Member Handbook - What you need to know about your ...

1 Member Handbook What you need to know about your benefits health Net Combined evidence of coverage (EOC) and Disclosure Form 2018 Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 2 Other languages and formats Other languages You can get this Member Handbook and other plan materials for free in other languages. Call health Net Customer Contact Center 1-800-675-6110 (TTY 711). The call is toll free. Other formats You can get this information for free in other auxiliary formats, such as braille, 18 point font large print and audio. Call health Net Customer Contact Center 1-800-675-6110 (TTY 711). The call is toll free. Interpreter services You do not have to use a family Member or friend as an interpreter.

2 For free interpreter, linguistic and cultural services and help available 24 hours a day, 7 days a week, or to get this Handbook in a different language, call health Net Customer Contact Center 1-800-675-6110 (TTY 711). The call is toll free. Other languages and formats Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 3 Armenian: , , health Net Community Solutions- , : 1-800-675-6110 (TTY: 711) Chinese (Traditional): health Net Community Solutions 1-800-675-6110 (TTY: 711) Panjabi (Punjabi): , , , health Net Community Solutions ( ) , 1-800-675-6110 (TTY: 711) Other languages and formats Call Member services at 1-800-675-6110 (TTY 711).

3 health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 4 Hindi: , , health Net Community Solutions ( ) , : , 1-800-675-6110 (TTY: 711) Hmong (White): Yog koj, lossis lwm tus koj pab, muaj lus nug txog health Net Community Solutions, koj muaj txoj cai tau kev pab thiab ntaub ntawv ua koj hom lus tsis muaj nqi them. Xav nrog ib tug neeg txhais lus, hu 1-800-675-6110 (TTY: 711). Japanese: health Net Community Solutions 1-800-675-6110 TTY 711 Korean: health Net Community Solutions.

4 1-800-675-6110 (TTY: 711) . Other languages and formats Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 5 Russian: Если у Вас или у кого-то, кому Вы помогаете, есть вопросы о плане health Net Community Solutions, Вы имеет право бесплатно получить необходимые сведения в переводе на Ваш язык. Для того чтобы воспользоваться помощью устного переводчика, позвоните по телефону 1-800-675-6110 (TTY: 711). Other languages and formats Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 6 Spanish: Si usted, o alguna persona a la que asiste, tiene preguntas sobre health Net Community Solutions, tiene derecho a obtener ayuda e informaci n en su idioma sin cargo.

5 Para hablar con un int rprete, llame al 1-800-675-6110 (TTY: 711). Tagalog: Kung ikaw o ang isang taong tinutulungan mo ay mayroong mga tanong tungkol sa health Net Community Solutions, mayroon kang karapatang makakuha ng tulong at impormasyon na nasa wika mo nang walang babayaran. Para makipag-usap sa isang interpreter, tumawag sa 1-800-675-6110 (TTY: 711) Vietnamese: N u qu v , ho c m t ng i n o qu v ang gi p , c th c m c v health Net Community Solutions, qu v c quy n nh n c tr gi p v th ng tin b ng ng n ng c a qu v mi n ph . trao i v i phi n d ch vi n, h y g i s 1-800-675-6110 (TTY: 711). Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 7 Notice of non-discrimination Discrimination is against the law.

6 health Net complies with applicable federal and State civil rights laws and does not discriminate (exclude or treat people differently) on the basis of race, color, national origin, creed, ancestry, religion, language, age, marital status, sex, sexual orientation, gender identity, health status, physical or mental disability, or identification with any other persons or groups defined in Penal Code , and health Net will provide all Covered Services in a culturally and linguistically appropriate manner. health Net: 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 (braille, large print, audio, accessible electronic formats, and other formats) 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 health Net s Customer Contact Center at 1-800-675-6110 (TTY: 711).

7 If you believe that health Net has failed to provide these services or discriminated in another way on the basis of race, color, national origin, creed, ancestry, religion, language, age, marital status, sex, sexual orientation, gender identity, health status, physical or mental disability, or identification with any other persons or groups defined in Penal Code , you can file a grievance with: health Net Appeals & Grievances 10348 Notice of non-discrimination Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 8 Van Nuys, CA 91409 1-800-675-6110 (TTY711) Fax: 1-877-831-6019 for online submissions You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, health Net s Customer Contact Center at 1-800-675-6110 (TTY: 711) is available to help you.

8 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 Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 9 Welcome to health Net Community Solutions! Thank you for joining health Net. health Net is a health plan for people who have Medi-Cal. Heath Net works with the State of California to help you get the health care you need. Member Handbook This Member Handbook tells you about your coverage under health Net.

9 Please read it carefully and completely. It will help you understand and use your benefits and services. It also explains your rights and responsibilities as a Member of health Net. If you have special health needs, be sure to read all sections that apply to you. This Member Handbook is also called the Combined evidence of coverage (EOC) and Disclosure Form. It is a summary of health Net rules and policies and based on the contract between MCP and DHCS. If you would like to learn exact terms and conditions of coverage , you may request a copy of the complete contract from Member services. Call 1-800-675-6110 (TTY 711) to ask for a copy of the contract between health Net and DHCS. You may also ask for another copy of the Member Handbook at no cost to you or visit the health Net website at to view the Member Handbook . You may also request, at no cost, a copy of the health Net non-proprietary clinical and administrative policies and procedures, or how to access this information on the health Net website.

10 Contact us health Net is here to help. If you have questions, call 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. You can also visit online at any time at Notice of non-discrimination Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 10 Thank you, health Net health Net Community Solutions 21281 Burbank Blvd., C-5 Woodland Hills, CA 91367 Call Member services at 1-800-675-6110 (TTY 711). health Net is here 24 hours a day, 7 days a week. The call is toll free. Or call the California Relay Line at 711. Visit online at 11 Table of contents 1. Getting started as a 13 How to get help .. 13 Who can become a 13 Identification (ID) cards .. 14 Ways to get involved as a Member .