individual sales brochure outside the exchange

Washington Individuals and Families

1.1.2016

Find the right plan for you and your budgetHere for your health

2 | LifeWise Health Plan of Washington

For help choosing and enrolling in a plan

844-LIFEWISE (844-543-3947)

3

We have a plan that fits youLifeWise offers you a choice of regional providers and a cost that fits your budget.

LifeWise plans cover the benefits you need from the local doctors, pharmacies, and hospitals you know. Your plan also includes discounts, tools, and wellness programs. And youre not paying for a lot of features you dont use.

Were here to walk you through the process of choosing and enrolling in a plan, making sure you understand all your options and what youre getting. We can help you figure out if youre eligible for help paying for your plana subsidyand enroll you through Washington Healthplanfinder if you are.

Make sure youve got the documents you need handy, then give us a call at 844-LIFEWISE. The whole process can be as easy as one phone conversation. Of course, were also happy to give you all the time you need to make the right choice.

Welcome to LifeWise Health Plan of Washington.

LifeWise is dedicated to offering you the right size plan to support your health and your budget, at every stage of your life. Our streamlined plans empower you to control how healthcare works for you and those you care for.

We are ready to help you understand your options every step of the way.

Thank you for considering LifeWise. We welcome the opportunity to be your health support partner.

Jim HavensPresident & CEOLifeWise Health Plan of Washington


Which doctors you can see The provider network

LifeWise offers exclusive provider organization (EPO) plans, which cover the cost of care from in-network doctors, pharmacies, hospitals, and other care providers in Washington, Oregon, or Alaska. You can also get covered care from in-network providers without a referral. These plans cover care only from in-network providers, unless you have a medical emergency.

What you get for your moneyThe benefits

Our plans cover recommended preventive care at no cost to you, plus office visits (unlimited visits before deductible), urgent and emergency care, prescription drugs, lab tests, maternity and newborn care, hospitalization, mental health care, and more.

All of our plans offer access to virtual care, so you can consult with a doctor anytime by phone or online videofor only a $15 copay per visit (except HSA plans, which do not use copays). You also have free access to the 24-Hour NurseLine for advice anytime day or night.

For some plans, when you select a primary care doctor and tell us about it, your primary visit copay is lower. In addition, your first two visits to this provider are covered in full.

For your primary care provider, you can choose a family medicine doctor, but also a naturopath or physicians assistant, nurse practitioner, pediatrician or geriatric specialist, or several other specialties. The Find a Doctor tool will tell you whether a particular provider is eligible as a primary care provider.

Take an online health assessment by June 30, 2016 and earn a $30 reward.

Consider these factors when choosing a health plan1

step

In addition to the essential benefits, all LifeWise medical plans include discounts on other health options that you might like.

Gym And Fitness Club Memberships

Diet And Nutrition Products

Alternative Care

Find a Doctor

If you already have a doctor or go to certain pharmacies or hospitals, use the Find a Doctor tool on lifewisewa.com to see if they are in the LifeWise Connect provider network.

Check your medication coverage

If you take prescription medications, check coverage at lifewisewa.com. Select Pharmacy, then click Rx Search to see if your medication is covered by the X1 formulary. Your share of the cost for prescriptions varies depending on whether the medication is a generic, brand-name, or specialty drug.

5

Plan generally covers this percentage of your healthcare costs

80% 70% 60%

Monthly premiums Higher Medium Lower

Your share of costs for medical care (deductible, copay, coinsurance)

Lower Medium Higher

Out-of-pocket maximum Lower Medium Higher

Good fit if you... Expect to need care frequently

May need care sometimes

Are healthy and expect to need little care

Gold Plans Silver Plans Bronze Plans

How much it costs youMonthly premiums and cost shares

Monthly payments. Premiums are due monthly, similar to your car or home insurance.

Paying when you get care. When you see a doctor or get other medical care, you pay a share of the cost and your health plan pays the rest. Your share includes deductibles, copays, and coinsurance.

Another important cost to pay attention to is your out-of-pocket maximumthe most youll pay in a year for covered healthcare services.

For more details about these terms, see page 15.

Cost levelsabout the metallics. LifeWise plans are available at different levelsbronze, silver, and goldso you can pick the one that best meets your needs. These levels refer only to the costs of the plans, not the quality. In most cases, they cover the same benefits.

You May Be Eligible For A Subsidy

Depending on your household income, you may be eligible for a subsidy to help pay for your health coverage. In Washington, as many as half of the individuals enrolling in health plans are eligible for a subsidy.

We can help you find out if you qualify for a subsidy and even apply through Washington Healthplanfinder. Call 844-LIFEWISE.


2step

Choose the LifeWise plan thats right for you

For More Information

For help selecting a plan and enrolling, call 844-LIFEWISE (844-543-3947)

LifeWise Health Plan of Washington offers several different plans, available at different cost levelsbronze, silver, and gold. Most LifeWise plans are exclusive provider organization (EPO) plans, but one is a preferred provider organization (PPO) plan. Both types of plan cover the same benefits.

Whats the difference between EPO plans and PPO plans?

EPO plans offer you care from in-network providers and hospitals in Washington, Oregon, and Alaska. PPO plans offer you care in and out of network, but you pay more out of network. Also, PPO plan premiums are higher.

EPOs with a health savings account (HSA)

Some LifeWise EPO plans can be paired with a health savings account. These plans allow you to set up an account to save and invest your money for future healthcare costs, and they have certain tax advantages. These plans generally have lower premiums, but you usually pay your share upfront.

EPO plans PPO plans

Out-of-network care not covered, except emergencies

Monthly premium $

HSA plans available

Lower copay when you choose a primary care provider (PCP) (except HSA)

You pay more for out-of-network covered care

Monthly premium $$

No HSA plan

Lower copay when you choose a PCP

LifeWise EPO provider networks

LifeWise network in Washington, national network elsewhere in United States

7

Get high-quality dental coverage at a great value from the same company you already trust for your medical coverage.

Adult Dental CoverageOur Adult Dental Plan gives you coverage for most preventive and diagnostic, basic and major dental services. Its easy and seamless to add this coverage when you enroll in a medical plan, or any time during the year.

With your medical and dental coverage from one company, you get the convenience of having all your coverage documents and claims records in one place, and one Customer Service team to call if you have questions.

Pediatric dental coverageIf your medical plan will cover dependents 18 or younger, federal law requires you to also purchase a pediatric dental plan, either from LifeWise or another company, at the same time. This coverage is not required if you dont cover any children.

The LifeWise Individual Pediatric Dental Plan provides:

Coverage for most preventive and diagnostic, basic and major dental services

Access to a network of dentists throughout Washington

No waiting period for dental servicesyour child can see a dentist immediately after enrolling

For details about dental benefits, visit lifewisewa.com, click Shop for Plans, and then select Individual Dental Plans.

Consider dental coverage 3step

Why dental health is important

Dental and oral health can offer clues about your overall health, and problems in your mouth can affect the rest of your body.

For details about these plans, visit lifewisewa.com, click Shop for Plans, then select Individual Dental.


Essential Gold EPO 1000Washington EPO plan for individuals & familiesBeginning January 1, 2016

This LifeWise EPO plan covers healthcare from providers in the LifeWiseConnect EPO network in Washington, Oregon, and Alaska. This plan also coversemergency care from out-of-network providers. However, you will pay the fullcost of non-emergency care from out-of-network providers. To find doctors andhospitals in the LifeWise Connect EPO network, go to lifewisewa.com and usethe Find a Doctor tool.

Essential Gold EPO 1000

LifeWise Connect network providers

1

2

3

4

5

6

7

8

9

10

10 Essential Benefits Covered Services

Annual Deductible

Coinsurance

Out-of-Pocket Maximum

Ambulatory Patient Services

Office Visits

Emergency Services

Hospitalization

Maternity & Newborn Care

Mental Health & Substance

Use Disorder Services,

including Behavioral Health

Treatment

Prescription Drugs

Retail/Specialty: 30-day supply

Mail Order: 90-day supply

Rehabilitative & Habilitative

Services & Devices

Laboratory Services

Preventive/Wellness Services

Pediatric Vision

Under 19 years of age

Per Calendar Year (PCY)

Family = 2x individual (in-network only)

Amount you pay after your deductible is met

Includes deductible, coinsurance, and copays


Outpatient services

Designated PCP office visit

Non-designated PCP & specialist office visit

Urgent care

Virtual care

Spinal manipulation: 10 visits PCY;

Acupuncture: 12 visits PCY

Emergency care (copay waived if directly

admitted to an inpatient facility)

Ambulance

Inpatient services

Organ and tissue transplants, inpatient

Prenatal, delivery, postnatal care

Office visit

Inpatient hospital: mental/behavioral health

Outpatient services

Generic

Preferred brand

Non-preferred brand

Specialty

Drug formulary

Inpatient rehabilitation: 30 days PCY

Physical, speech, occupational, massage

therapy: 25 visits combined PCY

Durable medical equipment

Includes x-ray, pathology, imaging/diagnostic,

ultrasound

Major imaging including MRI, CT, PET

(prior authorization required for certain services)

Screenings

Exams and immunizations

Eye exam: 1 PCY

Eyewear: 1 pair of glasses PCY (frames

& lenses); 12-month supply of contacts

PCY, in lieu of glasses (frames & lenses)

$1,000

20%

$4,500

Deductible, then 20%

$30 copay, first 2 PCP visits covered in full

$50 copay

$50 copay

$15 copay

$30 copay

$200 copay, then deductible, then 20%





$50 copay







X1






Covered in full

Covered in full

$30 copay

Covered in full

LifeWise Health Plan of Washington does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment & benefit determinations.

027829 (03-2015) LifeWise Health Plan of Washington

9

Essential Gold 1500Washington PPO plan for individuals & familiesBeginning January 1, 2016

Essential Gold 1500

LifeWise Connect networkproviders

Non-LifeWise Connect networkproviders

1

2

3

4

5

6

7

8

9

10


Annual Deductible

Coinsurance



Office Visits

Emergency Services

Hospitalization





Treatment

Prescription Drugs



(copay x3)


Services & Devices

Laboratory Services


Pediatric Vision







Outpatient services



Urgent care

Virtual care





Ambulance

Inpatient services



Office visit


Outpatient services

Generic

Brand

Specialty

Drug formulary






ultrasound



Screenings


Eye exam: 1 PCY




$1,500 2x individual deductible

20% 50%

$4,500 Unlimited

Deductible, then 20% Deductible, then 50%

$10 copay Deductible, then 50%



$15 copay Not covered


$200 copay, then deductible, then 20% Same as in-network

Deductible, then 20% Same as in-network






Deductible waived, then 20% Deductible, then 50%



Deductible waived, then 20% Not covered

X3




Deductible waived, then 20% Deductible, then 50%


Covered in full Deductible, then 50%

Covered in full Not covered

$30 copay Same as in-network

Covered in full Same as in-network




Essential Silver EPO 3000Washington EPO plan for individuals & familiesBeginning January 1, 2016


Essential Silver EPO 3000


1

2

3

4

5

6

7

8

9

10


Annual Deductible

Coinsurance



Office Visits

Emergency Services

Hospitalization





Treatment

Prescription Drugs




Services & Devices

Laboratory Services


Pediatric Vision







Outpatient services



Urgent care

Virtual care





Ambulance

Inpatient services



Office visit


Outpatient services

Generic

Preferred brand

Non-preferred brand

Specialty

Drug formulary






ultrasound



Screenings


Eye exam: 1 PCY




$3,000

20%

$6,850


$30 copay, first 2 PCP visits covered in full

$50 copay

$50 copay

$15 copay

$30 copay






$50 copay







X1






Covered in full

Covered in full

$30 copay

Covered in full



11

Essential Bronze EPO 6350Washington EPO plan for individuals & familiesBeginning January 1, 2016


Essential Bronze EPO 6350


1

2

3

4

5

6

7

8

9

10


Annual Deductible

Coinsurance



Office Visits

Emergency Services

Hospitalization





Treatment

Prescription Drugs




Services & Devices

Laboratory Services


Pediatric Vision







Outpatient services



Urgent care

Virtual care





Ambulance

Inpatient services



Office visit


Outpatient services

Generic

Preferred brand

Non-preferred brand

Specialty

Drug formulary






ultrasound



Screenings


Eye exam: 1 PCY




$6,350

20%

$6,850


$30 copay



$15 copay

$30 copay













X1






Covered in full

Covered in full

$30 copay

Covered in full




Essential Silver EPO 3000 HSAWashington EPO plan for individuals & familiesBeginning January 1, 2016


Essential Silver EPO 3000 HSA


1

2

3

4

5

6

7

8

9

10


Annual Deductible

Coinsurance



Office Visits

Emergency Services

Hospitalization





Treatment

Prescription Drugs




Services & Devices

Laboratory Services


Pediatric Vision







Outpatient services

PCP office visit


Urgent care

Virtual care



Emergency care

Ambulance

Inpatient services



Office visit


Outpatient services

Generic

Preferred brand

Non-preferred brand

Specialty

Drug formulary






ultrasound



Screenings


Eye exam: 1 PCY




$3,000

20%

$4,850



















X1






Covered in full

Covered in full

Deductible waived, then 20%

Covered in full



13

Essential Bronze EPO 6000 HSAWashington EPO plan for individuals & familiesBeginning January 1, 2016


Essential Bronze EPO 6000 HSA


1

2

3

4

5

6

7

8

9

10


Annual Deductible

Coinsurance



Office Visits

Emergency Services

Hospitalization





Treatment

Prescription Drugs




Services & Devices

Laboratory Services


Pediatric Vision







Outpatient services

PCP office visit


Urgent care

Virtual care



Emergency care

Ambulance

Inpatient services



Office visit


Outpatient services

Generic

Preferred brand

Non-preferred brand

Specialty

Drug formulary






ultrasound



Screenings


Eye exam: 1 PCY




$6,000

0%

$6,000

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

X1

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Deductible, then 0%

Covered in full

Covered in full

Deductible waived, then 20%

Covered in full




step

4

What youll need before you call

When you call, be sure you have names, birth dates and Social Security numbers for all family members you want to enroll, and household income to determine if you qualify for a subsidy.

Let us help you enroll nowWe want to help you choose the right plan with the coverage you need at a price that fits your budget. We can help you find out whether you qualify for a subsidy to help pay for your health plan.

For help enrolling and detailed information about coverage and costs:

Call 844-LIFEWISE (844-543-3947) 8 a.m.5 p.m. Pacific time, MondayFriday

15

General exclusions and limitations

Orthognathic surgery (except when repairing a dependent childs congenital abnormality)

Service in excess of specified benefit maximums

Services payable by other types of insurance coverage

Services received when you are not covered by this program

Sexual dysfunction

Sterilization reversal

For a list of services and procedures that require approval for coverage from your plan before you receive them (prior authorization), visit lifewisewa.com.

Benefits are not provided for treatment, surgery, services, drugs, or supplies for any of the following:

Cosmetic surgery or reconstructive surgery (except as specifically provided)

Experimental or investigative services

Infertility

Obesity/morbid obesity, including surgery, drugs, foods, and exercise programs

Definitions

allowed amount: When providers have a contract with us, the amount your health plan has agreed to pay healthcare providers for services or supplies. Youll be responsible only for any applicable cost sharing, including deductibles, copays, coinsurance, charges in excess of the stated benefit maximums and charges for services and supplies not covered under this plan. In-network providers cannot bill you for charges over the allowed amount.

coinsurance: Your share of the cost for a service. If your plans coinsurance is 20%, you pay 20% of the allowed amount and your plan pays the other 80% of the allowed amount.

copay: A flat fee you pay for a specific service, such as an office visit, at the time you receive service.

covered in full: Services of which your plan pays the total cost, at 100% of the allowed amount. You do not pay deductibles, coinsurance or copays for these services.

deductible: The amount of money you pay every year for covered services before the plan pays for certain benefits.

exclusive provider organization (EPO): Plans that only cover the cost of care from an in-network provider in Oregon, Washington and Alaska, unless you have a medical emergency. If you receive non-emergency care from an out-of-network healthcare provider you will be responsible for the full cost of that care.

formulary: A list of drugs covered by a health plan. Not all generic, brand-name and specialty drugs are included in every formulary.

health savings account (HSA): A savings account through a bank that is available to individuals who are enrolled in a qualified high deductible health plan. The funds contributed to the account, as well as interest and investment earnings, arent subject to federal income tax when used for qualified medical expenses.

in-network: Doctors, dentists, hospitals, and other healthcare providers that are contracted to provide services and supplies at negotiated amounts called allowed amounts.

out-of-pocket maximum: The maximum amount of money you will pay for covered services in a calendar year. After youve paid this amount, your plan pays 100% of the allowed amount for services received from in-network providers.

This is only a summary of the major benefits provided by our plans. This is not a contract. Please see lifewisewa.com/SBC for the Summary of Benefits and Coverage and Glossary. On our website, you can also find a Supplemental Guide with information about privacy policies, provider organization, key utilization management procedures, and pharmaceutical management procedures.

016891 (10-2015)

LifeWise Health Plan of WashingtonPO Box 91120Seattle, WA 98111

lifewisewa.com

Cost transparency tool. Know what costs to expect.

Spending activity report. Track your claims and the status of your deductible, among other things.

For help choosing and enrolling in a plan

844-LIFEWISE (844-543-3947)

Find a Doctor. Research providers and check which networks include them at lifewisewa.com or via LifeWise Mobile.

LifeWise Mobile. Download the free app for on-the-go access to locate doctors, show proof of coverage, manage benefits, claims, and prescriptionsand more.

Free tools make it easier. All LifeWise health plans include tools to help you manage your health and your plan:

037336 (07-2016)

Discrimination is Against the Law LifeWise Health Plan of Washington complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. LifeWise does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. LifeWise: 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, audio, accessible

electronic formats, other 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, contact the Civil Rights Coordinator. If you believe that LifeWise 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 - Complaints and Appeals PO Box 91102, Seattle, WA 98111 Toll free 855-332-6396, Fax 425-918-5592, TTY 800-842-5357 Email [email protected] You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the 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, D.C. 20201, 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. Getting Help in Other Languages This Notice has Important Information. This notice may have important information about your application or coverage through LifeWise Health Plan of Washington. There may be key dates in this notice. You may need to take action by certain deadlines to keep your health coverage or help with costs. You have the right to get this information and help in your language at no cost. Call 800-592-6804 (TTY: 800-842-5357). (Amharic): LifeWise Health Plan of Washington 800-592-6804 (TTY: 800-842-5357)

:(Arabic) .

LifeWise Health Plan of Washington. .

. (TTY: 800-842-5357) 6804-592-800 .

(Chinese): LifeWise Health Plan of Washington

800-592-6804 (TTY: 800-842-5357)

Oromoo (Cushite): Beeksisni kun odeeffannoo barbaachisaa qaba. Beeksisti kun sagantaa yookan karaa LifeWise Health Plan of Washington tiin tajaajila keessan ilaalchisee odeeffannoo barbaachisaa qabaachuu dandaa. Guyyaawwan murteessaa taan beeksisa kana keessatti ilaalaa. Tarii kaffaltiidhaan deeggaramuuf yookan tajaajila fayyaa keessaniif guyyaa dhumaa irratti wanti raawwattan jiraachuu dandaa. Kaffaltii irraa bilisa haala taeen afaan keessaniin odeeffannoo argachuu fi deeggarsa argachuuf mirga ni qabaattu. Lakkoofsa bilbilaa 800-592-6804 (TTY: 800-842-5357) tii bilbilaa. Franais (French): Cet avis a d'importantes informations. Cet avis peut avoir d'importantes informations sur votre demande ou la couverture par l'intermdiaire de LifeWise Health Plan of Washington. Le prsent avis peut contenir des dates cls. Vous devrez peut-tre prendre des mesures par certains dlais pour maintenir votre couverture de sant ou d'aide avec les cots. Vous avez le droit d'obtenir cette information et de laide dans votre langue aucun cot. Appelez le 800-592-6804 (TTY: 800-842-5357). Kreyl ayisyen (Creole): Avi sila a gen Enfmasyon Enptan ladann. Avi sila a kapab genyen enfmasyon enptan konsnan aplikasyon w lan oswa konsnan kouvti asirans lan atrav LifeWise Health Plan of Washington. Kapab genyen dat ki enptan nan avi sila a. Ou ka gen pou pran kk aksyon avan sten dat limit pou ka kenbe kouvti asirans sante w la oswa pou yo ka ede w avk depans yo. Se dwa w pou resevwa enfmasyon sa a ak asistans nan lang ou pale a, san ou pa gen pou peye pou sa. Rele nan 800-592-6804 (TTY: 800-842-5357). Deutsche (German): Diese Benachrichtigung enthlt wichtige Informationen. Diese Benachrichtigung enthlt unter Umstnden wichtige Informationen bezglich Ihres Antrags auf Krankenversicherungsschutz durch LifeWise Health Plan of Washington. Suchen Sie nach eventuellen wichtigen Terminen in dieser Benachrichtigung. Sie knnten bis zu bestimmten Stichtagen handeln mssen, um Ihren Krankenversicherungsschutz oder Hilfe mit den Kosten zu behalten. Sie haben das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Rufen Sie an unter 800-592-6804 (TTY: 800-842-5357). Hmoob (Hmong): Tsab ntawv tshaj xo no muaj cov ntshiab lus tseem ceeb. Tej zaum tsab ntawv tshaj xo no muaj cov ntsiab lus tseem ceeb txog koj daim ntawv thov kev pab los yog koj qhov kev pab cuam los ntawm LifeWise Health Plan of Washington. Tej zaum muaj cov hnub tseem ceeb uas sau rau hauv daim ntawv no. Tej zaum koj kuj yuav tau ua qee yam uas peb kom koj ua tsis pub dhau cov caij nyoog uas teev tseg rau hauv daim ntawv no mas koj thiaj yuav tau txais kev pab cuam kho mob los yog kev pab them tej nqi kho mob ntawd. Koj muaj cai kom lawv muab cov ntshiab lus no uas tau muab sau ua koj hom lus pub dawb rau koj. Hu rau 800-592-6804 (TTY: 800-842-5357). Iloko (Ilocano): Daytoy a Pakdaar ket naglaon iti Napateg nga Impormasion. Daytoy a pakdaar mabalin nga adda ket naglaon iti napateg nga impormasion maipanggep iti apliksayonyo wenno coverage babaen iti LifeWise Health Plan of Washington. Daytoy ket mabalin dagiti importante a petsa iti daytoy a pakdaar. Mabalin nga adda rumbeng nga aramidenyo nga addang sakbay dagiti partikular a naituding nga aldaw tapno mapagtalinaedyo ti coverage ti salun-atyo wenno tulong kadagiti gastos. Adda karbenganyo a mangala iti daytoy nga impormasion ken tulong iti bukodyo a pagsasao nga awan ti bayadanyo. Tumawag iti numero nga 800-592-6804 (TTY: 800-842-5357). Italiano (Italian): Questo avviso contiene informazioni importanti. Questo avviso pu contenere informazioni importanti sulla tua domanda o copertura attraverso LifeWise Health Plan of Washington. Potrebbero esserci date chiave in questo avviso. Potrebbe essere necessario un tuo intervento entro una scadenza determinata per consentirti di mantenere la tua copertura o sovvenzione. Hai il diritto di ottenere queste informazioni e assistenza nella tua lingua gratuitamente. Chiama 800-592-6804 (TTY: 800-842-5357).

(Japanese): LifeWise Health Plan of Washington

800-592-6804 (TTY: 800-842-5357) (Korean): . LifeWise Health Plan of Washington . . . . 800-592-6804 (TTY: 800-842-5357) . (Lao): . LifeWise Health Plan of Washington. . . . 800-592-6804 (TTY: 800-842-5357). (Khmer):

LifeWise Health Plan of Washington

800-592-6804 (TTY: 800-842-5357) (Punjabi): . LifeWise Health Plan of Washington . . , , 800-592-6804 (TTY: 800-842-5357).

:(Farsi) .

. LifeWise Health Plan of Washington .

.

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