<First Name> <Last Name> <Street Address> <City>, <State> <Zip Code> Do you want to change your health insurance plan? Now is the time.
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1 <First Name> <Last Name> <Street Address> <City>, <State> <Zip Code> Do you want to change your health insurance plan? Now is the time.
2 Call us MA-ENROLL ( ) Dear <FIRST> <LAST>, Do you want to change your health insurance plan? Now is the time. Contact us from May 25th - June 25th to make a change that will take effect July 1, Our records show that you are a Commonwealth Care member. This mailing is your Open Enrollment packet. It shows the Commonwealth Care health plans that you can choose from, new monthly premium and copayment amounts and the steps to take to change your health insurance plan. Read this information carefully so that you can make the health plan choice that is best for you. If you live in an area where more than one health plan is available you can change your health plan for any reason. Depending on where you live, you may have a new health plan available to you and your monthly premium and copayment amounts may be changing. Details about these changes are in this packet. What do you need to know? The Open Enrollment period - the time that you can make a change - is from May 25, 2009 through June 25, If you change your health plan those changes will take effect July 1, What do you need to do? If you are happy with the health plan you have now, you do not need to do anything. You will stay enrolled with your current health plan. If you want to change your plan, review the information provided in this packet and call Commonwealth Care Customer Service or visit us online to make your selection. Your change must be made by June 25, 2009.
3 This packet contains: Health plans available to you. Where you live determines which health plans are available to you. Health benefits and copays. This chart lists your health benefits and how much you pay (copays) for each health visit or service. Tips for choosing a new health plan. Listed are some things to consider before making a health plan change. Open Enrollment instructions. You can change your health plan by calling the Customer Service Center or visiting us online at MAhealthconnector.org. If this is your first time using the website, follow the instructions provided. Health plan flyers. Each health plan that is available in your area has provided information about its plan and any special programs that may be offered. To learn more about Open Enrollment, visit Remember, you can change your health plan from May 25, 2009 through June 25, 2009 online or over the phone. Call Commonwealth Care Customer Service Monday - Friday, 8:00 a.m. to 5:00 p.m. at MA ENROLL ( ) TTY for people with total or partial hearing loss. Commonwealth Care is proud to be your connection to good health. Sincerely, Do you want to change your health insurance plan? Now is the time. Melissa A. Boudreault Director, Commonwealth Care Commonwealth Health Insurance Connector Authority Visit us online
4 1. Health plans available to you <FIRST> <LAST>, Our records show that as of April 2009, you are a Commonwealth Care Plan Type < # > member, currently enrolled in < health plan name> with a monthly premium of < $ amount>. If you want to stay in your current health plan, you do not need to do anything. You will stay enrolled with your current plan. The premiums (monthly costs) are based on your income and where you live. You may see a premium increase or decrease in your current health plan. While every health plan has the same medical services, each one has different extra services, such as programs for weight loss or diabetes management. Some offer telephone help lines or discounts at fitness centers. Review the health plan flyers to see which plans offer extra services you want or need. Your primary care provider may be available in more than one health plan. Choose from these health plans in your area. <Member RID>
5 2. Health benefits and copays Copayment amounts are the same for all health plans. Outpatient care Office visit to your primary care provider (PCP) Office visit to a specialist Radiology, imaging (x-rays), lab work Outpatient surgery at a hospital or ambulatory surgery center Abortion Inpatient care Hospital stay, may include surgery, x-rays, lab services, and room and board (copay is per stay) Emergency care Emergency room visit Prescription drugs 30 day supply from a pharmacy Generic drug Drug on your plan s preferred list Drug not on your plan s preferred list Alcohol, drug abuse and mental health care Outpatient or office visit Inpatient care (copay is per stay) Methadone maintenance (dosing, counseling, screens) Dental Check-ups/cleanings/fillings/X-rays/restorations Vision Eye exam every 24 months Free glasses every 24 months Diabetes care Office visit to PCP or podiatrist for routine foot care (may include foot orthotics) Visit to specialist (may include foot orthotics) Rehabilitation services Extended inpatient care (100 total days per year) In a skilled nursing facility In a rehabilitation hospital or chronic disease hospital (copay is per stay) Physical therapy, speech or hearing therapy, pulmonary or occupational therapy (need plan approval for more than 20 visits) Cardiac rehabilitation Home health care Maternity and family planning Outpatient office visit Other benefits Ambulance (emergency only) Prosthetics, oxygen and respiratory therapy equipment, other durable medical equipment Hospice Maximum copays Maximum amount a member will need to pay for all prescriptions in a benefit year * Maximum amount a member will need to pay for services excluding prescription drugs in a benefit year * * Your benefit year is from July 1, June 30, 2010.
6 3. Choosing a new health plan Choosing a health plan is an important decision. Consider these questions before making a decision. Consider Cost - Does your current health plan s premium increase or decrease on July 1? Are there other health plans available to you with a lower premium? Consider Providers - Which providers do you currently see? Make a list of the providers and hospitals you use now. (Remember to list specialists, therapists and counselors that you see.) Which of these providers do you want to continue to see? Are those providers available in other health plans? To find out if a provider is available within a plan, you can use the provider directory on our website or contact the health plan directly. Consider Hospitals Which hospitals are available? Consider Extra Services - What extra services do the plans offer?
7 4. Open Enrollment instructions There are two ways to make a choice - over the phone and online. * Over the phone: Call Commonwealth Care Customer Service Monday - Friday, 8:00 a.m. to 5:00 p.m. at MA ENROLL ( ) TTY for people with total or partial hearing loss. Online: Go to To change your health plan over the web you must first create an online account. How to create an account 1. Log on to 2. Click Register for access to your account 3. Complete all fields marked by a red asterisk (*) Note: your username and password are case sensitive 4. Click the Next button. After you register, you will see a confirmation message 5. Click Return to go back to the Connector homepage then Click Log-in to access your account information How to log in 1. From the Connector homepage, Click Log-in 2. Enter your username and password and Click Log-in 3. You will see My Home page where you can review your personal information 4. Click Account History, then Click Enroll / Change Plan 5. Follow the instructions on each page, when you are finished, Click Quit Remember, If you are happy with the health plan you have now, you do not need to do anything. You will stay enrolled with your current health plan. If you want to change your health plan, your change must be made by June 25, Any change you request will take place July 1, * If you are unable to call or go online, cut out the entire Step 1 page, make your selection and mail it to: Commonwealth Care Customer Service, P.O. Box , Boston MA DO NOT SEND PAYMENT with your health plan selection.
8 Quiere cambiar su plan de seguro médico? Ahora es el momento adecuado. (Spanish) etig~kcg pâas b èr KMeragFanaraÔb rgsuxpabrbs G~k ÉeT? ²LèvenHdl eblehiy. (Cambodian) 您希望更換健康保險計劃嗎? 現在正是時候 (T.CHI) 您希望更换健康保险计划吗? 现在正是时候 (S.CHI) Èske w vle chanje plan asirans medikal ou a? Se kounye a pou fè sa. (Haitian Creole) ທ ານຕ ອງການປ ຽນແຜນປະກ ນສ ຂະພາບຂອງທ ານບ? ດຽວນ ເຖ ງເວລາແລ ວ. (Lao) Você gostaria de mudar o seu plano do seguro de saúde? Agora é a hora. (Portuguese) Вы хотите изменить свой план медицинского страхования? Сейчас самое время. (Russian) Quý vị có muốn thay đổi chương trình bảo hiểm không? Bay giờ chính là thời điểm đó. (Vietnamese)
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