Language Assistance. TTY: 711 For language assistance in English call ▇-▇▇▇-▇▇▇-▇▇▇▇ at no cost. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj ▇-▇▇▇-▇▇▇-▇▇▇▇. (Serbo-Croatian) Fii yo on heɓu ▇▇▇▇▇ ▇ ▇▇ yowitii e haala Pular noddee e oo numero ɗoo ▇-▇▇▇-▇▇▇-▇▇▇▇. Njodi woo fawaaki on. (Sudanic-Fulfulde) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) c2e. 2e u œ c2e 22v 2 c&u 2 zo _2c czv 2 c (cairyS-nairyssA) ., e o s ▇-▇▇▇-▇▇▇-▇▇▇▇ ua22& c e o 2e c ą ª 3 o sª £c 6e o ḅ cş e´£co& 1-800-370-4526s ė ´ o& . ( ˇec c) (Telugu) สำ˚ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร ▇-▇▇▇-▇▇▇-▇▇▇▇ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni ▇-▇▇▇-▇▇▇-▇▇▇▇ ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden ▇-▇▇▇-▇▇▇-▇▇▇▇. (Turkish) Щоб отримати допомогу перекладача української мови, зателефонуйте за безкоштовним номером ▇-▇▇▇-▇▇▇-▇▇▇▇. (Ukrainian) )udrU( - t z1-800-370-4526 y y ~ Để được hỗ trợ ▇▇▇▇ ▇▇▇̃ bằng (▇▇▇▇ ▇▇▇̃), hãy gọi miễn phí đến số ▇-▇▇▇-▇▇▇-▇▇▇▇. (Vietnamese) (Yiddish) . אצפא jıפ "רפ▇-▇▇▇-▇▇▇-▇▇▇▇ פıר א j א y yארפ ראפ Fún ìrànlọwọ ▇▇▇▇ ▇▇▇ (Yorùbá) pe ▇-▇▇▇-▇▇▇-▇▇▇▇ lái san owó kankan rárá. (Yoruba) Underwritten by AETNA HEALTH OF CALIFORNIA INC. in the State of Thank you for choosing Aetna. This is your Evidence of Coverage, or EOC for short. It is one of three documents that together describe the benefits covered by your Aetna plan. This EOC will tell you about your covered benefits – what they are and how you get them. The second document is the schedule of benefits. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only a certain number of visits. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”) and your contract holder. Ask your employer if you have any questions about the group agreement. Oh, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes: • Family planning • Contraceptive services, including emergency contraception • Sterilization, including tubal ligation at the time of labor and delivery • Infertility treatments • Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Welcome Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Referrals 12 Standing referrals 12 Second opinion 12 Eligible health services under your plan 14
Appears in 2 contracts
Sources: Hmo Agreement, Hmo Agreement
Language Assistance. TTY: 711 For language assistance in English call ▇-▇▇▇-▇▇▇-▇▇▇▇ at no cost. (English) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj ▇-▇▇▇-▇▇▇-▇▇▇▇ . (Serbo-Croatian) Za jezičnu pomoć na hrvatskom jeziku pozovite besplatan broj ▇-▇▇▇-▇▇▇-▇▇▇▇. (Serbo-Croatian) Fii yo on heɓu ▇▇▇▇▇ ▇ ▇▇ yowitii e haala Pular noddee e oo numero ɗoo ▇-▇▇▇-▇▇▇-▇▇▇▇. Njodi woo fawaaki on. (Sudanic-Fulfulde) Ukihitaji usaidizi katika lugha ya Kiswahili piga simu kwa 1-800-370-4526bila malipo. (Swahili) c2e. 2e u œ c2e 22v 2 c&u 2 zo _2c czv 2 c ()cairyS-nairyssA) ., e o s ( . ▇-▇▇▇-▇▇▇-▇▇▇▇ ua22& c e o 2e c ą ª 3 o sª £c 6e o ḅ cş e´£co& 1▇-800▇▇▇-370▇▇▇-4526s ė ´ o& . ▇▇▇▇ ( ˇec c) (Telugu) สำ˚ สำ หรับควำมช่วยเหลือทำงดำ้ นภำษำเป็ นภำษำไทย โทร ▇-▇▇▇-▇▇▇-▇▇▇▇ฟรีไม่มีค่ำใชจ้ ่ำย (Thai) Kapau ‘oku fiema’u hā tokoni ‘i he lea faka-Tonga telefoni ▇-▇▇▇-▇▇▇-▇▇▇▇ ‘o ‘ikai hā tōtōngi. (Tongan) Ren áninnisin chiakú ren (Kapasen Chuuk) kopwe kékkééri 1-800-370-4526nge esapw kamé ngonuk. (Trukese-Chuukese) (Dil) çağrısı dil yardım için. Hiçbir ücret ödemeden ▇-▇▇▇-▇▇▇-▇▇▇▇. (Turkish) Щоб отримати допомогу перекладача української мови, зателефонуйте за безкоштовним номером ▇-▇▇▇-▇▇▇-▇▇▇▇. (Ukrainian) )udrU( - t z1▇-800▇▇▇-370▇▇▇-4526 y y ~ ▇▇▇▇ Để được hỗ trợ ▇▇▇▇ ▇▇▇̃ bằng (▇▇▇▇ ▇▇▇̃), hãy gọi miễn phí đến số ▇-▇▇▇-▇▇▇-▇▇▇▇. (Vietnamese) ()Yiddish) . אצפא jıפ "רפ( ▇-▇▇▇-▇▇▇-▇▇▇▇ פıר א j א y yארפ ראפ Fún ìrànlọwọ ▇▇▇▇ ▇▇▇ (Yorùbá) pe ▇-▇▇▇-▇▇▇-▇▇▇▇ lái san owó kankan rárá. (Yoruba) Underwritten by AETNA HEALTH OF CALIFORNIA INC. in the State of Thank you for choosing Aetna. This is your Evidence of Coverage, or EOC for short. It is one of three documents that together describe the benefits covered by your Aetna plan. This EOC will tell you about your covered benefits – what they are and how you get them. The second document is the schedule of benefits. It tells you how we share expenses for eligible health services and tells you about limits – like when your plan covers only a certain number of visits. The third document is the group agreement between Aetna Health of California Inc. (“Aetna”) and your contract holder. Ask your employer if you have any questions about the group agreement. Oh, and each of these documents may have amendments or riders attached to them. They change or add to the documents they’re part of. Where to next? Flip through the table of contents or try the Let’s get started! section right after it. Let's get started! section gives you a thumbnail sketch of how your plan works. The more you understand, the more you can get out of your plan. Welcome to your Aetna plan. Some hospitals and other providers do not provide one or more of the following services that may be covered under your plan that includes: • Family planning • Contraceptive services, including emergency contraception • Sterilization, including tubal ligation at the time of labor and delivery • Infertility treatments • Abortion Call your prospective provider or refer to Let’s get started! – How to contact us for help section, if you have any questions. Welcome Let's get started 6 Some notes on how we use words 6 What your plan does – providing covered benefits 6 How your plan works – starting and stopping coverage 6 How your plan works while you are covered 6 How to contact us for help 8 Your member ID card 8 Who the plan covers 9 Who is eligible 9 When you can join the plan 9 Who can be on your plan (who can be your dependents) 9 Adding new dependents 10 Special times you and your dependents can join the plan 11 Medical necessity, referral and precertification requirements 12 Referrals 12 Standing referrals 12 Second opinion 12 Eligible health services under your plan 14
Appears in 1 contract
Sources: Hmo Agreement