Example: air traffic controller

2018 FORMULARY (List of Covered Drugs) - Blue Cross Blue ...

blue Cross Community MMAI. (Medicare-Medicaid Plan) SM. 2018 FORMULARY . (List of Covered Drugs). PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION. ABOUT THE DRUGS WE COVER IN THIS PLAN. Effective January 2018. 1-877-723-7702 (TTY/TDD: 711) We are available 24 hours a day, seven (7) days a week. The call is free. For more information, visit H0927_BEN_IL_RX18 Approved 08082017 Updated 08/2018 blue Cross Community MMAI 2018 LIST OF Covered DRUGS. blue Cross COMMUNITY MMAI | 2018 List of Covered Drugs ( FORMULARY ). This is a list of drugs that members can get in blue Cross Community MMAI.

Blue Cross Community MMAI (Medicare-Medicaid Plan)SM 2018 FORMULARY (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File ID: 00018122

Tags:

  Cross, Blue, Blue cross blue, Blue cross

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of 2018 FORMULARY (List of Covered Drugs) - Blue Cross Blue ...

1 blue Cross Community MMAI. (Medicare-Medicaid Plan) SM. 2018 FORMULARY . (List of Covered Drugs). PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION. ABOUT THE DRUGS WE COVER IN THIS PLAN. Effective January 2018. 1-877-723-7702 (TTY/TDD: 711) We are available 24 hours a day, seven (7) days a week. The call is free. For more information, visit H0927_BEN_IL_RX18 Approved 08082017 Updated 08/2018 blue Cross Community MMAI 2018 LIST OF Covered DRUGS. blue Cross COMMUNITY MMAI | 2018 List of Covered Drugs ( FORMULARY ). This is a list of drugs that members can get in blue Cross Community MMAI.

2 blue Cross Community MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you. Benefits may change on January 1 of each year. You can always check blue Cross Community MMAI's up-to- date List of Covered Drugs online at Limitations and restrictions may apply. For more information, call blue Cross Community MMAI Member Services at 1-877-723-7702 (TTY/TDD 711), We are available 24 hours a day, seven (7) days a week.

3 Or, read the blue Cross Community MMAI Member Handbook. If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-877-723-7702. (TTY/TDD 711), We are available 24 hours a day, seven (7) days a week. The call is free. Si habla espa ol, los servicios de asistencia ling stica est n a su disposici n sin costo alguno para usted. Llame al blue Cross Community MMAI al 1-877-723-7702 (TTY/TDD: 711). Estamos a su disposici n las 24. horas del d a, los siete (7) d as de la semana. La llamada es gratuita. You can get this document for free in other formats, such as large print, braille, or audio.

4 Call 1-877-723-7702. (TTY/TDD 711), We are available 24 hours a day, seven (7) days a week. The call is free. You can request to always have your materials sent to you in the language and/or format (such as large print, braille, or audio) that you need. Call 1-877-723-7702 (TTY/TDD: 711). We are available 24 hours a day, seven (7) days a week. Once requested, Member Services will always send you materials in your chosen language and/or format until you request to have it changed. This service is free. If you have questions, please call blue Cross Community MMAI at 1-877-723-7702 (TTY/TDD 711), We are available 24 hours a day, seven (7) days a week.

5 The call is free. For more information, visit i blue Cross Community MMAI 2018 LIST OF Covered DRUGS. blue Cross and blue Shield of Illinois complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. blue Cross and blue Shield of Illinois does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. blue Cross and blue Shield of Illinois: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats).

6 Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages If you need these services, contact Civil Rights Coordinator. If you believe that blue Cross and blue Shield of Illinois has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator, Office of Civil Rights Coordinator, 300 E. Randolph St., 35th floor, Chicago, Illinois 60601, 1-855-664-7270, TTY/TDD: 1-855-661-6965, Fax: 1-855-661-6960, You can file a grievance in person or by mail, fax, or email.

7 If you need help filing a grievance, Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at , or by mail or phone at: Department of Health and Human Services 200 Independence Avenue, SW. Room 509F, HHH Building Washington, 20201. 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at If you have questions, please call blue Cross Community MMAI at 1-877-723-7702 (TTY/TDD 711), We are available 24 hours a day, seven (7) days a week.

8 The call is free. For more information, visit ii blue Cross Community MMAI 2018 LIST OF Covered DRUGS. English: ATTENTION: If you speak a non-English language, language assistance services, free of charge, are available to you. Call 1-877-723-7702 (TTY/TDD: 711). Espa ol (Spanish): ATENCI N: si habla espa ol, tiene a su disposici n servicios gratuitos de asistencia ling stica. Llame al 1-877-723-7702 (TTY/TDD: 711). (Chinese): 1-877-723-7702. (TTY/TDD: 711). Tagalog (Tagalog Filipino): PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.

9 Tumawag sa 1-877-723-7702 (TTY/TDD: 711). Fran ais (French): ATTENTION : Si vous parlez fran ais, des services d'aide linguistique vous sont propos s gratuitement. Appelez le 1-877-723-7702 (ATS : 711). Ti ng Vi t (Vietnamese): CH : N u b n n i Ti ng Vi t, c c c d ch v h tr ng n ng mi n ph d nh cho b n. G i s 1-877-723-7702 (TTY/TDD: 711). Deutsch (German): ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verf gung. Rufnummer: 1-877-723-7702 (TTY/TDD: 711). (Korean): : , . 1- 877-723-7702 (TTY/TDD: 711) . Русский (Russian): ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.

10 Звоните 1-877-723-7702 (телетайп: 711). ( Arabic): : ) 2077-327-778-1 . : ..(117. ! % (Hindi): ! ' : ) ) . 4 6 : ' @ 4 1- 877-723-7702 (TTY/TDD: 711) ' . Italiano (Italian): ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-877-723-7702 (TTY/TDD: 711). u (Gujarati): ! : % ' u , : u3 9 = @ B. 1- 877-723-7702 (TTY/TDD: 711). ( Urdu): : . 1-877-723-7702 (TTY/TDD: 711). Polski (Polish): UWAGA: Je eli m wisz po polsku, mo esz skorzysta z bezp atnej pomocy j zykowej. Zadzwo . pod numer 1-877-723-7702 (TTY/TDD: 711).


Related search queries