2017 CeltiCare Health Plan of Massachusetts, Inc.

Member Handbook

This Member Handbook is a detailed guide to your CeltiCare Health CarePlus plan. For a listing of your covered and excluded benefits, see the Covered Services List included in your welcome packet. Keep the Covered Services List and Member Handbook together for complete information about your health insurance coverage.

Effective Date: January 1, 2017 Revised: April 8, 2017

CeltiCare Health Plan of Massachusetts, Inc. (CeltiCare Health), will accept you into our plan upon referral from the MassHealth regardless of your income, physical or mental condition, age, gender, sexual orientation, religion, physical or mental disability, ethnicity or race, previous status as a Member, pre-existing conditions, and/or expected health or genetic status.

CarePlus

CeltiCare Health Member Services: 1-855-678-6975; (TDD/TTY) 1-866-614-1949 M F, 8 a.m. -5 p.m.

Cenpatico Behavioral Health: 1-866-896-5053 (TDD/TTY: 1-800-439-2370) M F, 8 a.m. 6 p.m. After hours CeltiCare Health and Cenpatico calls forward to the 24-hour/7 day NurseWise line

www.CeltiCareHealthPlan.com MassHealth Customer Service: 1-800-841-2900 (TDD/TTY) 1-800-497-4648, M F, 8 a.m.-5 p.m.

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MEMBER HANDBOOK

WELCOME TO CELTICARE HEALTH This Member Handbook describes your CeltiCare Health CarePlus Plan. It is designed to make it easy for you to make the most of your CeltiCare Health services. As an enrollee in MassHealths CarePlus program, we are pleased to have you as a CeltiCare Health Member.

CeltiCare Health is a Managed Care Organization (MCO) overseen by the Massachusetts Executive Office of Health and Human Services (EOHHS). You became a CeltiCare Health Member because you live in Massachusetts. You also became a Member because you are eligible to receive MassHealth benefits in the Massachusetts CarePlus program. CeltiCare Health is a healthcare plan that gives you choices from choosing your Primary Care Provider (PCP) to a variety of Member services and special programs that help you stay healthy.

If you are a new Member, you will be contacted by CeltiCare Health by phone to welcome you to the Plan and review your benefits. During this call you can ask any questions you may have about your coverage. If we cant reach you, please call the Member Services department and a representative will be happy to speak with you.

To make sure we can reach you, always call our Member Services department and MassHealth Customer Service if you change your address or phone number. If you dont keep MassHealth up to date on your contact information, you could lose your MassHealth and CeltiCare Health Eligibility. You can find MassHealth and CeltiCare Health contact information at the bottom of every page of this Member Handbook.

If you also want us to contact you via email, please be sure to provide us with that address either on the phone or by logging into your secure online Member Portal. You can find the portal and get more information on our services by visiting our website: www.CeltiCareHealthPlan.com.

OTHER FORMATS AND LANGUAGES The information in this Member Handbook is about your CeltiCare Health Plan of Massachusetts, Inc. (CeltiCare Health) benefits. If you need information in a different language or provided to you in a different way, please call Member Services so we can help you. The phone number and business hours are at the bottom of each page in this handbook. Other Languages and Alternative Formats: Call CeltiCare Healths Member Service department to have a Spanish version of this handbook sent to you. If you need any other language, you can have this document read to you free of charge. CeltiCare Health will also provide information from this handbook in American Sign Language (ASL), braille, large font, or video recorded ASL upon request. All written materials sent to Members are available in Spanish. English and Spanish versions of this Member Handbook are available on our website: www.CeltiCareHealthPlan.com. Words that are capitalized throughout this Member Handbook are defined in the glossary at the end of the handbook.

http://www.celticarehealthplan.com/http://www.celticarehealthplan.com/http://www.celticarehealthplan.com/

MEMBER HANDBOOK

ENGLISH: If the enclosed information is not in your primary language, please call 1-855-678-6975 (TDD/TTY only: 1-866-614-1949).

HAITIAN CREOLE: Enfomasyon ki nan tiliv sa a, se sou avantaj nan CeltiCare Health Plan nan Eta Massachusetts (CeltiCare). Si w bezwen enfomasyon nan yon lot lang, rele

Sevis pou Manm yo nan 1-855-678-6975,TDD/TTY: 1-866-614-1949, pou nou kapab ede w.

PORTUGUESE: A informacao incluida neste folheto diz respeito aos beneficios do seu Plano de Saude CeltiCare de Massachusetts (CeltiCare). Se necessitar de informacoes

numa outra lingua, por favor ligue para os Servicos ao Associado atraves do numero 1-

855-678-6975, TDD/TTY: 1-866-614-1949 para que o(a) possamos ajudar. RUSSIAN: , , , 1-855-678-6975 ( () : 1-866-614-1949). UKRAINIAN: , , , , , 1-855-678-6975 ( () : 1-866-614-1949). KOREAN: 1-855-678-6975 (/ : 1-866-614-1949) . FRENCH: Si les pieces jointes ne sont pas dans votre langue maternelle,veuillez appeler le 1-855-678-6975 (Pour sourds et malentendants seulement: 1-866-614-1949).

ROMANIAN: Dac informaiile alturate nu sunt in limba dumneavoastr principal, v rugm s sunai la 1-855-678-6975 (TDD/TTY: 1-866-614-1949). AMHARIC: 1-855-678-6975 (TDD/TTY: 1-866-614-1949). TIGRIGNA: 1-855-678-6975 (TDD/TTY: 1-866-614-1949). SPANISH: Si la informacion adjunta no esta en su idioma primario, por favor llame al 1-855-678-6975 (Para TDD/TTY, llame al 1-866-614-1949).

LAO: , 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

VIETNAMESE: Nu tin tc nh km khng c ngn ng ca qu v xin gi 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

CHINESE: 1-855-678-6975 (TDD/TYY: 1-866-614-1949)

CAMBODIAN: 1-855-678-6975 ( TDD/TTY 1-866-614-1949). TAGALOG: Kung ang nakalakip na impormasyon ay hindi nakasulat sa inyong pangunahing wika, mangyaring tawagan ang 1-855-678-6975 (TDD/TTY: 1-866-614-1949).

FARSI: (1-866-614-1949: TDD/TTY ) -678-855- . 6975

CeltiCare Health Member Services: 1-855-678-6975; (TDD/TTY) 1-866-614-1949 M F, 8 a.m. -5 p.m.

Cenpatico Behavioral Health: 1-866-896-5053 (TDD/TTY: 1-800-439-2370) M F, 8 a.m. 6 p.m. After hours CeltiCare Health and Cenpatico calls forward to the 24-hour/7 day NurseWise line

www.CeltiCareHealthPlan.com MassHealth Customer Service: 1-800-841-2900 (TDD/TTY) 1-800-497-4648, M F, 8 a.m.-5 p.m.

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MEMBER HANDBOOK

Table of Contents WELCOME TO CELTICARE HEALTH ........................................................................................... 1 OTHER FORMATS AND LANGUAGES ....................................................................................... 1 Table of Contents ................................................................................................................... 3 Your Covered Benefits ............................................................................................................ 5 INFORMATION SOURCES ........................................................................................................ 6 Your Member Handbook ........................................................................................................ 6 Your Provider Directory .......................................................................................................... 6 CeltiCare Health Website ....................................................................................................... 7 HOW TO CONTACT US ............................................................................................................ 7 INTERPRETER SERVICES .......................................................................................................... 8 YOUR MEMBER ID CARD ........................................................................................................ 8 HOW YOUR PLAN WORKS ...................................................................................................... 9 Service Areas Covered ............................................................................................................ 9 Member Services ................................................................................................................. 10 Membership Eligibility ......................................................................................................... 10 Major Life Changes .............................................................................................................. 10 Newborn Enrollment ............................................................................................................ 11 Disenrollment ...................................................................................................................... 11 COVERED SERVICES .............................................................................................................. 11 MEMBER EXTRAS ................................................................................................................. 12 CentAccount Program. ....................................................................................................... 12 myStrength.com. ................................................................................................................. 12 YOU AND YOUR PRIMARY CARE PROVIDER (PCP) .................................................................. 12 Choosing Your PCP from the CeltiCare Health Provider Directory ...................