Advantage 2012 Member Handbook - Medicare Advantage

2012 Member Handbook
A Coordinated Care plan with a Medicare Advantage contract and a contract with the
Ohio Medicaid program
H0908_MEM012_003 CMS Approved 08/25/2011

Member Handbook
Welcome to Buckeye
Welcome to Advantage by Buckeye Community Health Plan (HMO SNP) (Buckeye), a
subsidiary of Centene Corporation. Buckeye is a Medicare Advantage Special Needs
Plan offering Medicare Advantage Part D, and is not a “Medigap” Medicare Supplement
Insurance policy.
It is important for any new members with a health condition that requires
ongoing care to call our Member Services department as soon as possible.
For example, if you need surgery, have asthma, diabetes, congestive heart
failure, are receiving physical therapy, or treatment for behavioral health
conditions, you need to call Member Services. Also, new members
currently taking any medication(s) need to confirm as soon as possible
whether or not their medication(s) must be prior approved. If a medication
needs prior approval, you cannot obtain the medication until your doctor
submits a request and it is approved. You can check by contacting our Member
Services department, or you can look on our website at www.bchpohio.com.
It is important to remember that you must receive all medically-necessary covered
healthcare services from Buckeye facilities and/or providers. You should have received
a Provider Directory that lists all of our panel providers, as well as other providers you
can see. The only time you can use providers not on Buckeye’s panel is for emergency
or urgently needed care, or for services that Medicare requires our plan to cover but we
are unable to provide in network.
If you need to receive the information in this Member Handbook in a different format
(such as in Spanish or another language, large print, or audio CD), please call us so we
can send you a copy.
As you review the information in this Member Handbook, remember we are here to
answer any questions you have and assist you in any way that we can. If you have
questions or concerns, please call us at (toll-free) 1-866-389-7690 or (TTY) 1-800-750-
0750 8 a.m. to 8 p.m. seven days a week.
We look forward to working with you to safeguard your health!
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Member Handbook
Table of Contents
Introduction……………………………………………………………………………………3
Identification Cards……………...……………………………………………………………5
Family Doctor or Primary Care Provider…………………………………………………6
Out-of-Area, After Hours, and Emergency Care…………………………………...……7
Covered Services……………………………..………………………………………………9
More Services and Programs………………..……………………………………………10
Coordination of Benefits Between Medicare and Medicaid…………………10
Additional Value Added Services..………………………………………………10
Additional Programs..………………………………………………………………10
Nursewise..……………………………………………...……………………10
MemberConnections..……………………………………...………………11
Case Management..…………………………………………………………11
Prescription Medications..…………………………………...……………………………13
Asked to Pay – Just Say No..…………………………………………………..…………14
Member Rights and Responsibilities..………………………..…………………………15
Complaints and Appeals..…………………………………………………………………16
Definitions..……………………………………………………………..……………………17
Important Phone Numbers..………………………………….……………………………19
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Member Handbook
Introduction
Thank you for your interest in Buckeye!
We are hoping to serve you by providing Medicare services and benefits in a way that
enables you to get the most out of life.
About Buckeye
Buckeye is a Medicare Advantage Plan, contracted with the Centers for Medicare and
Medicaid Services (CMS). Buckeye offers:
• All Original Medicare benefits (Parts A and B)
o Hospital care
o Home health care
o Preventive care
o Durable medical equipment
• Prescription drug coverage (Part D)
To be a member of our Plan, you must live in our service area, be entitled to Medicare
Part A, be enrolled in Medicare Part B, and be eligible for Medicaid in Ohio.
Consumers eligible for full Medicaid can enroll or disenroll in our plan at any time during
the year.
Today, Buckeye’s service area spans 30 counties in Ohio.
What’s so “special” about Buckeye?
Buckeye is also known as a Special Needs Plan because we only enroll Medicare and
Medicaid eligible consumers, known as “dual eligible” consumers. Our Advantage
plan was created to help dual eligible consumers get the most out of the benefits and
services available through Medicare and Medicaid. We provide access to personal,
local care needed to help people stay healthy and independent.
Advantage by Buckeye Community Health Plan helps Medicare and Medicaid
consumers get quality healthcare and live independently. See the page ten for many
of the benefits you can get in addition to your healthcare services. It is your choice!
For Help Understanding These Materials
If you have any problems in reading or understanding this information, please contact
Buckeye Member Services for help. We can help to explain the information or provide
the information in other formats. If you are visually or hearing-impaired, special help
can also be provided.
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Member Handbook
Counties of Operation
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Member Handbook
Identification Cards
Identification Cards
You should have received your Buckeye membership identification (ID) card. This card
replaces your red, white and blue Medicare card and is good for as long as you are a
member of Buckeye. Store your red, white, and blue Medicare card in a safe place
in case you need it later. You won’t need to show this card again unless you come off
of our plan or need hospice services.
Please carry your Buckeye Advantage membership card that we gave you at all times.
You will need your Buckeye Advantage ID card each time you get medical services –
you should take all of your medical cards (Buckeye Advantage ID, Medicaid, AARP), to
any healthcare appointment.
This means that you will need your Buckeye ID card when you:
• See your primary care provider (PCP)
• See a specialist or other providers
• Go to an emergency room
• Go to an urgent care facility
• Go to a hospital for any reason
• Get medical supplies
• Have medical tests
Here is a sample card to show you what it looks like:
If your ID card is lost, stolen, or arrives with incorrect information on it (for example, it is
missing your PCP name, has an incorrect PCP listed) or your name is spelled incorrectly,
call Member Services right away.
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Member Handbook
Primary Care Provider
Choosing a Family Doctor or Primary Care Provider (PCP)
Each member must choose a family doctor or primary care provider
(PCP) from Buckeye’s provider directory. Your PCP is an individual
physician, physician group practice, advance practice nurse or advance
practice nurse group practice trained in family medicine (general practice)
or internal medicine.
Your PCP will work with you to direct your healthcare. Your PCP will treat
you for most of your routine healthcare needs. If needed, your PCP will
send you to other doctors (specialists) or admit you to the hospital.
Sometimes, there may be a reason that a specialist may need to be your PCP. If you
and/or your specialist believe that they should be your PCP, you should call the Member
Services department to discuss.
You can reach your PCP by calling the PCP’s office. Your PCP’s name and telephone
number are printed on your Buckeye ID card.
Changing Your PCP
If for any reason you want to change your PCP, you must first call the Member Services
department. When you call, be sure to tell Member Services if you are seeing a
specialist or getting other covered services that needed you PCP’s approval (such as
home health services and durable medical equipment). Member Services will help you
make sure that you can continue with the specialty care and other services you have
been getting when you change your PCP. They will check to be sure the PCP you want
to switch to is accepting new patients. Member Services will change your membership
record to indicate your new PCP and will tell you when the change to your new PCP will
take effect. They will also send you a new ID card that shows the name and phone
number of your new PCP.
For the names of contracted PCPs, you may look in your provider directory, on our
website at www.bchpohio.com, or you can the Member Services Department for help.
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Member Handbook
Out-of-Area, After Hours and
Emergency Care
Out-Of-Area And After Hours Care
If your PCPs office is closed or you are away from home and you have a problem that is
not an emergency, call your PCP at the phone number listed on your ID card. You can
also call NurseWise 24 hours a day, seven days a week toll-free at 1-866-389-7690,
option 7, (TTY 1-800-750-0750). A nurse will answer and help you determine what to
do.
Medical care is available through Buckeye physicians 24 hours a day, seven days a
week. After hours, your PCP’s phone will be answered by either answering service or
and answering machine with specific instructions. Be sure to follow the machine’s
instructions. The answering service will have your PCP or the doctor who is covering
for the PCP call you back. Tell them you are a Buckeye member and explain your
problem. They will tell you what to do. You can also visit a contracted Urgent Care
Center listed in our provider directory or on our website at www.bchpohio.com, or your
can call NurseWise.
Emergency Services
Emergency services are services for a medical problem that you think is so serious that
it must be treated right away by a doctor.
Some examples of when emergency services are needed include:
-A fracture (broken bone) -Severe bleeding
-Chest pain or other severe pain
-Severe shortness of breath
-Poisoning
-A bad burn
-Fainting/unconsciousness
-Seizures
-Suddenly not able to see, move or speak
-Shock (you may sweat, feel thirsty or dizzy, or have pale skin)
You do not have to call Buckeye for an okay before you get emergency services.
If you have an emergency, call 911 or go to the NEAREST emergency room (ER),
call your PCP or the Buckeye NurseWise 24-hour nurse hotline, at 1-866-389-7690,
option 7 (TTY 1-800-750-0750) (24 hours a day). Your PCP or the Buckeye
NurseWise hotline can talk to you about your medical problem and give you advice on
what you should do.
Please note that you may self-refer to a Buckeye plan Urgent Care Center after hours if
that facility is open at the time.
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Member Handbook
Emergency Care
Remember, if you need emergency services:
• Go to the NEAREST hospital emergency room or other appropriate setting. Be
sure to tell them that you are a Buckeye member and show them you ID card.
• If the provider that is treating you for an emergency takes care of your
emergency but thinks that you need other
medical care to treat the problem that caused
your emergency, the provider must call Buckeye.
• Call your PCP (or ask the hospital to call your
PCP) as soon as possible. This lets your PCP
know that care you received. Your PCP can
then take over coordination of your care. You
must contact your PCP within 24 hour to arrange
follow-up care within the service area with
participating providers.
• If the hospital has you stay, please make sure
that Buckeye is called within 24 hours.
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Member Handbook
Covered Services
Buckeye covers the following medically necessary Medicare-covered services:
Ambulance transportation
• Chiropractic (back) services
• Diabetes self-monitoring, training and supplies
• Dialysis (kidney)
• Durable medical equipment and related supplies
• Emergency services
• Home health services
• Hospice care (care for terminally ill, e.g., cancer patients)
• Inpatient hospital services
• Inpatient mental healthcare
• Medical nutrition therapy
• Outpatient diagnostic tests (x-ray, lab) and therapeutic services and supplies
• Outpatient mental healthcare
• Outpatient rehabilitation services (physical/occupational/speech therapy)
• Outpatient substance abuse services
• Outpatient surgery (including ambulatory surgical center services)
• Physician services, including doctor office visits
• Podiatry (foot) services
• Prescription drugs
• Preventive care
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o
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o
o
o
o
o
Bone-mass measurements
Cardiovascular disease testing
Colorectal screening
Immunizations
Mammography screening
Pap tests, pelvic exams, and clinical breast exams
Physical exams (initial exam as well as additional checkups needed for
the diagnosis or treatment of an illness or injury or to improve the
functioning of a malformed body member)
Prostrate cancer screening exams
o
Prosthetic devices and related supplies
Skilled nursing facility care
Urgently needed care
Vision services (limited)
*For a list of services not routinely covered by Buckeye, or more information
about the above benefits, refer to your Evidence of Coverage booklet or contact
Member Services.
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Member Handbook
More Services & Programs
Coordination of Benefits Between Medicare and Medicaid
Most of the covered benefits are also covered by Medicaid. Advantages of this are:
Medicaid is usually the payer of last resort – this means you must access
benefits that are covered by both programs through Medicare (Buckeye) first and
Medicaid last.
Once you have reached your limit for a service in the Medicare program, you
might be able to continue getting the benefit through the Medicaid program.
In some cases, Medicaid will pay for services or costs that Medicare does not
(such as routine dental and vision care, and hearing aids).
If you have questions about how your benefits are coordinated between programs,
contact (see contact phone numbers on last page) -
• Medicare-Buckeye Member Services
• Medicaid-ODJFS Consumer Hotline
Additional Value-Added Services
Buckeye also offers the following additional benefits for our members:
• Emergency medical response system
• Non-emergency transportation – up to 30 round trips per year
• Over-the-counter (OTC) supplies – up to $25 per month for certain OTC items
shipped free to your home from our mail order pharmacy
• Health club membership – up to $250 annual reimbursement for health club
membership and fitness classes
• Dental services – up to 1 oral exam and cleaning every year with additional
comprehensive services
• Vision services – up to $300 every year for one routine eye exam and eyewear
including lenses, frames, contacts, and upgrades
• Hearing services – up to $750 every year for routine hearing test and hearing
aid, including warranty, fitting, and evaluation
• NurseWise – free access to our 24 hour health information line staffed by
nurses.
The services below are available by contacting NurseWise, Buckeye’s 24-hour
nurse hotline, at 1-866-246-4358, option 7 (TTY 1-800-750-0750):
o Medical advice line
o Health information library
o Help in determining where to go for care
o Answers to questions about your health or medicines
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Member Handbook
More Services & Programs
Buckeye also offers several additional programs for our members, including but not
limited to:
MemberConnections
We have a special program called MemberConnections.
Our MemberConnections outreach representatives will talk
to you on the phone, send you information in the mail, and/or
visit your home if you prefer. They will be glad to talk to you about:
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How to choose or change doctors
Covered healthcare services and how to use services
How to get medical advice when you can't get your doctor
How to live a healthy life
Any other healthcare service problem you may have
MemberConnections outreach representatives can also help connect you to
community social services if you need food, housing, clothing, utility services, etc. To
reach MemberConnections, call Member Services.
Care Management
Buckeye is pleased to inform you that we have a case management program to help
members learn more about their health concerns. Our care management program is
designed to let us work with members to help them maintain good health and assist
them and their doctor to arrange services that they may need to manage their health.
The goal of our program is to learn what information or services members need
to meet their healthcare needs in order to become more independent.
Members who have serious conditions may be referred to the care management
program. Examples of these conditions include:
• Asthma
• Diabetes
• Congestive heart failure (CHF)
• Coronary artery disease (CAD)
• Non-mild hypertension (high blood pressure)
• Chronic obstructive pulmonary disease (COPD)
• Severe mental illness
• Severe cognitive and/or developmental limitation
• High-risk or high-cost substance abuse disorder
• Frequent admissions or ED room visits
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Member Handbook
More Services & Programs
Please call Buckeye’s Member Services if you would like more information about our
care management services.
When you are a patient in the hospital, if you are feeling well enough to
have visitors, our nurses or social workers may come to your hospital
room to visit you to discuss your discharge planning needs, answer any
questions you may have about our benefits and services offered, and
provide information to you about our case management program. Our
staff will always check with the hospital staff first before entering your
room to be sure that the timing is right for us to visit you.
Other ways care managers work with our members include:
• Care managers will work with your healthcare providers behind the scenes to
manage any transitions from one hospital to another, from a hospital to a nursing
facility, or from your home to a nursing facility. Our goal is to handle the
coordination of these events so that you can focus on what’s important – your
health.
• Buckeye staff, including nurses, care managers, and outreach workers may
contact you if a doctor has requested a phone call, if you request the phone call,
or if Buckeye feels that care management services would be helpful to you.
• Buckeye staff may ask you questions to learn more information about your
conditions(s).
• Buckeye staff will provide information to help you understand how to care for
yourself and how to access services (including local resources).
• Buckeye staff will talk to your family doctor or PCP and any other healthcare
providers to coordinate care.
Who do you contact if you have questions?
You should call Buckeye’s Member Services if you have any questions about care
management services or if you feel you would benefit from care management services.
What to do if you want out of the program?
Although Buckeye provides care management services for our members, we are aware
that some members would prefer to not participate. For specifically identified members,
Buckeye provides an "opt-out of care management" process. If you choose to not
participate in our care management program, you can decline participation at any time
by notifying your care manager (call Member Services and ask for your care manager).
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Member Handbook
Prescription Medications
While Buckeye covers all medically necessary Medicare-covered medications, we use a
formulary. These are drugs that we prefer that your physician prescribe. We may also
require that your provider submit information to us (a prior authorization request) to
explain why a specific medication and/or a certain amount of the medication is needed.
We must approve the request before you can get the medication. Reasons why we
have prior authorization requirements on certain drugs include:
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There is a generic or pharmacy alternative drug available
The drug can be misused/abused
There are other drugs that must be tried first
Some drugs may also have quantity (amount) limits and
some drugs are never covered, such as drugs for weight loss
How do I get my medications?
You must get all prescriptions filled at a pharmacy in our provider network. When you
go to the pharmacy, make sure to take ALL of your medical cards (for example, your
Buckeye Advantage, Medicaid, and any other medical or prescription plan ID cards
such as AARP ID cards). Your pharmacist will know which medications are covered by
which program.
What will my drugs cost?
Most Buckeye members have a $0 co-payment for generic medications (including brand
drugs treated as generic) and a $0, $3.30, or $6.50 co-payment for other medications.
Ask your provider to prescribe generic medications if possible so that you will have no
co-payment.
Where can I get more information about the pharmacy benefit?
You can obtain additional information on your pharmacy benefits from:
•
•
•
Your Evidence of Coverage (Chapters 5 and 6)
Your formulary online at www.bchpohio.com
Buckeye Medicare Member Services – please contact us immediately if you
are having any trouble getting your medications or are being asked to pay
something other than $0, $3.30, or $6.50 for a medication.
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Member Handbook
Asked to Pay–Just Say No
Because our Medicare members are dual eligible (also on Medicaid), the only costs
you should ever have to pay for Medicare covered and authorized services from a
network (plan) provider are co-payments for non-generic medications. This section
explains how this is possible and what to do if something goes wrong.
As a Buckeye Medicare Plan Member, Your Costs For Medicare Services Are:
Part A and B Services - $0
Part D Services - $0 for generic medications and $3.30 or $6.50 for brand name
medications. If you are in an institution, you will have no co-payments. Your costs may
be more if you lose full Medicaid and eligibility for Medicare low-income subsidy.
Your Evidence of Coverage has costs listed for all of these services (such as
premiums, co-pays, and other charges). All costs, except for the Part D co-payments
will be paid for by Medicaid or Medicare.
As an ODJFS Medicaid Member, Your Costs For Medicaid Services Are:
•
•
•
•
•
Visits to the emergency room that are not an emergency - $3
Dental visits - $3
Vision visits - $2 & eyeglasses - $1
Brand name, non-generic drugs - $2
Drugs that require prior authorization - $3 (Medicaid drugs not covered by
Medicare)
Why is maintaining your Medicaid eligibility so important?
You can only be on our plan if you have eligibility for Medicaid. If you lose Medicaid
eligibility, your membership in this plan will end after 6 months. During this time, your
costs for Medicare services will increase because Medicaid will no longer cover all of
your out-of-pocket Medicare costs.
How do you maintain your Medicaid eligibility?
Your CDJFS office will notify you when your case is due for review, a process known as
redetermination. Cases are reviewed to make sure your circumstances have not
changed (for example, you still require the level of assistance you are receiving). This
may require you to return completed paperwork by mail, or visit your local CDJFS office
within a certain time period. You have to successfully complete this process to
maintain your Medicaid eligibility – so watch for those notices from Medicaid!
If you have any questions about your program eligibility, contact:
• Medicare-Buckeye Member Services
• Medicaid-ODJFS Consumer Hotline
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Member Handbook
Member Rights & Responsibilities
As a member of Buckeye, you have the following rights:
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•
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•
•
•
•
To be treated with dignity and respect
To have your personal and health information kept private
To file complaints (sometimes called grievances), including complaints about the
quality of your care
To appeal (get a review of) certain decisions about health care coverage
To receive emergency care when and where you need it
To receive information in a way you understand
To learn about all of your treatment choices and participate in treatment decision
To have your questions about Buckeye answered
To receive access to doctors, specialists, and hospitals
To be protected from discrimination
As a member of Buckeye, you also have several responsibilities.
They are to learn and understand each right you have under our plan.
That includes the responsibility to:
•
•
•
•
•
•
•
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•
•
Ask questions if you don’t understand your rights
Keep your scheduled appointments
Cancel appointments in advance when you can’t keep them
Only go to the emergency room when it is an emergency
Keep your Buckeye Advantage ID card with you at all times
Notify your PCP of emergency room treatment
Always contact your PCP for your non-emergency
medical needs
Be sure you have approval from your PCP before going to a
specialist (except for providers that you can self-refer to such as women’s health
specialists, federally qualified health centers/rural health clinics, community
mental health centers)
Tell your PCP about your health
Talk to your providers about your healthcare needs and ask questions about the
different ways your healthcare problems can be treated.
Treat providers and staff with respect
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Member Handbook
Complaints & Appeals
You have the right to appeal any decision made by Buckeye concerning your treatment
or payment for services. If you wish to file a grievance/appeal, please contact Member
Services. If you do not have access to a phone, you can complete this form or write a
letter that includes the information requested below. The complete form or your letter
should be mailed to:
Advantage by Buckeye Community Health Plan
Attention: Grievance & Appeals
175 South 3 rd Street, Suite 1200
Columbus, Ohio 43215
Fax 1-866-786-1036
Date: ________________
Member: _____________________________________________________________
Address of Member: _____________________________________________________
Phone number of Member: ________________________________________________
Member ID Number Listed on Buckeye ID Card: _______________________________
Has this issue been brought to the attention of a Buckeye employee before? _________
If yes, when? __________________________ To whom? _______________________
Nature of Complaint: (Please state all details relating to the incident in question,
including names, dates, places, etc. Please attach additional sheets of supporting
documentation about your grievance/appeal if necessary.)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
*If you wish to end your membership in our plan, contact Member Services. Until your
membership ends, you must keep getting your Medicare services and/or prescription
drug coverage through our Plan.
*If you have a complaint about the Medicaid program or want to find out how to appeal
a decision about your Medicaid benefits, contact the ODJFS Medicaid Consumer
Hotline.
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Member Handbook
Definitions
Appeal: An appeal is a special kind of complaint you make if you disagree with a decision to
deny a request for health care services or payment for services you already received.
Copayment: An amount you may be required to pay as your share of the cost for a
medical service or supply, like a doctor’s visit or a prescription. A copayment is usually
a set amount, rather than a percentage. For example, you might pay $10 or $20 for a
doctor’s visit or prescription.
Covered Services: The general term we use in this booklet to mean all of the healthcare
services and supplies that are covered by our Plan.
Dual Eligible or Dually Eligible Consumers: Individuals who are entitled to Medicare
Part A and/or Supplemental Medical Insurance and are eligible for Medicaid to pay
some form of Medicare cost sharing (such as premiums, copays, etc.). To maintain
your dual eligible status, you MUST maintain your full Medicaid eligibility.
Emergency Care: Emergency services are services for a medical problem you think is so
serious that it must be treated right away by a doctor.
Extra Help: A Medicare Program to help people with limited income and resources pay
Medicare prescription drug program costs, such as premiums, deductibles, and
coinsurance.
Identification Card (ID Card): A card for each member that is needed by your doctor’s office
before you can receive care.
Medically Necessary: Services or supplies that: are proper and needed for the diagnosis or
treatment of your medical condition.
Medicare: Created by Congress in 1965, Medicare (also know as Original or fee-forservice
Medicare) is the federal government’s national health insurance program for:
• People age 65 or older
• People under age 65 with disabilities who have been receiving Social Security
disability benefits for a set amount of time (24 months in most cases)
• People of any age with end-stage renal disease (ESRD) (permanent kidney
failure that requires dialysis or a transplant)
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Member Handbook
Definitions
Medicare benefits are divided into two categories: Part A and Part B. Medicare Part A
is hospital insurance that provides basic coverage for hospital stays, nursing home
facilities, hospice care, and home health care. Medicare Part B is medical insurance
that covers many of the fees associated with doctor visits, laboratory testing, and
outpatient services and supplies.
Medicare Advantage Plan: Medicare Advantage Plans (also known as Medicare Part
C) are types of health plans that are approved by Medicare and run by private insurance
companies like Buckeye. These plans are paid a set amount of money by the federal
government to provide basic Medicare benefits (Parts A and B) and the resulting
savings are passed along to you in the form of additional benefits such as lower costs
and additional benefits. Medicare Prescription Drug Plans are a type of Medicare
Advantage Plan that offer prescription drug coverage (Part D).
Member Services: A department within our Plan responsible for answering your
questions about your membership, benefits, grievances, and appeals.
Premium: The periodic payment to Medicare, or Buckeye, for health care coverage.
Primary Care Provider (PCP): Your family doctor (who must be contracted with the
insurance company) is trained in family medicine (general practice) or internal medicine.
Your PCP will work with you to direct your healthcare. Your PCP will do your check-ups
and treat you for most of your healthcare needs. If needed, your PCP will send you to
other doctors (specialists) or admit you to the hospital.
Prior Authorization – Approval in advance to get services AND/OR certain drugs that
may or may not be on our formulary. In Buckeye, some in-network services are
covered only if your doctor or other network provider gets “prior authorization” from
Buckeye. Some drugs are covered only if your doctor or other network provider gets
“prior authorization” from us. Covered drugs that need prior authorization are marked in
the formulary.
Special Needs Plan: A type of Medicare Advantage Plan that focuses on individuals
with special needs such as institutionalized beneficiaries, dually eligible (eligible for
Medicaid and Medicare), and/or beneficiaries with severe or disabling chronic
conditions.
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Member Handbook
Important Phone Numbers
Member Services
Advantage by Buckeye Community Health Plan
1-866-389-7690
1-800-750-0750 (TTY)
1-866-719-5435 (Fax)
175 S. 3 rd Street, Suite 1200 Columbus, OH 43215
www.bchpohio.com
8 a.m. - 8 p.m., 7 days a week
NurseWise: 1-866-389-7690 option 7
Your Buckeye Care Manager/Phone:__________________________
Transportation: 866-973-2522
Medicaid
Ohio Department of Job and Family Services
Ohio Medicaid Consumer Hotline
1-800-324-8680
1-800-292-3572 (TTY)
http://jfs.ohio.gov
Monday – Friday 7 a.m. – 8 p.m. and Saturday 8 a.m. – 5 p.m.
County You Live In:_______________________________________
Case Number:___________________________________________
Case Worker/Phone/Address:_______________________________
Primary Care Provider
Your Primary Care Provider/Phone:________________________________
Your Pharmacy/Phone:__________________________________________
Notes:________________________________________________________
_____________________________________________________________
Emergency: 911 or local emergency number
19

175 South 3rd Street, Suite 1200, Columbus, Ohio 43215
1-866-389-7690
TDD/TTY: 1-800-750-0750
Hours of Operation:
8 a.m. - 8 p.m., 7 days a week
www.bchpohio.com
© 2012 Buckeye Community Health Plan HMO SNP. All rights reserved.