ALABAMA
HOW MANY HEARING AIDS ARE COVERED BY THE PLAN?
WHATS IS "LIMITED TO 2 HEARINF AIDS EVERY 2 YEARS"
THIS PLAN IS AVAILABLE IN ALL 67 FLORIDA COUNTIES.
WHAT IS THE "REGIONAL PPO DUAL SNP--- R7444-012 AND R7444-013"
THIS MEDICAID STATUS CODE COVERS PART B COST SHARE 100% OF THE TIME
WHAT IS " DUAL STATUS CODE 01 AND 02"
THIS PROGRAM IS COVERED ONE (1) TIME PER CALENDAR YEAR IMMEDIATELY FOLLOWING AN INPATIENT STAY.
WHAT IS "MOM'S MEALS NOURISHCARE"
HOW MANY CONTRACTS DOES THIS STATE HAVE?
WHAT IS "13"
THIS SERVICE COVERS MEDICAL AND SOCIAL SERVICES, MEDICAL EQUIPMENT AND SUPPLIES, PART TIME SKILLED NURSING, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY.
WHAT IS "HOME HEALTH AGENCY CARE"
THIS MEDICAID LEVEL STATUS IS RESPONSIBLE FOR PAYING ALL COST SHARING.
WHAT IS "PARTIAL MEMBERS"
THIS PLAN NAME IS NOW CHANGING TO H8748-009
WHAT IS "H8748-001 & H8748-023"
WHAT TRANPLANTS ARE COVERED BY INSURANCE UNDER CERTAIN CONDITIONS?
WHAT IS "CORNEAL, KIDNEY, KIDNEY-PANCREATIC, HEART, LIVER, LUNG, HEART/LUNG, BONE MARROW, STEM CELL, AND INTESTINAL/MULTIVISCERAL.
THIS BENEFIT GIVES THE MEMBER $1,200 LOADED TO THEIR CARD ANNUALLY
WHAT IS "HEALTH PRODUCTS CARD"
THIS SERVICE PROVIDES COST FOR SPECIAL CARE UNITS, MEALS INCLUDING SPECIAL DIETS, AND A PRIVATE ROOM
WHAT IS "INPATIENT HOSPITAL CARE"
THIS PLAN'S QUARTERLY ALLOWANCE AMOUNT IS $125
WHAT IS "MEDICARE DUAL COMPLETE LP(H1045-039)
WHAT IS "STATEWIDE RPPO (R7444)"
THIS BENEFIT ALLOWS THE REMOVAL OF CORNS UP TO SIX (6) TIMES A YEAR.
WHAT IS" FOOT CARE"
THIS BENEFIT TAKES CARE OF BODY AND MIND.
WHAT IS "FITNESS BENEFIT"
THESE DRUGS ARE NOT COVERED BY MEDICARE.
WHAT IS "NON PRESCRIPTION DRUGS, DRUGS USED TO PROMOTE FERTILITY, DRUGS USED FOR COSMETIC PURPOSES, DRUGS USED FOR TREATMENT OF SEXUAL OR ERECTILE DYSFUNCTION, DRUGS USED FOR THE TREATMENT OF ANOREXIA, WEIGHT LOSS, WEIGHT GAIN, ETC"
THIS ELIGIBLITY CATEGORY PAYS FOR UNLIMITED TRANSPORTATION TRIPS
WHAT IS "FULL DUAL"
WHAT FORM DO YOU ASSIST THE MEMBER WITH, IF THEY ARE NEEDED MEDICAL SERVICES FOR BENEFITS NOT COVERED UNDER THE PLAN?
WHAT IS THE "MIOD FORM"
THIS PROGRAM PROVIDES TRAINING FOR YOUR CONDITION.
WHAT IS "DIABETES SELF-MANAGEMENT TRAINING"
THIS CONDITION MAKES YOU NOT ELIGIBLE FOR THIS PLAN TYPE.
WHAT IS "END STAGE RENAL DISEASE
THIS ADDRESS IS USED FOR WHEN A MEMBER REQUEST PAYMENT.
WHAT IS "UNITEDHEALTHCARE, P.O. BOX 31362, SALT LAKE CITY, UT, 84131-0362.
THIS PLAN PROVIDES REIMBURSEMENT OF BOTH PCP AND SPECIALIST AT 100% OF THE ALLOWABLE COST SHARE FOR OFFICE VISITS
WHAT IS "MEDICARE DUAL COMPLETE LP (H1045-039 AND H1045-040)
THIS MEDICAID CATEGORY ALLOWS PROVIDER TO COLLECT COPAY FROM THE MEMBER.
WHAT IS " SLMB+ … SPECIFIED LOW INCOME MEDICARE BENEFICIARIES/PLUS FULL MEDICAID"
THESE LOCATIONS PROVIDE THE PNEUMONIA SHOT TO OUR MEMBERS.
WHAT IS " ALBERTSONS, CVS, KMART, MEIJER, RITE AID, SAFEWAY, SHOPKO, TARGET, UNITED SUPERMARKETS, WALGREENS, AND WALMART"
WHAT TYPE OF MEDICA CARE CAN YOU GET WITHOUT PCP APPROVAL?
WHAT IS "
Routine women’s health care, which includes breast exams, screening mammograms (x-rays
of the breast), Pap tests, and pelvic exams as long as you get them from a network provider.
· Flu shots, Hepatitis B vaccinations, and pneumonia vaccinations.
· Emergency services from network providers or from out-of-network providers.
· Urgently needed services from network providers or from out-of-network providers when
network providers are temporarily unavailable or inaccessible, e.g., when you are temporarily
outside of the plan’s service area.
· Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are
temporarily outside the plan’s service area. (If possible, please call Customer Service before
you leave the service area so we can help arrange for you to have maintenance dialysis while
you are away. Phone numbers for Customer Service are printed on the back cover of this
booklet.)