Healthy Start/Healthy Families

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Heather Claire Gallagher
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1 Welcome Home! Healthy Start/Healthy Families

2 Choose Anthem for Great Health Care Close to Home More Services at No Cost or Low Cost You can now choose Anthem Blue Cross Blue Shield Partnership Plan, Inc. (Anthem) as your new Ohio Healthy Start/Healthy Families Medicaid plan. With Anthem, you keep the same Medicaid coverage you have now: Medical coverage, including dental, vision, and mental health Many doctors to choose from, AND changing doctors is easy Prescribed drugs A special program for pregnant women Well-Child visits and vaccines Plus, We Are Nearby to Help You Drop by our Community Resource Center. Or you can call us toll-free at (866) ; TTY (800) Our friendly staff will: Help you in your language Find a doctor who speaks your language Help you fill out forms Connect you to other services and free health classes in your area Arrange to visit you if you request We Provide Help in Many Ways Along with our local Community Resource Centers and phone support, Anthem offers: A 24-hour nurse help line to answer health questions, plus special nurses trained to talk to teens Local classes and programs about healthy living Kits to teach kids how to eat well and stay active A gift and booklet to help you if you are pregnant It s Easy to Join Anthem For more information about Anthem, call us at (866) ; TTY (800) We can help you learn more about the Anthem Healthy Start/Healthy Families Medicaid plan, and help answer any questions you have about Medicaid. Call Automated Health Systems toll-free at (800) ; TTY (800) You can choose Anthem if it is available in your region. Questions? Please call us at (866) ; TTY (800) All calls are free. Fast Answers About Our Health Plan The following provides answers to many common questions about the Anthem Healthy Start/Healthy Families health plan. For more details and/or a provider directory, please call toll-free (866) ; TTY (800) Who can become a member of the Anthem Healthy Start/Healthy Families health plan? Anthem Blue Cross Blue Shield Partnership Plan, Inc. is an MCP that Covered Families and Children Medicaid consumers, including Healthy Start and Healthy Families, can choose to join. You may choose to join Anthem if your family qualifies for Ohio Medicaid Healthy Start/Healthy Families, and if Anthem is available in your region.

With Anthem, you keep the same Medicaid coverage you have now: Medical coverage, including dental, vision, and mental health Many doctors to choose from, AND changing doctors is easy Prescribed drugs

3 Call Automated Health Systems at (800) or TTY (800) to learn more about the MCP in your county and for help in selecting an MCP. Will I still receive Medicaid-covered services? As a member of Anthem, you will still be able to get all medically necessary Medicaid-covered services, including Healthchek (EPSDT). You will also be able to get the Ohio Medicaid Healthy Start/Healthy Families services that Anthem offers. You may call (866) ; TTY (800) for more details. Will I lose my other benefits by selecting Anthem as my health plan? Joining an MCP will not cause you to lose your Medicaid, WIC, or other public assistance benefits. Joining Anthem is voluntary. It s your choice. Can I get help in other languages? Anthem offers free services to meet your language and cultural needs and to give you access to quality care. Call Member Services toll-free at (866) ; TTY (800) , for help with the following: 24-hour telephone interpreter services Staff able to speak your language Sign language and face-to-face interpreter services Providers who speak your language Health education materials translated into different languages How do I use my Anthem Identification (ID) card? When you join Anthem you will get an Anthem ID card. This card replaces your monthly Medicaid card and should be kept with you at all times. You must present this card when visiting the doctor or hospital, or when you get drugs from the pharmacy. How do I choose a doctor? Each person who joins the Anthem health plan must choose a primary care physician (PCP) from Anthem s provider directory. Your PCP is your personal doctor and will provide your care or send you to other doctors (specialists) if needed. You can ask to change your PCP to another Anthem health plan doctor at any time. To change your PCP, you must first call Anthem Member Services at (866) ; TTY (800) When must I use an Anthem provider? When you join Anthem, you must receive all medically necessary health care services from Anthem facilities and/or providers. The only time you can use providers not with Anthem is for emergency care or for services provided at federally qualified health centers/rural health clinics, family planning providers listed in your provider directory, community mental health centers, and Ohio Department of Alcohol and Drug Addiction Services facilities which are Medicaid providers. Additionally, you can receive care from certified nurse midwives and certified nurse practitioners in your county who are not contracted with Anthem. Anthem will give you a provider directory that will list all of our providers as well as other providers that you can see. What are emergency services? Emergency services are services for a medical problem that you think is so serious that it must be treated right away by a doctor. We cover care for emergencies both in and out of the county where you live. If you have an emergency, you can call 911 or go to the nearest emergency room or other appropriate setting.

You will also be able to get the Ohio Medicaid Healthy Start/Healthy Families services that Anthem offers. You may call (866)-464-9953; TTY (800) 750-0750 for more details.

4 Some examples of when emergency services are needed can include miscarriage or pregnancy with vaginal bleeding; broken bones; chest pain; severe burns; drug overdose; paralysis or sudden weakness or numbness of the face, arm, or leg on one side of the body; difficulty breathing; or shortness of breath. If you are not sure whether you need to go to the emergency room, you can call your primary care physician (PCP), or a nurse from Anthem s 24-hour nurse help line at (866) ; TTY (800) Your PCP, or a nurse from the help line, can talk to you about your medical problem and give you advice on what you should do. open selection month for your area. ODJFS will send you something in the mail to let you know when your open selection month will be. You may ask to end your Anthem membership for certain reasons. Some people do not have to receive their health care through an MCP. ODJFS will give you more information about this. Also, if there is something special about the care you need or how to get the care that your MCP is not able to provide, you can ask to end your Anthem membership. You can ask to end your Anthem membership for these reasons at any time. If ODJFS decides that you do meet one of these reasons, it will end your Anthem membership. How can I get more information or join an MCP? If you want more information about the MCPs in your area, or if you want to join an MCP, you can call toll-free (800) ; TTY (800) , and staff will be happy to help you. If you must join an MCP to receive your health care services, the Ohio Department of Job and Family Services (ODJFS) will send you a letter. It is important that you read the letter and choose an MCP by the date given on the letter. If you do not choose an MCP by the date given, ODJFS will choose an MCP for you. Remember, you can call (800) ; TTY (800) , for more information about the MCPs you can join or for help in selecting an MCP. Can I change or end my MCP? When you join an MCP, you have the right to change to another MCP at certain times. You can change during the first three months of your membership or during the How can I learn more about Anthem? If you have any problem reading or understanding this brochure or other Anthem information, please contact us at (866) ; TTY (800) , for help at no cost to you. We can help to explain the information or provide the information orally, in English or in your primary language. We may have the information printed in certain other languages or in other ways. If you are visually or hearing-impaired, special help can be provided. We hope this information has answered some of your questions about Anthem. However, we know that this brochure gives you only some of the important information you need to choose a health plan. You can contact Anthem to get more information, including a list of the providers that belong to Anthem, how we pay our providers, or answers to any other questions you have, before you make a choice. If you would like more information, please contact Anthem at (866) ; TTY (800) We will be happy to help you. You can also learn more about us from our website at

If you are not sure whether you need to go to the emergency room, you can call your primary care physician (PCP), or a nurse from Anthem s 24-hour nurse help line at (866) 374-9480; TTY (800)

5 Welcome to a New Choice for Healthy Start/ Healthy Families Members! Call us today at (866) Those with hearing loss may call the TTY line at (800) In Ohio, Anthem Blue Cross Blue Shield Partnership Plan, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. Registered marks Blue Cross and Blue Shield Association OH W 8/06

Those with hearing loss may call the TTY line at (800) 750-0750.

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