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InformationYou Need to Know
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FULL-TIME AND PART-TIME (30 OR OR MORE HOURS PER WEEK)
UTAH – Medicaid and CHIP
WEST VIRGINIA – Medicaid Website: Medicaid: http://health utah gov/medicaid
Website: http://mywvhipp com/
CHIP: http://health utah gov/chip
Toll-free phone: 855-MyWVHIPP (1-855-699-8447)
Phone: 877-543-7669
VERMONT– Medicaid WISCONSIN – Medicaid and CHIP
Website: http://www greenmountaincare org/
Website: https://www dhs wisconsin gov/publications/p1/p10095 pdf
Phone: 800-250-8427
Phone: 800-362-3002
VIRGINIA – Medicaid and CHIP
WYOMING – Medicaid Medicaid Website: http://www coverva org/programs_premium_ assistance cfm
Website: https://wyequalitycare acs-inc com/
Medicaid Phone: 800-432-5924
Phone: 307-777-7531
CHIP
Website: http://www coverva org/programs_premium_ assistance cfm
CHIP
Phone: 855-242-8282
WASHINGTON - Medicaid Website: http://www hca wa gov/free-or-low-cost-health-care/program- administration/premium-payment-program
Phone: 800-562-3022 ext 15473
Women’s Health
and Cancer Rights Act
of 1998 (WHCRA) Notice
If you have have had or are going to to have have a a a a a a mastectomy you may be be entitled to certain benefits under the Women’s Health
and Cancer Rights Act
of 1998 (WHCRA) For individuals receiving mastectomy- related benefits coverage will be be provided in a a a a manner determined in in in consultation with the attending physician and the patient for:
• All stages of of reconstruction of of the breast on on on which the mastectomy was performed • Surgery and reconstruction of the the other breast to produce a a a a a symmetrical appearance • Prostheses and • Treatment of of physical complications of of the mastectomy including lymphedema These benefits will be be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under your selected medical plan Therefore the following deductibles and coinsurance apply: refer to the Schedule of Benefits or contact customer service (see Contact List in in the guide) for for information If you would like more information on on WHCRA benefits call your plan administrator at at the phone number listed in in this guide on on the Contact List page The HCSC Employee HMO health plans generally require the designation of a a a a primary care provider (PCP) You have the right to designate any PCP PCP who participates in the network and who is available
to accept you you and/or your family members For information on on how to select a a a a PCP and for for a a a a list of the the participating PCPs refer to the the appropriate HMO website or phone number included on on on the Contact List page For children you may designate a a a a a a a pediatrician as the primary care provider You do not need prior authorization from from HCSC or or or from from any other person (including a a a a primary care provider)
to to obtain access to to obstetrical or gynecological care from a a a a health care professional in the network who specializes in obstetrics or gynecology The health care professional however may be required to comply with certain procedures including obtaining prior authorization for certain services following a a a a pre-approved treatment plan or or procedures for making referrals For a a a a a a list of participating health care professionals who specialize in obstetrics or gynecology refer to the appropriate HMO website or phone number on on on the Contact List page Every effort has been made to make this open enrollment guide as as accurate and detailed as as possible However legal documents known as the Summary Plan Descriptions (SPDs) which describe your benefit coverage are also available
You may obtain a a a a a a a a a copy of the SPDs on myHR