ofer a Silver or Bronze level plan - and save! Employees gain the beneits that put health irst. And they
Medical-Only HMO, Keystone 65 Select Medical-Only HMO, and Keystone 65 Select Rx HMO have networks of doctors, hospitals, pharmacies, and other providers. Keystone 65 Basic Rx HMO, Keystone 65 Liberty Medical-Only HMO, Keystone 65 Select Medical-Only HMO, and Keystone 65 Select Rx HMO: If you use providers that are not in
Medical-Only HMO and Keystone 65 Preferred Rx HMO cover and what you pay. Keystone 65 Preferred Medical-Only HMO and Keystone 65 Preferred Rx HMO are Medicare Advantage HMO (Health Maintenance Organization) plans. With an HMO plan, members choose a family doctor, called a primary c
Para afiliados a Health Net Seniority Plus (HMO)*, Health Net Healthy Heart (HMO), Health Net Ruby Select (HMO), Health Net Gold Select (HMO), Health Net Jade (HMO SNP) y Health Net Seniority Plus (Employer HMO). Su examen de la vista de rutina está cubierto como un beneficio médico básico a través de su plan médico.
My Avatar - Financial Eligibility Guide . 10 Baycare Medical Group 44 HMO Insurance 11 BC Freedom Blue MDC HMO 42 HMO Insurance (MDC) 12 Benefit and Risk Management Services 45 HMO Insurance 13 Benesight 46 HMO Insurance 14 Blue Cross of CA 4 HMO Insurance (MDC) 15 Blue Shield Federal Emp Program 47 HMO Insurance
of branched rough paths introduced in (J. Differential Equations 248 (2010) 693–721). We first show that branched rough paths can equivalently be defined as γ-Hölder continuous paths in some Lie group, akin to geometric rough paths. We then show that every branched rough path can be encoded in a geometric rough path. More precisely, for every branched rough path Xlying above apathX .
