Disclaimer

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2/1/16 Revised

The information on this website is not to be construed as medical advice or recommendations or as a substitute for professional medical advice and is not a substitute for consultation with a qualified physician. You should consult with a physician or other healthcare professional for any healthcare concerns including without limitation before you take any prescription or over the counter drugs. The information provided on this website does not replace the relationship that exists between patients and their physicians or other healthcare professionals. Never disregard your physician’s or other healthcare provider’s advice or delay seeking their advice as a result of anything you have read on this website. All materials and information contained herein is provided “as is” and is for educational purposes only. Reliance on any information provided on this website or otherwise from Magellan Health, Inc. and its subsidiaries and affiliates (“Magellan”) is solely at your own risk.

Please see Terms of Use and Privacy Policy for further information that governs your use of this website. By accessing, browsing and/or using this website, you accept and agree to be bound by this Disclaimer and the Terms of Use and Privacy Policy (“Terms and Conditions”). If you do not agree to all of the Terms and Conditions, do not access or use this website! Magellan may revise and update the Terms and Conditions from time to time without notice. Your continued use of this website means you accept those changes.

Member Information

This information is not a complete description of benefits. Contact the plan for more information. Benefits and/or copayments/coinsurance may change on January 1 of each year. The formulary and pharmacy and provider network may change at any time. You will receive notice when necessary. Limitations, copayments and restrictions may apply. You must receive all routine care from plan providers. This is general health information and is not meant to replace care or advice you get from your doctor. Always ask your doctor or other health care provider for information about your own health care needs.

Participating physicians, hospitals and other providers are independent contractors and are neither agents nor employees of Magellan Complete Care of Arizona (HMO SNP). The availability of any particular provider cannot be guaranteed, and the provider network is subject to change. You will receive notice when necessary.

 

Contract Termination:

If your prescription drug coverage is provided under a contract with Medicare, your coverage is not guaranteed beyond the end of the current contract year. In the event that Medicare or MCC of AZ (HMO SNP) terminates or chooses not to renew this contract, as is allowed by law, your coverage may end. If this occurs, you will be able to choose another plan without having to pay a late enrollment penalty, as long as you’re within the time period required by Medicare.

 

Legal information

This plan is a dual eligible special needs plan (D-SNP). Your ability to enroll will be based on verification that you are entitled to both Medicare and medical assistance from a state plan under Medicaid.

MCC of AZ (HMO SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until [year] based on a review of MCC of AZ (HMO SNP)’s Model of Care.

For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, 7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Call 1-800-424-4509 (TTY 711) for more information. Limitations, copayments and restrictions may apply.

Benefits, premiums and/or copays may change on January 1 of each year.

The formulary and pharmacy and provider network may change at any time. You will receive notice when necessary.

You must receive all routine care from plan providers.

Out-of-network providers are under no obligation to treat MCC of AZ (HMO SNP) members, except in emergency situations. Please call Member Services or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Every year, Medicare evaluates plans based on a 5-star rating system.

For accommodations of persons with special needs at meetings, call 1-800-424-4509 (TTY 711).

IF YOU HAVE A MEDICAL EMERGENCY

IMMEDIATELY CALL 911 TO GET PROMPT MEDICAL ATTENTION.