A SIMPLE GUIDE TO YOUR BENEFITS
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1 A SIMPLE GUIDE TO YOUR BENEFITS 2017 H6751_17_47470 Approved Cigna
2 My Information Name: Cigna-HealthSpring Member ID#: Address: Phone number: Date of birth: My Important Contacts Customer Service (TTY: 7-1-1) Care Coordination hour Nurse Line Transportation services Dental services Vision services Behavioral/Mental Health services
3 This booklet gives you details about some of our services that help keep you healthy. This booklet does not list every service offered by Cigna-HealthSpring CarePlan of Illinois. For more detailed information, please review the Member Handbook or call Customer Service toll-free at (TTY: 7-1-1) 7 days a week, 8 a.m. to 8 p.m. Central Time You can also visit our website: CarePlanIL.com Table of Contents 24-hour Nurse Line 1 Care Coordinator 1 Transportation services 1 Dental services 2 Vision services 2 Hearing services 3 Over-the-counter medicines and items 3 Cigna-Home Delivery Pharmacy 4 Gym membership 4 Meal benefit 5 Cold & flu kit 5 Fleece lap blanket 5 Reacher/grabber 5
4 24-hour Nurse Line You can talk to a nurse 24 hours a day, 365 days a year. 24-hour Nurse Line Care Coordinator A Care Coordinator is one main person for you to contact that will work with you to develop a plan that meets your specific health needs. This person helps to manage all your providers, services, and supports. They will work with you, the health plan, and your doctors to make sure you get the care you need. Care Coordination Monday - Friday, 8 a.m. to 5 p.m. Central Time. Transportation services You can get a ride to and from your doctor and other medical appointments. Customer Service (TTY: 7-1-1) 7 days a week, 8 a.m. to 8 p.m. Central Time. 1
5 Dental services Cigna-HealthSpring offers many choices for dental services for FREE! One (1) oral exam every 6 months One (1) cleaning every 6 months One (1) bitewing x-ray every year One (1) full mouth or panoramic x-ray every 36 months Fillings every 12 months Dentures (removable only) Partials (removable only) Oral Surgery Our dental provider at Monday - Friday, 7 a.m. to 6 p.m. Central Time. Vision services Annual routine eye exam One (1) pair of eyeglasses (frames and lenses) or one (1) pair of contact lenses every two years. Our vision provider at Monday - Friday, 8 a.m. to 4 p.m. Central Time. 2
6 Hearing services Hearing exams Fitting/evaluation for a hearing aid once every 3 years Hearing aid once every 3 years Hearing aid batteries and accessories Hearing aid repair and replacement of parts Customer Service days a week, 8 a.m. to 8 p.m. Central Time. Over-the-counter medicines and items You get $10 every month to use for over-the-counter medicines or healthcare related items that do not require a prescription. Members receive a catalog that lists all of the medicines and items. Some are listed below. Allergy medicines Asthma medicines Dental care Eye care Foot care Flu medicines Headache medicines Skin care Sunscreen And many more! Over-the-counter provider (TTY: 7-1-1) Monday - Friday, 7 a.m. to 7 p.m. Central Time. 3
7 Cigna-Home Delivery Pharmacy A mail-order program that allows you to get up to a 90-day supply of prescription drugs mailed to your home. Customer Service, (TTY: 7-1-1) 7 days a week, 8 a.m to 8 p.m Central Time. Gym membership You can choose to exercise in your home or at a gym for FREE! You can choose from one of the following: Gym membership: You can join a gym to stay healthy. This program allows members to join a fitness center that allows your caregivers access to the facility to help you as needed. Call the number below to find gyms near you. Home fitness kit: You can exercise in your own home.* Available kits: Exercise Aqua Exercise Walking Tai Chi Yoga Stress Management Pilates *You can choose 2 home fitness kits per year. How do I join? Call Customer Service (TTY: 7-1-1), Monday - Friday, 8 a.m. to 4 p.m. Central Time. 4
8 Meal benefit Cigna-HealthSpring has a supplemental covered meal program. After you are discharged from a hospital stay (for traumatic or chronic illness), Cigna-HealthSpring will have 20 nutritional meals delivered to your home, with the goal of making your transition to home more comfortable and safe. Who is this for? Members who are discharged from a hospital stay (for traumatic or chronic illness). AVAILABLE ITEMS Cold & flu kit - NEW One (1) cold & flu kit every 12 months. Items include: carrying case, one (1) thermometer, two (2) hand sanitizer wipes, one (1) tissue packet, one (1) medicated lip ointment. Fleece lap blanket - NEW Members can request one (1) fleece lap blanket per year. Reacher/grabber - NEW Members can request one (1) reacher/grabber per year. Customer Service (TTY: 7-1-1) 7 days a week, 8 a.m. to 8 p.m. Central Time. 5
9 Notice of Nondiscrimination: Discrimination is Against the Law Cigna-HealthSpring complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Cigna-HealthSpring does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Cigna-HealthSpring: 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) 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 Customer Service. If you believe that Cigna-HealthSpring 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: Cigna-HealthSpring - Attention: Appeals, Complaints, and Grievances Department, P.O. Box , Bedford, Texas 76095, (TTY: 7-1-1), 7 days a week, 8 a.m. to 8 p.m. Central Time. Fax: You can file a grievance in writing by mail or fax. If you need help filing a grievance, Customer Service is available to help you. You can also file a civil rights complaint with the U.S. 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: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C , (TDD) Complaint forms are available at 6
10 Multi-language Interpreter Services Spanish - ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711). Chinese - 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (TTY 711) Tiếng Việt (Vietnamese) - CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (TTY: 711). Korean - 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 (TTY: 711) 번으로전화해주십시오 Tagalog - PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (TTY: 711) Russian - ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (телетайп: 711). Arabic - تنبيه: إذا كنت تتحدث اللغة العربية تتوافر لك خدمات املساعدة اللغوية مجان ا. اتصل عىل الرقم )لضعاف السمع 711(.1 French - ATTENTION: Si vous parlez français, des services d aide linguistique vous sont proposés gratuitement. Appelez le (ATS : 711). Polish - UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (TTY: 711). 7
11 Italian - ATTENZIONE: In caso la lingua parlata sia l italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (TTY: 711). German - ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (TTY: 711). Japanese - 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます (TTY: 711) まで お電話にてご連絡ください توجه: اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شام فراهم می باشد. - Farsi با :TTY) 711) تماس بگيريد. Hindi - ध य न द : अगर आप ह द ब लत त आपक ललए भ ष स यत स व ए नन:श ल क उपलब ध (TTY 711) पर क ल कर Gujarati - સ ચન : જ તમ ગ જર ત બ લત હ, ત નન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (TTY: 711). خربدار: اگر آپ اردو بولتے ہيں تو آپ کو زبان کی مدد کی خدمات مفت ميں دستياب ہيں کال - Urdu :TTY) (711 ک Lao - ເ ອາໃຈໃສ : ຖ າທ ານເ ວາພາສາລາວ, ານ ບ ລການໃຫ ຄວາມຊ ວຍເຫ ອດ ານພາສາຈະໃ ຫ ບ ລ ກ ານຟຣ ແກ ທ ານ. ໂທ: (TTY 711). Greek - ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε (TTY: 711).
12 You can get this information for free in Spanish or speak with someone about this information in other languages for free. Call (TTY: 7-1-1), 7 days a week, 8 a.m. to 8 p.m. Central Time. The call is free. Usted puede obtener gratuitamente esta información en español o hablar con alguien sobre esta información en otros idiomas, gratis. Llame al (TTY: 7-1-1), 7 días de la semana, de 8 a.m. a 8 p.m. hora del Centro. La llamada es gratuita. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations and restrictions may apply. For more information, call Cigna-HealthSpring CarePlan of Illinois Customer Service or read the Cigna-HealthSpring CarePlan of Illinois Member Handbook. Benefits may change on January 1 of each year. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including HealthSpring of Tennessee, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Cigna-HealthSpring CarePlan of Illinois is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees.
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