IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 2. ILLINOIS Member Handbook Welcome. the plan. that gives your family. more.

Transcription

1 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 2 Welcome to the plan that gives your family more. ILLINOIS Member Handbook 2007 _07

2 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 1 YOUR PRIMARY CARE PHYSICIAN As soon as you receive your Harmony Health Plan membership ID card(s), be sure to make an appointment with the Primary Care Physician you have selected. Remember, you must contact your doctor to arrange all health care services needed by your family. Your Primary Care Physician: Name Phone Address City State Zip After Hours Phone Your Child s Primary Care Physician: Name Phone Address City State Zip After Hours Phone Women s Health Care Provider: Name Phone Address City State Zip After Hours Phone IMPORTANT! Always bring your Harmony membership ID card with you when you or your children visit the doctor! Page 1

3 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 2 WELCOME TO HARMONY HEALTH PLAN. We want to provide you and your family with the quality health care coverage and the personal respect you deserve. Harmony Health Plan has been designed for families who are in an Illinois Medical Assistance program. It gives you medical coverage that covers a wide range of care and services, yet costs you nothing. It s 24-hour coverage, with doctor s offices close to where you live. This Member Handbook contains valuable information about your health coverage. If you have additional questions about your coverage or benefits, just pick up the phone and give us a call! One of our Member Services representatives will be happy to help you. Member Services: , TTY When you have a question, any question, just pick up the phone! Table of Contents Important Phone Numbers and Language Services Top Harmony Member Questions Medical Services Your Primary Care Physician Other Health Care Providers Preventive Care Your Membership ID Card Other Information Your Rights & Responsibilities Harmony +10 Personal Care Items Page 2

4 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 3 IMPORTANT PHONE NUMBERS Harmony Member Services TTY for the Hearing Impaired Harmony Transportation Hotline Harmony Hugs Program INTERPRETIVE SERVICES Harmony also provides interpretive services to help you obtain medical services if you speak a language other than English or if you are hearing or vision impaired. For more information, please call Harmony Member Services at (TTY ). You may also request a copy of Harmony s translated or interpreted materials by calling Harmony will mail them to you. We can provide interpreters for most languages, including: Spanish Español Señale su idioma. Se llamará a un intérprete. Polish Ploski Prosze wskazac na swój jezyk ojczysty. Thumacz zostanie poproszony do telefonu. Vietnamese Tiéng Viêt Chi rõ tiéng ban nói. Se có môt thông dich viên nói chuyên voí ban ngay. Haitian Creole Kreyòl Ayisyen Montre lang ou-a. Yap voye chèche yon entèprèt. Arabic Mandarin Cantonese Page 3

5 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 4 TOP HARMONY MEMBER QUESTIONS 1. How can I change my Primary Care Physician/Women s Health Care Provider? Call Harmony Member Services at (TTY ), Monday Friday, 8am 5pm. 2. What should I do if I can t reach my Primary Care Physician? Call Harmony Member Services at (TTY ) and we will help you reach your doctor. 3. How can I get a prescription for my children or me? Use your Healthcare and Family Services (HFS) Medical Card to get your prescriptions. You can get your prescriptions from any pharmacy that takes that card. 4. What if I lose Harmony ID card? Call Harmony Member Services at (TTY ) and we will send a new ID card to you. 5. Who should I call if I move or my phone number changes? Call Harmony Member Services at (TTY ) so we can change your address and phone number. Then you will get all the information we send to you. 6. How can I schedule a ride to my doctor s appointment? Call for transportation at (TTY ) at least 48 hours in advance of your appointment. A ride will be scheduled for you. 7. How can I get my Harmony +10 Personal Care Items? It is easy to do. See page 15 and 16 of this handbook for instructions and the list of items. Page 4

6 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 5 MEDICAL SERVICES Here is a list of some of the medical services and benefits that are covered by Harmony Health Plan. For a complete listing of covered services, look in your Certificate of Coverage. Covered Hospital inpatient services Home health care services Physical therapy Speech and language therapy Laboratory and x-ray services Transportation Private duty nursing Emergency services Transplant services (non-experimental) Family planning services Contraceptive devices Durable and non-durable medical equipment and supplies Whole blood and blood products Physician services Hospital outpatient services Mental health services Preventive services Alcohol and substance abuse treatment services Early periodic screenings and diagnostic testing services Maternity care services Well child care services Health education Skilled nursing care Immunizations Hospice Not Covered Elective cosmetic surgery Custodial care services Elective abortions Covered by HFS Medical Card Optical Dental services Pharmacy Harmony Additional Benefits HFS pharmacy co-pays covered* No co-pay for doctor visits Additional dental services for adults* Harmony Hugs Harmony Healthy Kids Club Harmony +10 Personal Care items * At participating providers. Service, service, service! You can call Member Services any time you have a question 24 hours a day at (TTY ). Page 5

7 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 6 YOUR PRIMARY CARE PHYSICIAN Choose a Primary Care Physician (PCP) from among our network of doctors. As your personal doctor, he or she will help you arrange for all of the medical care you and your family need. You will find a listing of doctors to choose from in Harmony s Provider Directory. Changes are made to the Provider Directory on a continuing basis. To obtain an updated version of the Directory, contact Harmony s Member Services department at (TTY ). You can change your PCP any time. Just call Member Services for an up-to-date physician listing. Getting Medical Care Always call your PCP FIRST! That way, your doctor can prepare for your visit and you will spend less time waiting. Many times your doctor may be able to help you over the phone, saving you a trip to the office. You can call your PCP any time of the day or night, when immediate care is necessary. In the case of a severe or life-threatening emergency, call 911 or go directly to the nearest emergency room, then call your doctor as soon as possible. Remember always carry your Harmony Health Plan membership ID card in your wallet or purse. Seeing a Specialist You must see or contact your PCP first. Your PCP will arrange for you to see a specialist when you need one. If your PCP does not refer you to the specialist you want, you may choose a new PCP who has a referral arrangement with the specialist you want. If you see a specialist on a regular basis, you can request a standing referral. A standing referral would let you go to the specialist for as long as one year before you have to get another referral from your PCP. If you have any questions about a referral, call your PCP. You can also call Member Services at (TTY ). Hospitalization Your PCP will make all the arrangements for you to be admitted to a hospital when needed. He or she will see to it that you get the proper care you need. New Enrollee Transition of Care If you are in a treatment plan by a doctor who is not in Harmony s network, you can ask to keep seeing that doctor for up to 90 days after becoming a member of Harmony under the following conditions: You must keep seeing the same doctor regularly for treatment of a medical condition or disease. You are in your 7th, 8th or 9th month of pregnancy. You can ask to keep your doctor until after your baby is born and all follow up care is completed. Your doctor agrees to follow Harmony s rules and payment. You must make this request in writing. Call Member Services and they will help you. Harmony will respond in writing within 15 days with approval or, if denied with the specific reason. Appointments It is very important that you keep all appointments you make for doctor visits, lab tests or x-rays. Not showing up or getting there late makes it hard for your doctor to give you all of the time you might want and deserve. Please call your PCP at least one day ahead of time if you cannot keep a scheduled appointment. If you are having trouble scheduling an appointment, call Member Services at (TTY ). Prescriptions Your good health depends on good medicine. You must use your Harmony member ID card and your HFS Medical Card to get your prescriptions filled at participating pharmacies. There is no co-pay when you fill your prescription through a participating pharmacy. Please see the Harmony Web site or contact Member Services at (TTY ) to see if your pharmacy is participating. You will go through the Illinois Medical Assistance program when filing your prescription by mail order or other methods. Page 6

8 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 7 OTHER HEALTH CARE PROVIDERS It s Your Right Illinois law allows you to select a Women s Health Care Provider (WHCP) in addition to selecting a primary care physician. A WHCP is a physician licensed to practice medicine in all its branches, specializing in obstetrics or gynecology or in family practice. A WHCP may be seen for care without referrals from your PCP. If you have not already selected a WHCP, you may do so at any time. However, you are not required to select a WHCP. You may continue to see your PCP and be referred to an obstetrician/gynecologist when necessary. Your WHCP must be a part of Harmony s network of doctors. To obtain a list of participating obstetricians, gynecologists and family practice specialists, you should call our Member Services department at (TTY ). Behavioral Health Care Behavioral Health Care deals with health problems such as depression, anxiety, substance abuse and other mental health disorders. The Behavioral Health program can provide evaluation and counseling services. You can seek treatment without going through your Primary Care Physician. To self refer, call PsycHealth at This number is available 24 hours a day, 7 days a week. Page 7

9 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 8 PREVENTIVE CARE The whole idea behind Harmony Health Plan is good health. It s not just coverage for when you re sick. Your plan covers a wide range of preventive care services to help keep you and your family healthy all year long. Immunizations Harmony also covers immunizations, because one of the best ways to avoid many diseases is by protecting your child and you against them early. Here are the immunizations that every child should have: Ages DTaP 2, 4, 6, months and once between the ages of 4 and 6. IPV 2, 4, 6 18 months and once between the ages of 4 and 6. VZV HIB months and between the ages of 11 and 12 if no previous vaccine or history of chicken pox. 2, 4, 6 and months. MMR months and once between the ages of 4 and 6. Hepatitis B PCV Influenza (Option 1) Birth, 1 2 months and 6 18 months. (Option 2) 1 2 months, 4 months and 6 18 months. (Pneumococcal vaccine) 2, 4, 6 and months. 6 months and older with certain risk factors (consult your child s PCP). Checkups and Physicals A physical is one way for your doctor to find health problems at an early stage. Harmony Health Plan covers physicals and checkups so you can take care of many minor health concerns early, before they develop into something more serious. This could save you from missing work or even spending time in the hospital. Mammograms Early detection of breast cancer offers an excellent recovery rate. Every woman over age 35 may have a baseline mammogram. Women age 40 or older may have a mammogram every year or earlier if you, or someone in your family, has had breast cancer. Pap Smears Pap smears are also covered by your plan. We encourage every woman to have a Pap smear and a gynecological exam once a year. Prenatal Visits When you are pregnant you need to visit your doctor. The number of visits change during pregnancy. From months one to six: one visit a month. From months seven to eight: two visits a month. Month nine: one visit a week. Remember that the use of alcohol, tobacco and illicit drugs may lead to low birth weight babies and birth defects. Page 8

10 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 9 PREVENTIVE CARE (Continued) Prenatal Program Prenatal care is important because it helps to give your new baby a healthy start to life. Our Harmony Hugs program includes all doctor visits, tests, x-rays and ultrasounds needed before your baby is born. It also includes your personal Harmony nurse who will: Contact you throughout your pregnancy Provide a health screening over the phone to determine if the pregnancy is high risk Assist you with getting OB (obstetric) appointments Arrange transportation services for your doctor visits, if needed Send you health education material regarding your pregnancy and baby care Send you a gift for having your baby within the Harmony program Call Harmony at l (TTY l ) as soon as you find out you are pregnant. You Should Know: During your 9th month of pregnancy you should stay close to your doctor and the hospital where you will have your baby. If you need to go out of town, check with your doctor to make sure it is safe to leave. If your doctor tells you to stay in town and you ignore this advice and have your baby out of town, your medical bills may not be covered. Page 9

11 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 10 YOUR MEMBERSHIP ID CARD Your Harmony Health Plan membership ID card is one of the most important cards you can carry. It is your personal proof that you are entitled to the care and services offered by Harmony and our participating network of doctors and hospitals. Always Carry Your Card! Always carry your Harmony Health Plan membership ID card with you. You will need your card when you seek medical care. It has your PCP s name and phone number on the front and an emergency phone number on the back. You will receive a membership card for each member of your family. Your card is for your use only. Should you have a baby, please call us so that we can help you enroll your child in Harmony as soon as possible. This will help you take advantage of all that Harmony has to offer you and your family. Replacement Cards If you should lose or misplace your Harmony membership ID card, simply call our Member Services department at (TTY ). We will send you a new card immediately. Eligibility Your Harmony membership and your membership ID card are good as long as you are in an Illinois Medical Assistance program and remain a member of Harmony Health Plan. Emergency Care In the case of an emergency, call 911. Call an ambulance if no 911 service is available in your area, or go immediately to the nearest hospital emergency room. Emergency medical condition means a medical condition manifesting itself by acute symptoms of sufficient severity (including, but not limited to, severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in: placing the health of the individual (or, with respect to a pregnant women, the health of the woman or her unborn child) in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part. Some examples of emergency conditions are: Heart attacks Severe bleeding Poisoning Strokes Unconsciousness Significant difficulty in breathing Broken bones Either you, a family member or a friend must call your PCP within 24 hours of receiving emergency treatment. Remember, for an emergency visit to be covered, the visit must be for a medical condition that a reasonable person would consider to be an emergency, or for any covered service authorized by your PCP. If you are admitted to a non-plan hospital through the emergency room, you may be transferred to a Harmony network hospital when it is medically safe to do so. Urgent care includes conditions that require immediate medical attention, but are not life-threatening. Examples include minor cuts and lacerations, viral infections, etc. If you need urgent care, call your doctor first, or call Harmony s Member Services department at Out of Town Care In the case of a severe or life-threatening emergency, your coverage travels with you, even out of town. Harmony Health Plan will pay for any doctor or hospital you need to use as long as the services were for emergency care. Page 10

12 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 11 OTHER INFORMATION Eligibility You will remain eligible for membership in the Harmony Health Plan as long as you are in an Illinois Medical Assistance program unless you decide to disenroll. You may disenroll by calling our Member Services department at You will forwarded to the Client Enrollment Broker to make another health care choice. Disenrollment usually takes about 4 to 6 weeks. You may also lose your membership if: You move out of the service area Harmony Health Plan stops covering the Illinois Medical Assistance program You let someone else use your membership card You no longer have coverage from the Illinois Medical Assistance program Medical Records You may need to sign a release form to have your medical records sent to a doctor. There is no charge for you to transfer medical records. Member Services If you need help understanding any of the benefits, services or coverage of Harmony Health Plan, simply call our Member Services department at (TTY ). We re here to help you get the most out of your health plan. Advance Directives Your doctor or the hospital, by law, has to ask all patients if they have made what is called an advance directive. This is a paper which tells the doctor and hospital what type of medical services (such as being on a respirator or being fed with tubes or restarting your heart if it stops beating) you want to receive, or do not want to receive, if you are so sick that you will not get better. Advance directives can state your wishes to donate specific organs or your entire body. This is sometimes called a Living Will. You can say what you want, or you can name a person to make those decisions for you if you are not able to make them for yourself. This is called Durable Power of Attorney for Health Care Decisions. If you decide to have an advance directive, you should provide a copy to your PCP and to Harmony. If you are hospitalized, Harmony will give the information to the hospital. To get a copy of the advance directive form, contact your local hospital. Bills You pay nothing for covered medical services as long as your PCP referred you for the care. If you decide to use a doctor, hospital or other medical provider without a referral from your PCP, these services may not be covered. Neither Harmony nor the Illinois Department of Healthcare and Family Services will be responsible for these changes. The exception is when you need care for a severe or life-threatening emergency (as discussed under Emergency Care ). If you receive a bill in error, please send it to the Harmony Health Plan Claims Department or call Member Services at (TTY ). Page 11

13 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 12 OTHER INFORMATION (Continued) Health Care Service Appeals Harmony members who disagree with a decision or an action made by Harmony about medical services, such as the denial of coverage for a treatment or service may appeal a decision within 30 days of receipt of notice. Your request should be made in writing unless your situation requires an urgent decision. Your designee, authorized in writing (such as your guardian, your PCP, or your health care provider), may also request an appeal. Non-urgent Situation If your situation is NOT urgent, submit a written request for an appeal to: Member Services Department Harmony Health Plan of Illinois, Inc. P.O. Box Tampa, FL Within 3 business days of receiving your request, Harmony will notify you of all the information that is required to process your appeal. Harmony will make a decision within 15 business days of receiving the requested information and notify you and the provider orally and in writing within 5 business days of the decision. Urgent Situation If your situation is URGENT, call Harmony s Member Services department at (TTY ) to request an urgent appeal. Harmony will notify you within 24 hours if additional information is needed to decide your urgent appeal. Harmony will make a decision within 24 hours after receiving all the required information, and will notify you and the provider orally and in writing of the decision. External Independent Review If your appeal for medical services is denied, you can request an external independent review. You have the right to participate in the process for selecting an independent external review organization. Non-urgent Situation If your situation is NOT urgent, send a written request for an external independent review within 30 days of receiving the appeal denial to: Member Services Department Harmony Health Plan of Illinois, Inc. P.O. Box Tampa, FL If the situation is not urgent, Harmony will tell you of the decision within 5 days after receiving all the information necessary to make a decision. Urgent Situation If your situation is URGENT, you can request an external independent review by calling Harmony s Member Services department at (TTY ). If the situation is urgent, Harmony will tell you of the decision within 24 hours after receiving all the requested information. Page 12

14 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 13 OTHER INFORMATION (Continued) Complaints If you are not satisfied with your doctor or anything about Harmony Health Plan, you have the right to complain to Harmony. You can make your complaint on the phone, in person, or in writing. You can also complain if you think you have been treated badly, denied services or discriminated against in any way. Please call Harmony s Member Services department at (TTY ) to express your complaint or write to: Member Services Department Harmony Health Plan of Illinois, Inc. P.O. Box Tampa, FL Grievance Procedures If you are not satisfied with Harmony s resolution of your complaint, you may file a grievance. You may obtain the grievance form by contacting Harmony s Member Services department at (TTY ). Grievances must be in writing. Grievances must be submitted within one year of the occurrence. Harmony will notify you within 5 days of receipt of the grievance. You will be given a formal hearing before Harmony s Grievance Committee. You may bring a person of your choice to the hearing, including an attorney. The Grievance Committee must give you a decision in writing within 30 days after the receipt of your grievance. If you are not satisfied with the resolution, you may appeal to the Illinois Department of Healthcare and Family Services at the address below. The resolution by the Department is final. Illinois Department of Healthcare and Family Services Bureau of Contract Management Prescott E. Bloom Building 201 S. Grand Avenue East Springfield, IL Page 13

15 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 14 YOUR RIGHTS AND RESPONSIBILITIES Your Rights As a member of Harmony Health Plan you have the following rights: To be treated with respect and courtesy by your PCP, all office staff members and staff members of Harmony Health Plan. To choose your own doctor within the Harmony Health Plan network. To be told about your treatment plan, before treatment begins. To receive care consistent with sound nursing and medical practices. To refuse treatment to the extent of the law and to be told of the outcome. To voice concerns or complaints about the program and receive prompt answers. To request information relating to Harmony s Physician Incentive Plan. To request a description of the financial relationships between Harmony and any health care provider. You can also ask for the percentage of total premiums spent on health care related expenses and the percentage of total premiums spent on other expenses, including administrative expenses. You have the right to request the following information from Harmony s participating health care providers: Copy of the total bill for services you received from your health care provider. Educational background, experience, training, specialty and board certification. The names of the licensed facilities in Harmony s network where the health care provider presently has privileges for the treatment, illness, or procedure you are inquiring about. Information about the health care provider s participation in continuing education programs. Compliance with licensure, certification or registration requirements. Your Responsibilities As a member of Harmony Health Plan you have the following responsibilities: To treat your PCP and office staff with courtesy and respect. To fully inform your doctor about your medical problems. To decide about having a medical treatment or procedure before it begins. To help your PCP obtain your medical records. To not seek care from a specialist, unless referred by your PCP. To not seek care in an emergency room for conditions that are not life-threatening without contacting your PCP. To keep all scheduled appointments and be on time. To follow the rules and regulations of Harmony Health Plan. Page 14

16 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 15 HARMONY +10 PERSONAL CARE ITEMS Personal care items are products, grouped by medical use, which you can have delivered to your home. (Products will be available in generic equivalency and the list is subject to additions and deletions.) Every month you simply review the list and identify the items you desire (you can select up to $10 in products). To place your order, call toll-free, weekdays (TTY ). Within 10 business days, your order will be processed and shipped directly to you. Any unused portion of your allowance does not carry over to your next order. ITEM BRAND DESCRIPTION GENERIC COMPARABLE PRICE Analgesics 1 Advil Tabs Ibuprofen 200mg FC Tabs Aleve Caplets Naproxen Sodium 220g Caplets Bayer Aspirin Aspirin 325mg Ct Tabs Bayer EC Aspirin (Adult Regimen) Aspirin EC 81mg Tabs Ecotrin Max-Strength Tabs EC Aspirin Max St Tabs Tylenol Ex-Strength Caplets Acetaminophen Ex-St Caplets Bengay Muscle Rub 5.00 Antacids 10 Mylanta Gas 80mg Anti-Gas 80mg Tabs Tums Tabs Antacid Chw Tabs Zantac Tabs Ranitidine Hcl 75mg Tabs 8.00 Anti-Diarrheals 13 Imodium Caplets Anti-Diarrheal 2mg Caplets Pepto-Bismol Liquid Pink Bismuth Liq 4.00 Anti-Fungals 15 Gyne-Lotrimin Cream Clotrimazole Vag 1% Crm 1 App Tinactin Cream Tolnaftate 1% Crm 5.00 Anti-Hemorrhoidals 17 Anusol Ointment Anusert Hcl Ointment Preparation H Oint Prompt Relief Hem Ointment 7.00 Children s Products 19 Orajel Baby Orajel Baby Balmex Oint Diaper Rash Ointment Mylicon Drops Gas Relief Drops Poly-Vi-Sol Drops Baby Vit Drops Motrin Suspension for Children Children s Ibuprofen Suspension Tylenol Children s Grape Elixir Acetaminophen Child s Grape Elx Tylenol Child s Chew Tabs Acetaminophen Chew Tabs Tylenol Infant Drops Acetaminophen Ped Drp Alc Free 5.00 Cough/Cold 28 Benadryl Tablets Diphenhydramine 25mg Caps Benadryl Elixir Diphenhydramine Liq Alc Free Chloraseptic Throat Lozenges - Cherry Vicks VapoRub Medicated Chest Rub Robitussin Syrup Guiatuss Syr Afrin Nasal Spray Nasal Decongestant Spr Claritin Loratadine 10mg Tabs 7.00 Page 15

17 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 16 HARMONY +10 PERSONAL CARE ITEMS (Continued) ITEM BRAND DESCRIPTION GENERIC COMPARABLE PRICE Eye Care 36 Visine Drops Sterile Eye Drops Irritation Relief 3.00 First Aid Creams, Ointments and Antiseptics 39 Calamine Lotion Calamine Lotion Cortaid Cream Hydrocortisone 1% Max-St Crm Neosporin Ointment Triple Antibiotic Ointment 5.00 First Aid Supplies 43 Cotton Balls Cotton Balls Ace Bandage Athletic Bandage Adhesive Tape Adhesive Tape 1" X 5 Yds Band-Aids Band-Aids Assorted Butterfly Closures Med Butterfly Closures Med Ear Wax Removal Ear Wax Removal J&J Gauze Stretch Gauze Bandage 2" X 5 Yds Cotton Swabs Cotton Swabs Oral Thermometer Oral Thermometer Alcohol Swabs Alcohol Swabs Ice Bag 9" Ice Bag 8.00 Laxatives 53 Colace Softgels Dos 100mg Sg Caps Dulcolax Supp Reliable Gentle Lax Supp Dulcolax Tabs Reliable Gentle Lax Tabs Glycerin Suppositories Children Glycerin Child s Supp 3.00 Pediculicides 58 Rid Extra Strength Shampoo Lice Treat Max Str Shampoo 7.00 Vitamins & Minerals 59 B-Complex w/b-12 Tabs B-Complex w/b-12 Tabs Caltrate 600 Tabs Calcarb 600 Tabs Centrum Tabs Certagen Tabs Flintstones Fruity Chew Tabs (NF) Stuart Prenatal Tabs Prenatal-S Tabs Vitamin C Tabs C Chew 500mg Tabs Vitamin E Softgels E DL Alpha 400 IU SG Caps Vitamin A 10,000 IU Vitamin A 10,000 IU 4.00 Family Planning 72 Condoms Condoms 3.00 Misc Items 73 Pill Box Pill Box Toothbrush Toothbrush Toothpaste Toothpaste Waxed Dental Floss Waxed Dental Floss Anbesol Anbesol 8.00 Page 16

18 IL03281_CAD_MHB_ENG_IL_05_07 9/26/07 4:15 PM Page 1 The time is right to put Harmony in your life. If you have any questions about information contained in this handbook, please call us. Member Services: (TTY ) IL03281_CAD_MHB_ENG WellCare 2007 IL_05_07