studies and hospice services). Keep your red, white, and blue Medicare card if applicable, in a safe place in case you need it later. this is so important: If you get covered services using your red, white, and blue Here’s why Medicare card instead of using your Provider Partners Pennsylvania Advantage (HMO SNP) membership card while you are a plan member, you may have to pay the full cost yourself. If your plan membership card is damaged, lost, or stolen, call Member Services right away and we will send you a new card. (Phone numbers for Member Services are printed on the back cover of this booklet.) Section 3.2 The Provider Directory: Your guide to all providers in the network plan’s The lists our network providers and durable medical equipment suppliers. Provider Directory What are “network providers”? Network providers are the doctors and other health care professionals, medical groups, durable medical equipment suppliers, hospitals, and other health care facilities that have an agreement with us to accept our payment and any plan cost-sharing as payment in full. We have arranged for these providers to deliver covered services to members in our plan. The most recent list of providers and suppliers is available on our website at www.pphealthplanpa.com. Why do you need to know which providers are part of our network? It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed services when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which Provider Partners Pennsylvania Advantage (HMO SNP) authorizes use of out-of-network providers. See Chapter 3 (Using for more specific the coverage for your medical services) plan’s information about emergency, out-of-network, and out-of-area coverage. If you have your copy of the you can request a copy from Member Provider Directory, don’t Services (phone numbers are printed on the back cover of this booklet). You may ask Member Services for more information about our network providers, including their qualifications. You can also see the at www.pphealthplanpa.com, or download it from this Provider Directory website. Both Member Services and the website can give you the most up-to-date information about changes in our network providers.
studies and hospice services). Keep your red, white, and blue Medicare card if applicable, in a safe place in case you need it later. Here’s why this is so important: If you get covered services using your red, white, and blue Medicare card instead of using your Provider Partners Pennsylvania Advantage (HMO SNP) membership card while you are a plan member, you may have to pay the full cost yourself. If your plan membership card is damaged, lost, or stolen, call Member Services right away and we will send you a new card. (Phone numbers for Member Services are printed on the back cover of this booklet.) Section 3.2 The Provider Directory: Your guide to all providers in the plan’s network The Provider Directory lists our network providers and durable medical equipment suppliers. What are “network providers”? Network providers are the doctors and other health care professionals, medical groups, durable medical equipment suppliers, hospitals, and other health care facilities that have an agreement with us to accept our payment and any plan cost-sharing as payment in full. We have arranged for these providers to deliver covered services to members in our plan. The most recent list of providers and suppliers is available on our website at www.pphealthplanpa.com. Why do you need to know which providers are part of our network? It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed services when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which Provider Partners Pennsylvania Advantage (HMO SNP) authorizes use of out-of-network providers. See Chapter 3 (Using the plan’s coverage for your medical services) for more specific information about emergency, out-of-network, and out-of-area coverage. If you don’t have your copy of the Provider Directory, you can request a copy from Member Services (phone numbers are printed on the back cover of this booklet). You may ask Member Services for more information about our network providers, including their qualifications. You can also see the Provider Directory at www.pphealthplanpa.com, or download it from this website. Both Member Services and the website can give you the most up-to-date information about changes in our network providers.
H4093_ISNP_HMO_NONPOS_Model_wRx_v2-PA_EOC.docx