MEMBERS

Know More About Your Health Plan

Do you want to know more about how your health plan works? Click on any of the bullets on this page to get answers to your questions.

Getting Healthcare Services

• What is a Primary Care Provider? How do I get one?
• How do I see a specialist? How do I get a second opinion?
• How do I get other health services: Routine women’s health? Hospital?  Behavioral health?
• How do I use my pharmacy benefit?
• What services require me to make a copayment?
• How am I covered if I’m away from Health Partners’ service area?

How the Plan Helps Improve Your Health

• What is Health Partners’ Quality Management program? What are its 2012 goals?
• What are the healthcare guidelines that Health Partners wants members to know about?
• How can our care managers help members who are pregnant, or have ongoing health concerns like asthma and diabetes?
• How do our case management services help members with complex illnesses or other special needs?
• How can Health Partners help members who need translation services?

More Information about Health Partners

• Where can I find out about covered and non-covered services?
• How does Health Partners decide about covering new kinds of healthcare services?
• Are Health Partners providers ever rewarded for limiting my care?
• What can I do if I disagree or have questions about a coverage decision that Health Partners makes? Member Relations is available 24 hours a day at 1-800-553-0784 (TTY 1-877-454-8477) to answer your questions. We can also help if you decide to file a formal grievance.
• How does Health Partners compare with other HealthChoices plans? How satisfied are its members?
• How does Health Partners protect my privacy?

Remember, our 24-hour Member Relations department is always ready to answer any questions you may have about benefits and services, and how to use your health plan. Call 1-800-553-0784 (TTY 1-877-454-8477).