Quick start guide www.anthem.com/vamedicaid 1-800-901-0020 (TTY 711) AVA-MEM-0732-17
Welcome to the Anthem HealthKeepers Plus plan We re glad you chose us! This booklet will help you learn how to use your new health plan. For more details, be sure to read your member handbook. Contents Getting started 2 Your care 4 Emergencies 5 Programs and benefits 7 Reporting your changes 9 Renewing your benefits 12 Resources 13
Getting started with our plan Look for your Anthem HealthKeepers Plus member ID card in the mail. Keep the card with you you ll use it to get all your services: doctor visits, prescriptions, getting care in your home or emergency care. Didn t get your ID card? If it doesn t come in the mail on or before your first day as an Anthem HealthKeepers Plus member, call us at 1-800-901-0020 (TTY 711) Monday through Friday from 8 a.m. to 6 p.m. Eastern time. How do I find, change or verify my PCP? Go to the website at www.anthem.com/ vamedicaid. Click on Login or Register. When you log in, you can view your current PCP or change it right on the site. Use our Find a Doctor tool to search for another provider. You may also call Member Services at 1-800-901-0020 (TTY 711). Getting started with our plan Help us learn about you In your new member packet, you should have gotten a Health Assessment (HA). It s a short questionnaire that won t take more than 5 minutes. The HA will tell us more about your health and make sure you get the right health care for you. If you have questions or didn t get the HA, call 1-844-327-4301 (TTY 711). We ll help you fill out the HA over the phone Monday through Friday from 8:30 a.m. to 5 p.m. Eastern time. 2
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Getting your care Urgent care and after-hours care An urgent medical condition is not an emergency, but needs medical care within 24 hours. This isn t the same as an emergency. Call your PCP if your condition is urgent and you need medical help within 24 hours. Your PCP will tell you what to do. He or she may tell you to come into the office right away, go to an urgent care center, or go to the emergency room. Getting your care Your primary care provider (PCP) is listed on your ID card. This is your main doctor who will coordinate all your medical needs. He or she will be your first contact when you need care. If you want to change your PCP, log in to our website at www.anthem.com/vamedicaid. You can talk to a nurse seven days a week, 24 hours a day, even on holidays! If you can t reach your PCP, call the 24/7 NurseLine at 1-800-901-0020 (TTY 711). The nurse will help you: Find a doctor after hours or on the weekend Find an open urgent care center or walk-in clinic With your health care needs 4
Emergencies If not seeing a doctor right away could end in death or very serious bodily harm, it s an emergency. If you think the problem is so severe it may be life-threatening or cause serious damage, call 911 or go to the nearest hospital emergency room (ER). If you re not sure you re having an emergency, call our 24/7 NurseLine at 1-800-901-0020 (TTY 711). IS IT AN EMERGENCY? Go to the ER if you Have trouble breathing Are bleeding badly Are having chest pains Go to urgent care if you Have a cold or the flu Have a fever over 100.5 degrees Fahrenheit Have a muscle strain Reasons why you would not want to go to the ER if it s not an emergency: The waiting time can be very long The ER doesn t have your medical records ER doctors don t know you as well as your PCP Call your PCP as soon as you can after you visit the ER or urgent care center. Your PCP can help with your follow-up care. 5
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Programs and benefits To help keep you and your family healthy, you get many great benefits* like these: Visits with a PCP you select Access to specialist providers from a wide variety of medical specialties Prescription medications and no-cost over-the-counter medicines with a prescription Vision benefits 24/7 NurseLine with toll-free access to registered nurses And you get these extra benefits: A no-cost cell phone with no-cost monthly minutes, data and text messages Sports physicals (ages 19 and younger) New Baby, New Life SM program to help you have a healthy pregnancy, with services like toll-free access to a care manager to answer your questions and tools to help you and your doctor see possible risks Coupons with special discounts to local retailers For information on all benefits, go to www.anthem.com/vamedicaid *Benefits may change. 7
For questions or to find dental services for children enrolled in Medicaid or FAMIS, call Smiles For Children at 1-888-912-3456. The Smiles For Children (managed by DentaQuest) program encourages good dental health and recommends regular checkups with your child s dentist. There is no cost or copayments for dental care services for Medicaid members You should only use dental providers in the Smiles For Children network To get services, use your child s Commonwealth of Virginia (blue and white) plastic ID card or managed care organization member card each time you visit the dentist Programs and benefits For information on special supplemental nutrition for Women, Infants, and Children (WIC), call 1-888-942-3663. WIC helps improve the health of pregnant women, infants and children (under 5 years) through better nutrition and access to health care. It provides nutrition education, breastfeeding promotion and support, supplemental nutritious foods, counseling at WIC clinics, and screening and referrals to other health, welfare and social services. To be eligible for the WIC program, applicants must meet categorical, residential, income and nutrition risk requirements. Rides to routine doctor visits and drugstores for Medicaid members Call Southeastrans at 1-877-892-3988 (TTY 711) Go online to www.southeastrans.com, click on Member Resources, Virginia members and select Anthem HealthKeepers 8
Reporting your changes You ll need to let us know if there is a change in your status. If you have a baby, move to a new address or change jobs, we need to know so we can give you the right health care for you. Tell the state if your information changes. Have you moved? Changed jobs? Gotten a new phone number? Be sure to let the state know. Call Cover Virginia at 1-855-242-8282 (toll free), (TDD 1-888-221-1590) Monday through Friday from 8 a.m. to 7 p.m. and Saturday from 9 a.m. to 12 p.m. You can also go to the Cover Virginia website at www.coverva.org. Having a baby? Be sure to enroll your newborn. Call us at 1-844-327-4301 (TTY 711). We can complete required documents to submit to your local Department of Social Services for you. 9
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Renewing your benefits Renew your health care coverage every year so you don t lose your benefits. You ll get a reminder letter and form from the state before your renewal deadline. The renewal form should be returned to your local Department of Social Services. You can also renew by visiting www.coverva.org or calling Cover Virginia at 1-855-242-8282. Renewing your benefits What does the Department of Social Services need from me? Full legal name, date of birth, Social Security number, citizenship or immigration status for you and anyone in your household who is applying for health care coverage. Most recent federal tax filing information (if available). Job and income information for members of your household for the month prior or the current month. Having recent pay stubs or W-2s to reference may be helpful. Information about other taxable income for members of your household. Other taxable income could be unemployment benefits, Social Security benefits, pensions, retirement income, rental income and alimony. Policy numbers for any health insurance you have now. 12
Your Anthem HealthKeepers Plus resources Go to www.anthem.com/vamedicaid to: Change your PCP Update contact information with us (still call the state, too!) Find a doctor or specialist Read your member handbook Find information about benefits Print your ID card For questions about benefits or to change or verify your PCP, call Member Services at 1-800-901-0020 (TTY 711), Monday through Friday from 8 a.m. to 6 p.m. Eastern time. To talk to a nurse seven days a week, 24 hours a day, call the 24/7 NurseLine at 1-800-901-0020 (TTY 711). Important phone numbers To renew your benefits, call Cover Virginia at 1-855-242-8282 (TDD 1-888-221-1590). To set up a ride, call Southeastrans at 1-877-892-3988 (TTY 711) or go online to www.southeastrans.com. For supplemental nutrition information for Women, Infants, and Children (WIC), call 1-888-942-3663. For dental benefits for your child, call DentaQuest (Smiles For Children dental program) at 1-888-912-3456. 13
Your Anthem HealthKeepers Plus resources 14
www.anthem.com/vamedicaid HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Call toll free for translation or oral interpretation at no cost/llame a la línea gratuita para servicios de traducción o interpretación sin cargo: 1-800-901-0020 (Medallion Medicaid, FAMIS); TTY 711.