2020 medicare advantage member guidebookmyhfhp.org/health_plans/medicare/member_resources/... ·...

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Providing you with the best health plan possible 2020 Medicare Advantage Member Guidebook Helpful contact information and online resources This guidebook contains valuable information about your health plan, and we hope you will use it as a resource through 2020. If you have any questions or need assistance, please contact Customer Service. By phone Contact Customer Service 321.408.5289 (TDD/TTY relay: 1.800.955.8771) Hours: Weekdays, 8 a.m. to 8 p.m., and Saturdays from 8 a.m. to noon. From October 1 to March 31, we’re available seven days a week from 8 a.m. to 8 p.m. Online Visit our website at: myHFHP.org Please see instruction inside on how to access our secure online member portal. In person Walk-in service hours are Monday through Friday, from 8 a.m. to 5 p.m., no appointment needed. 6450 U.S. Highway 1 Rockledge, FL 32955

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Page 1: 2020 Medicare Advantage Member Guidebookmyhfhp.org/health_plans/medicare/member_resources/... · Helpful contact information and online resources This guidebook contains valuable

Providing you with the best health plan possible

2020 Medicare Advantage Member Guidebook

Helpful contact information and online resources This guidebook contains valuable information about your health plan, and we hope you will use it as a resource through 2020. If you have any questions or need assistance, please contact Customer Service.

By phone Contact Customer Service 321.408.5289 (TDD/TTY relay: 1.800.955.8771) Hours: Weekdays, 8 a.m. to 8 p.m., and Saturdays from 8 a.m. to noon. From October 1 to March 31, we’re available seven days a week from 8 a.m. to 8 p.m.

Online Visit our website at: myHFHP.org Please see instruction inside on how to access our secure online member portal.

In person Walk-in service hours are Monday through Friday, from 8 a.m. to 5 p.m., no appointment needed.

6450 U.S. Highway 1 Rockledge, FL 32955

Page 2: 2020 Medicare Advantage Member Guidebookmyhfhp.org/health_plans/medicare/member_resources/... · Helpful contact information and online resources This guidebook contains valuable

At a Glance Thank you for choosing Health First Health Plans. To help provide you with the best health plan possible, this packet includes:

Plan Information How to request an ID card, pay your premiums, check claim statuses and more

Wellness Fitness benefit information and how to earn a $50 gift card for completing a Comprehensive Health Assessment (CHA)

Access to Care Information about telehealth, virtual clinic and urgent care centers

Your Network A map of hospital locations, as well as our urgent care and emergency facilities

Pharmacy Benefits A list of affordable and effective medications, to give you the best drug plan possible

You will receive information about additional services throughout the year, which will be color coded to match the categories above. Please keep this booklet, add new pieces to it as you go and contact Customer Service if you need any support. All contact information is listed on the inside front pocket of this guidebook.

Plan Information

Quick Tips Guide How to Begin Enjoying Your Health Benefits Please follow these four easy steps to get the most out of your new benefits.

Step 1: Register at myHFHP.org/login where you are able to print your ID card, see plan benefit details and more.

Step 2: View the Provider Directory to select a primary care physician (PCP) and schedule an annual wellness visit.

$50gift card

Step 3: Review the Drug List (Formulary) to be sure your current medications are covered.

Step 4: Schedule your annual Comprehensive Health Assessment (CHA) by calling 321.615.9427 to discuss all your health concerns, medications and recent treatments — and earn a $50 gift card.

If you have any questions, please call Customer Service at 321.408.5289 (TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we’re available seven days a week from 8 a.m. to 8 p.m.

Page 3: 2020 Medicare Advantage Member Guidebookmyhfhp.org/health_plans/medicare/member_resources/... · Helpful contact information and online resources This guidebook contains valuable

Plan Information

Online Member Self-Service Portal The online portal provides easy access to your plan information, go to myHFHP.org, select “Log In” near the top of the page, then click “Member.” Once you are logged in, click the tabs across the top of the screen to navigate through the various options:

Find a participating doctor or facility

■ Check your plan benefits: copayments,coinsurance, deductibles and out-of-pocketmaximum

■ Find your drug costs

■ Request an ID card

■ Print a temporary ID card

■ Pay your premium

■ Check the status of a medical or pharmacy claim

■ Request reimbursement

■ Access Healthy Living resources andour approach for improving the qualityof our health plan

■ View your Member Rights and Responsibilities, Limitations, Exclusions and Notice of Privacy Practices*

*Members can request a mailed copy by calling Customer Service at 321.408.5289 (TTY/TDD relay: 1.800.955.8771).

Wellness

Coming Soon Health First Health Plans is launching CaféWell®, a personalized health and wellness program that rewards you for completing healthy actions. Enjoy free, unlimited access to CaféWell® starting in 2020.

How will CaféWell® work?■ Log in to the Health First Health Plans secure member portal.■ Complete healthy programs to earn points.■ Redeem points for gift cards in the Marketplace.

CaféWell® information coming soon!

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Access to Care

When You Need Care, We Have Options

Nurse 24™

No cost to you

Speak with a registered nurse

for care advice and questions about medications and non-emergency

symptoms

■ Ailments andconditions■ Treatment

options■ Prescription drugs

Nurse24™ will not prescribe treatment or medications.

No Appointment Needed

Call 1.800.308.5848 24 hours a day,

seven days a week.

Primary Care Physician (PCP)

No cost to you

Prevent illnesses, determine the likely source of a problemand coordinate care

with specialists

■ Annual wellness visit■ Persistent

symptoms■ Chronic conditions■ Medication

management■ Allergies■ Mild cold■ Ear pain■ Insect bites or

rashes■ Immunizations

Appointment Needed

Visit myHFHP.org/ directory or call

Customer Service to find a PCP near you.

Walk-in Clinic

$ Same-day care with a Primary Care Physician

■ Cold and flusymptoms■ Rashes■ Allergies■ Upper

respiratoryinfections■ Urinary tract

infections■ Ear pain■ Vomiting or

diarrhea

Cost share applies

No Appointment Needed

Visit myHFHP.org/

directory or call Customer Service to find a walk-in clinic near you.

Virtual Clinic

$$ Convenient care for urgent but simple medical issues for those

out of the area or unable to visit an

urgent care

■ Allergies■ Cold and flu■ Ear infection■ Insect bites■ Rashes

$0 Primary Care

Urgent Care and Specialist

copays apply

Appointment Needed

Visit myHFHP.org/ virtualclinic to schedule an appointment.

Urgent Care*

$$ Same-day care for conditions that are not life-threatening, but require prompt

treatment

■ Sprains and strains■ Severe sunburn■ Flu and cold

symptoms■ Allergy and sinus

infections■ Lacerations■ Severe vomiting

or diarrhea■ Urinary tract

infection (UTI)■ Minor cuts,

abscesses and wound care

No Appointment Needed

To reduce your wait time, schedule

an appointment at myHFHP.org/ schedule or call Customer Service to find the nearest

urgent care.

EmergencyRoom

$$$$ Same-day care

for serious or life-threatening illnesses

and injuries

Call 911 for critical situations

■ Chest pains, heartattack■ Difficulty breathing■ Broken bones■ Heavy bleeding■ Severe cuts or burns■ Stroke■ Confusion, fainting or

blacking out■ Severe abdominal pain■ Coughing or vomiting

blood■ Changes in vision,

difficulty speaking■ Complications related

to pregnancy

No Appointment Needed

Go to the nearest emergency facility,

regardless of network participation.

NEW BENEFIT! Transportation Now Covered Health First Health Plans is now offering 20 one-way trips of ground transportation per year, to or from a health-related location at no cost to you. These services are covered in Brevard and Indian River counties through the national curb-to-curb service, Lyft. To schedule a Lyft ride, simply call Customer Service 24 hours in advance of your appointment at 321.408.5289.

Review your schedule of benefits for cost share *To avoid coverage challenges, please ensure the facility bills the insurance company as an Urgent Care location.

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2

7

5

75

Your Network

Network Map Health First Health Plans gives you access to more than 4,000 providers and 23 hospitals in nine counties across Central Florida. A list of providers, their locations and contact information can be found in your provider directory at myHFHP.org/directory.

GILCHRIST

LEVY

HERNANDO

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Atlantic Ocean

Gulf of Mexico

95

95

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OCALA

301

192

27

27

19

1

ST. LUCIE

FLAGLER

VOLUSIALAKE

SEMINOLE

ORANGE

INDIAN RIVER

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UGH P

SUMTER

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5

6

7

8

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12

13

16

18

19

20 21

22

23

1

4

2

3

1714 15

Health First Hospitals 1 Cape Canaveral Hospital 2 Holmes Regional Medical Center 3 Palm Bay Hospital 4 Viera Hospital

AdventHealth Hospitals Volusia and Flagler 5 AdventHealth Daytona Beach6 AdventHealth DeLand 7 AdventHealth Fish Memorial8 AdventHealth New Smyrna Beach 9 AdventHealth Palm Coast

Orange, Osceola and Seminole 10 AdventHealth Altamonte Springs 11 AdventHealth Apopka 12 AdventHealth Celebration 13 AdventHealth East Orlando 14 AdventHealth for Children 15 AdventHealth for Women 16 AdventHealth Kissimmee 17 AdventHealth Orlando 18 AdventHealth Winter Park

Hardee and Highland 19 AdventHealth Lake Placid 20 AdventHealth Sebring 21 AdventHealth Wauchula

Other Network Hospitals 22 Cleveland Clinic Indian River

Hospital 23 Sebastian River Medical Center

75

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Your Network

As of November 2019, Health First Health Plans members have access to services in:

9 Counties Across Central Florida

1,136 Primary Care

Physicians

2,695 Specialists

712 Outpatient Mental Health Providers

23 Hospitals

42 Skilled Nursing

Facilities

50 Urgent Care

Centers

268 Pharmacies

Health First Health Plans customers have access to urgent care and emergency facilities when traveling outside of the Health First Health Plans Network Service Area: Guidelines to know: ■ For non-emergencies, seek care through our Virtual Clinic at myHFHP.org/schedule or at the most

convenient urgent care facility, and confirm with the facility that they will bill as an urgent care. ■ In an emergency or when an urgent care facility is not available, seek care at the closest emergency medical

facility available. ■ Your normal copay applies. ■ If admitted during the visit, the emergency copay will be waived. ■ When traveling abroad, customers must request reimbursement for covered out-of-pocket medical expenses

(up to the allowed amount, minus the standard copay).

To verify benefits, and see if your plan has out-of-network benefits, please visit us at myHFHP.org or contact Customer Service at 321.408.5289.

Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. Y0089_MPINFO8147_C(01/20 ) | 2020 HFHP Medicare Member Benefit Book

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Pharmacy Benefits

Pharmacy Benefits As a member of Health First Health Plans, you have access to broad prescription drug coverage and specialty pharmacy benefits. Read about them here and let us help you make the most of your benefits. For more details about your prescription drug plan, including copayments, drug plan limitations and exceptions, visit myHFHP.org and select “Pharmacy.”

Pharmacy Network Our network of 268 pharmacies spans nine counties in Central Florida. For the most current list of network pharmacies, please see our Provider Directory at myHFHP.org/directory.

Free Mail-Order Delivery To save you money and time, you can choose to have a 90-day supply of your medications delivered directly to your home. There are two options to fill your prescriptions through the mail: 1 ) Health First Family Pharmacy at 321.434.7355 and select option 1 or visit HF.org/familypharmacy, or 2) MedVantx at 866.744.0621 or visit medvantxrx.com.

Save Money with 90-Day Prescriptions As a Health First member, you have options to save money on your prescription drugs. Depending on your plan and drug tier, you could save up to 33% of the cost when you fill a 90-day prescription. For questions, call our Customer Service at 321.408.5289 (TTY/TDD relay: 1.800.955.8771).

TIP: Before going to the pharmacy to have your prescription filled, discuss generics and more affordable alternatives to your current medications with your physician.

Save Money—Use Generic Some facts about generic medications: ■ They typically cost 80 to 85% less than their brand-name equivalents. ■ They always contain the same active ingredient and therapeutic effectiveness as their brand-name

equivalents. ■ The Food and Drug Administration (FDA) is responsible for ensuring each generic medication matches its

brand-name equivalent. ■ Approximately 50 percent of generic drugs are made by the same company that manufactures their brand-

name equivalent.

Generics and brands have the same…

Active Ingredient

Safety Efficacy Quality Benefits

But may be different in…

Size Shape Color Inactive

Ingredient Cost

Call our licensed pharmacists at 321.434.4396 to learn about the generic versions of your current medications.

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Pharmacy Benefits

Pharmacist Recommendations Medications to help maintain the health of your heart and kidneys, as well as those that control diabetes and blood sugar levels, are extremely important to your wellness today and in the future. If you are currently taking medications for one of those conditions, speak with your doctor or pharmacist to ensure you are on the most effective and affordable option for you. The list below displays many of the most affordable and effective options:

Blood Pressure Control and Kidney Protection

Drug Name Copay* Retail

30 Days

Benazepril $0

Enalapril $0

Irbesartan $0

Lisinopril $0

Losartan $0

Valsartan $0

Candesartan $0

Olmesartan $0

Telmisartan $0

Quinapril $0

Ramipril $0

Cholesterol Control and Heart Health

Drug Name Copay* Retail

30 Days

Atorvastatin $0

Pravastatin $0

Simvastatin $0

Lovastatin $0

Rosuvastatin $0

Ezetimibe $45

Ezetimibe-Simvastatin $45

Diabetes and Blood Sugar Control

Drug Name Copay* Retail

30 Days

Glimepiride $0

Glipizide $0

Metformin $0

Glyburide $0

Pioglitazone $0

Nateglinide $0

*Copay quoted prior to entering the Donut Hole (explained below)

What is the CMS Medicare Donut Hole? The donut begins after you and the health plan have paid a combined amount of $4,020. At this time your cost share will increase to 25% of all drugs, unless your plan offers additional coverage during this period.

We want to be the best prescription drug plan possible — that’s why we’ve got tips on reducing your drug costs during the Donut Hole.

1. Call us at 321.615.9426* to find out:■ If your Tier 2-4 medications qualify for a

lower tier cost ■ If you qualify for Low Income Subsidy (LIS) ■ If you can save on a 90-day mail-order supply

2. Talk with your doctor to see if they can review generic or alternative options that might be less expensive.

3. Review your formulary at myHFHP.org to see if any of your medications changed to Tier 6, meaning NO COST to you.

*(TTY/TDD relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, we’re available seven days a week from 8 a.m. to 8 p.m.

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Wellness

How to Read and Understand Your Personalized Health Report Your Personalized Health Report will be delivered to you twice annually. By keeping track of your unique health information, including a list of your needed healthcare screenings, you’ll be better prepared to discuss your current health status with your provider. Together, you will be able to develop the best healthcare plan possible.

Talk to your primary care provider (PCP) to see if you are up to date on all your preventive services.

This section is removable. You can bring this card with you to your office visits to keep your information current.

Use this section to keep track of

completed services and/or upcoming

appointments.

An unchecked box indicates you are due to

complete the “Health Action.” Contact your

PCP to coordinate.

You will see a checked box, which shows that

your “Health Action” has been completed.

If you see “N/A” on your health report,

this “Health Action” may not apply to you.

Contact your PCP with any questions.

Health Screening Schedule Because improving and maintaining your health is important, the schedule

below is a recommended timeline for routine health screenings. It does not replace the care of your doctor or guarantee insurance coverage. Your

physician may order other screening tests based on your unique risks.

Preventive Service Age Frequency

Bone mineral density screening (DEXA scan)

Women 65-85 Every 2 years

Cervical cancer screening (Pap test)

21-65 Every 3 years*

Colorectal cancer screening 50-75

Colonoscopy every 10 years, Sigmoidoscopy every 5 years, Cologuard every 3 years or fecal immunochemical test (FIT) annually

Dental checkup All Twice a year Depression screening 18+ Regularly if at risk Flu vaccination 6 months+ Every year

Breast cancer screening (mammogram)

40-49 Doctor recommendation 50+ Every 2 years

Physical examination (weight, height, BMI, blood pressure, etc.)

All Every year

Pneumonia vaccination 65+ Doctor recommendation Preventive screening labs (fasting glucose, cholesterol, etc.)

18+ Every year

Shingles vaccination 50+ Once in lifetime

Skin cancer screening Doctor recommendation

Doctor recommendation

Tetanus vaccination 18+ Every 10 years

Vision exam 20+ Every 1-2 years High risk of glaucoma Every year Diabetic patients Every year

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Health and w

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Comprehensive Health Assessm

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Flu vaccination

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Physical exam

Pneumonia vaccination

Preventive screening lab tests

Tetanus vaccination

Vision exam

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Tear off this Preventive Service Record and keep it in your wallet to help track your last screenings and w

hen they should be repeated.

Please consult your physician for medical guidance and contact your health plan for information about benefits.

*Depending on HPV co-testing Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. Y0089_MPINFO7455_C(10/19)

Health Action Status as of October 1,

2019

Appointment Date and Time

Mark When Completed

Colorectal Cancer Screening There are several different tests to screen for colorectal cancer. Ask your healthcare provider which test is best for you.

® ® ®

Breast Cancer Screening (Mammogram) A mammogram can detect breast cancer early and save lives. Schedule yours today. If you reside in Brevard County: Call Health First Centralized Scheduling at 321.434.6100 If you reside in Indian River County: Call Sebastian River Diagnostic Center at 772.589.5000 or Vero Radiology Services at 772.562.0163

˛ ˛ ˛

Bone Density Screening (DEXA Scan) This quick and painless scan tells you and your provider about the health of your bones, which can help you prevent falls and preserve your independence If you reside in Brevard County: Call Health First Centralized Scheduling at 321.434.6100 If you reside in Indian River County: Call Sebastian River Diagnostic Center at 772.589.5000 or Vero Radiology Services at 772.562.0163

N/A N/A N/A

Diabetic Eye Exam Diabetes can cause blindness. Call your ophthalmologist or optometrist for a diabetic eye exam.

Health Action Status as of October 1,

2019

Appointment Date and Time

Mark When Completed

Diabetic A1C Blood Test Talk with your provider about this blood test. Controlling your blood sugar reduces your chances of damage to your heart, eyes, kidneys and blood vessels.

Diabetic Urine Test Talk with your provider about this urine test. Detecting protein in the urine may indicate kidney damage.

Annual Flu Vaccine Remember, flu vaccines save lives. Your annual vaccine is available just before flu season at most retail pharmacies or at your physician’s office.

Comprehensive Health Assessment (CHA) Receive a $50 gift card after completing your annual CHA. Call 321.434.6712 to schedule your CHA.

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For more information and ways to schedule these exams, please visit myHFHP.org/screenings.

If you have any questions, call Customer Service at 321.408.5275*.

*Available weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to March 31, weekdays from 8 a.m. to 8 p.m. TTY/TDD relay 1.800.955.8771.

This section is removable. You can bring this card with you to your office visits to keep your medication list current.

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Wellness

The Silver&Fit® Exercise and Healthy Aging Program:

Something for Everyone™

Improving your physical health is important. The Silver&Fit® Exercise and Healthy Aging Program gives members:  ■ No-cost access to a fitness center or select YMCA  ■ Group classes made for older adults, where offered  ■ The option to work out at home using up to two home fitness

kits per year (34 to choose from)  ■ Healthy Aging materials four times a year (online or by mail)  ■ A newsletter four times a year (online, by email or by mail)  ■ The Silver&Fit Connected!™ program, a fun and easy way to

track exercise at a fitness center or through a wearable fitness device or app

 ■ Other web tools like a fitness center search and online classes

Get Started

1

Go to SilverandFit.com.

2 Register to use the website.

3 Choose a fitness center or YMCA, or sign up for the Home Fitness program.

4 If you prefer, you can call toll-free 1.888.797.7806 (TTY/TDD 711) 8 a.m. to 9 p.m. Eastern Time, Monday through Friday, to find a fitness center or YMCA near you or to enroll in the Home Fitness program.

Comprehensive Health Assessment

Complete your health assessment in 2020, and you’ll earn a $50 gift card.*

Health First Health Plans has partnered with your physician to offer you a thorough physical exam by a physician or nurse practitioner.

In Our Office or In Your Home You can choose to have your exam at a physician’s office or in the comfort of your own home. It takes about one hour, with plenty of time to discuss all your health concerns, medications and recent treatments. This exam is completely voluntary and will not affect your healthcare coverage in any way.

The Comprehensive Health Assessment and any health screenings you receive during the visit are provided at no additional cost to you.

Call 321.615.9427 to schedule your appointment, Monday through Friday, 8 a.m. to 6 p.m.

*Health First Health Plans will mail your gift card to you after a completed visit. Please allow six to eight weeks for delivery. Members are onlyeligible for one (1) assessment and one (1) gift card per calendar year.

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Wellness

Your Behavioral Health Program Provided by Health First Health Plans and Magellan Healthcare Services

Health First Health Plans and Magellan Healthcare Services teamed together to provide member-focused behavioral health benefits that focus on early intervention and prevention services to positively impact overall well-being.

Our program offers: ■ Outpatient solutions

■ Welcome-home calls

■ Online tools and resources

■ Integrated medical and behavioral care

■ Ongoing support as needed

Online tools and resources Members are given unique access to a member website where a variety of tools and resources are available to help and assist members based on their needs. With a number of different self-assessments, library articles, resource guides and other information, members can learn about different conditions and understand how to modify their daily living.

Visit MagellanAssist.com

Call 1.800.424.4347 (TDD/TTY: 1.800.424.1694)

at any time, day or night

Health First is contracted with Magellan to provide behavioral health management

services to our members.

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Plan Information

Financial Assistance Programs

Save as much as $144.60/per month or more on Part B Premiums in 2020. As a valued member, we want to ensure you receive all the government and community benefits to which you are entitled. We contract with My Advocate, a social service organization, to help our Medicare members determine if they are eligible for various types of assistance and help them complete the proper applications: ■ Medicare Savings Programs—To help pay for Part B premiums, an average of $144.60 a month (or more

depending on Part B Premium) in 2020, which amounts to $1,735.20 annually ■ Low Income Subsidy—To help pay for Part D prescription drug premiums and copays ■ Community Programs—To assist with daily needs like meals, utilities, transportation and more

For more information, call My Advocate at 1.866.743.5282 (TTY: 1.855.368.9643) Monday through Friday from 9 a.m. to 6 p.m. or visit Trust.MyAdvocateHelps.com.

Identity Protection Services As a Medicare Advantage member of Health First Health Plans, you have access to Experian IdentityWorksSM Identity Protection Services at no cost to you.

Experian IdentityWorks Experian IdentityWorks offers more protection and the option to enroll at any time—also at no cost to you. Once you enroll in IdentityWorks, you will have access to: ■ Experian credit report at signup* ■ Credit monitoring ■ Internet surveillance ■ Identity restoration ■ Up to $1 million identity theft insurance** ■ Lost wallet protection ■ Child monitoring** ■ Experian IdentityWorks ExtendCARE™

Enrollment is required. 1

Visit the Experian IdentityWorks website to enroll: experianidworks.com/RR1Bplus

2 Click “Get Started” and enter code: HFID 3 Complete the enrollment process.

How Experian Identity Restoration Works If you become a victim of identity theft, a dedicated Identity Restoration Specialist from Experian will act as your guide and advocate from start to finish by initiating the dispute process, and help ensure that your identity returns to its pre-identity theft state***.

If you have questions about protecting your identity or if you suspect that your identity has been stolen: 1 Call the Experian customer support team at

1.877.890.9332. 2 Provide engagement number DB14463.

* Offline members will be eligible to call for additional reports quarterly after enrolling. **The Identity Theft Insurance is underwritten and administered by American Bankers Insurance Company of Florida, an Assurant company. Please refer to the actual policies for terms, conditions, and exclusions of coverage. Coverage may not be available in all jurisdictions. ***You may be asked to provide a limited power of attorney to facilitate any identity restoration related work on your behalf.

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Nondiscrimination Notice Health First Health Plans complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Health First Health Plans does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

Health First Health Plans: ■ Provides free aids and services to people with disabilities

to communicate effectively with us, such as: ■ Qualified sign language interpreters ■ Written information in other formats (large print,

accessible electronic formats) ■ Provides free language services to people whose primary

language is not English, such as: ■ Qualified interpreters ■ Information written in other languages

If you need these services, please contact our Civil Rights Coordinator.

If you believe that Health First Health Plans has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with: Civil Rights Coordinator,

6450 US Highway 1, Rockledge, FL 32955, 321-434­4521, 1-800-955-8771 (TTY), Fax: 321-434-4362, [email protected]. You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, our Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/ office/file/index.html.

Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. Y0089_MPINFO7271_C (04/19)

English: ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-716-7737 (TTY: 1-800-955-8771).

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-716-7737 (TTY: 1-800-955-8771).

French Creole: ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-800-716-7737 (TTY: 1-800-955-8771).

Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-716-7737 (TTY: 1-800-955-8771).

Portuguese: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-800-716-7737 (TTY: 1-800-955-8771).

Chinese: 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-800-716-7737(TTY:1-800-955-8771)。 French: ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-800-716-7737 (ATS : 1-800-955-8771).

Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-716-7737 (TTY: 1-800-955-8771).

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-716-7737 (телетайп: 1-800-955-8771).

Arabic: لك إذا كنت تتحدث اذكر اللغة، فإن خدمات املساعدة اللغوية تتوافر ملحوظة:

.(1-800-955-8771 (رقم هاتف الصم والبكم: اتصل برقم 1-800-716-7737 باملجان.

Italian: ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-800-716-7737 (TTY: 1-800-955-8771).

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-716-7737 (TTY: 1-800-955-8771).

Korean: 주의: 한국어를 사용하시는 경우, 언어 지원서비스를 무료로 이용하실 수 있습니다. 1-800-716-7737(TTY: 1-800-955-8771) 번으로 전화해 주십시오. Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-800-716-7737 (TTY: 1-800-955-8771). Gujarati: સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષાસહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-800-716-7737(TTY: 1-800-955-8771).

Thai: เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทาง ภาษาได้ฟรี โทร 1-800-716-7737 (TTY: 1-800-955-8771).

Y0089_MPINFO6466 (08/17)