Finding Coverage information
The law recognizes advance directives as they relate to health care that’s provided to a patient who is unable to make decisions because of illness or injury. Examples include someone who has suffered brain damage and is in a coma; a patient with advanced Alzheimer’s disease; or a person in the final stages of cancer. Creating an advance directive helps protect your right to make choices about your medical care. It also helps your physician and family by providing guidelines for care. Your health care coverage from Prevea360 Health Plan doesn’t require you to create an advance directive. We’re simply letting you know you have the option to do so, as required by law. For more information about advance directives, contact your state’s agency on aging or visit their website. Women’s Health and Cancer Rights Act: Coverage after a mastectomy The Women’s Health and Cancer Rights Act requires health insurers and group health plans that cover mastectomies to provide certain benefits if a member chooses reconstructive surgery after a mastectomy. The law also requires health plans to provide members with written notice that this coverage is available. Refer to your member account at Prevea360.com/Login to see how your plan covers the following: • Reconstruction of the breast on which the mastectomy was performed. • Surgery and reconstruction of the other breast to produce a balanced look. • The cost of prosthesis and the treatment of any physical complications resulting from mastectomy. This includes treatment of lymphedema (swelling sometimes caused by surgery). Some members may have to pay a deductible, copayment, or coinsurance. The amount will be consistent with the deductibles, copayments, or coinsurance for other benefits in your plan. To determine the amount you would have to pay, see your coverage document available on your member account at Prevea360.com/Login . Have questions? We’re here to help. Call Member Services at the number on the back of your Prevea360 Health Plan ID card (TTY: 711) or find answers to commonly asked questions in your member account at Prevea360.com/Login .
You can find important information about your health care coverage in your coverage document. It describes what your plan covers, what your share of the costs will be when you get care, and other details about your plan. Member account If you haven’t checked out your Prevea360 Health Plan account, now’s the time! It’s your digital one-stop resource for all kinds of information to help you manage your health plan benefits, and improve your health. Go to Prevea360.com/Login and follow the instructions to create your account. Manage your health plan online Did you know you can find your coverage document, and other helpful information in your member account? Just sign into Prevea360.com/ Login . You can view, print, or download a copy of your current coverage document. Want your coverage document mailed to you free of charge? Order a copy through your member account or call Member Services at the number on the back of your Prevea360 Health Plan ID card. Find forms and more online Check out your member account to find out more about how to manage your plan, get claim forms, and learn about notices we’re required by Federal and State law to provide to our members, such as: • Your rights as a Prevea360 Health Plan member
• Coverage for services after a mastectomy • How to document your health care wishes Your health care rights: What you need to know Advance directives: Making your wishes known
The Patient Self-Determination Act of 1990 requires health plans to tell members about their health care decision- making rights. These rights allow you to create written instructions that tell doctors and family members what kind of care you want if you’re too sick to make health care decisions yourself. This type of document is called an advance directive. Your instructions are written and witnessed in advance of the possible need for them.
Visit Prevea360.com to find information on your benefits | 31
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