MCDTX_18_63331 02132018 Valid March 1, 2018 to August 31, 2018

MY BENEFITS GUIDE2

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Table of contents

4-5 Introduction

• Important phone numbers

• My Cigna-HealthSpring benefits

6-9 All Members

• Fitness benefit

• 24-hour Nurse Line

• $10 monthly allowance for over-the-counter health products

• Emergency response services

• Respite care services

• Extra help getting a ride

• Reaching tool

• Clip-on lamp

• NEW! Lumbar support pillow

• Vinyl gloves

• NEW! Personal fan

10-11 Members with Medicaid only

• Extra vision services

• Extra dental services

• $30 gift card for Good Health Rewards

12-13 Pregnant Members or new mothers

• Extra dental services

• Pregnancy book

• Home health visit

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Member Services

1-877-653-0327 (TTY: 7-1-1)Monday to Friday 8 a.m. to 5 p.m. Central Time

Service Coordination

1-877-725-2688Monday to Friday 8 a.m. to 5 p.m. Central Time

24-hour Nurse Line

1-855-418-455224 hours a day 7 days a week

Transportation

1-877-725-2688Monday to Friday 8 a.m. to 5 p.m. Central Time

Behavioral Health and Substance Abuse

1-877-725-2539Monday to Friday 8 a.m. to 5 p.m. Central Time

Dental care

1-855-418-1628Monday to Friday 7 a.m. to 8 p.m. Central Time

Vision care

1-800-879-6901Monday to Friday 7 a.m. to 7 p.m. Central Time

Fitness benefit

1-888-369-2746 (TTY/TDD: 1-877-710-2746)Monday to Friday 7 a.m. to 8 p.m. Central Time

Important phone numbers

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Review this booklet to learn about your benefits. Not every service may be listed. For more information, you can:

Review your Member Handbook.

Call Member Services toll-free 1-877-653-0327 (TTY: 7-1-1) Monday to Friday, 8 a.m. to 5 p.m. Central Time.

Go to STARPLUS.MyCignaHealthSpring.com/STARPLUShandbook.

My Cigna-HealthSpring benefits

Cigna-HealthSpring STAR+PLUS Members GET FREE SERVICES that are not covered by basic Medicaid.

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Fitness benefit

You can choose 1 of the following:

• Fitness facility membership, or

• 2 home fitness kits such as:

§ Exercise

§ Walking

§ Pilates

§ Tai Chi

§ Stress Management and more

Fitness facilities must be in-network. If you need help you may bring a caregiver to fitness facility. You can change fitness facilities once a month. Home fitness kits are for those who do not join a fitness facility. You can get 2 fitness kits yearly.

Call to find a fitness center or join in the Home Fitness program:

1-888-369-2746 (TTY/TDD 1-877-710-2746)Monday to Friday, 7 a.m. to 8 p.m. Central Time

24-hour Nurse Line

You can call to talk to a nurse 24 hours a day, 365 days a year. You can get health information and advice anytime day or night.

Call the 24-hour Nurse Line at:

1-855-418-4552 (TTY: 7-1-1)

ALL MEMBERS

The following benefits are available to all Cigna-HealthSpring STAR+PLUS Members.

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$10 monthly allowance for over-the-counter health products

You can get $10 every month to use toward your over-the-counter (OTC) health products. You will receive an OTC catalog that lists items such as:

• Anti-itch lotions and creams

• Cold, flu, decongestant and sinus relief

• Dental and denture care

• First aid and medical supplies

• Foot care

• Sleeping aids

• Vitamins and minerals

• Wart remover and more

Unused dollars rollover month to month but must be used by August 31, 2018.

To place an order call:

1-866-575-3744

Emergency Response Services

You can get a medical Emergency Response System in your home.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Respite care services

You can get 24 hours of respite care to help your family or other unpaid caregivers every 12 months.

If you are a Waiver Member you are not eligible for respite care.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Extra help getting a ride

You can get a ride to your doctor and other medical visits.

Service Coordinators will arrange for transportation services when State transportation services are unavailable. You must call at least 2 days before appointment to schedule transportation.

Call Service Coordination at:

1-877-725-2688 (TTY: 7-1-1)

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ALL MEMBERS(continued)

The following benefits are available to all Cigna-HealthSpring STAR+PLUS Members. Reaching tool

You can get a reaching tool every 12 months.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Clip-on lamp

You can get a lamp every 12 months.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

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NEW! Lumbar support pillow

You can get a pillow every 12 months.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

NEW! Personal fan

You can get a personal fan every 12 months.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Vinyl gloves

You can get a box of vinyl gloves every month.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

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MEMBERS WITH MEDICAIDONLY

The following benefits are available to Cigna-HealthSpring STAR+PLUS Medicaid Members only.

Extra vision services

If you are age 21 and older covered only by Medicaid you can get a vision services that include:

• 1 eye exam

• 1 pair of glasses

• Up to $100 for enhanced frame selection every 12 months

$100 allowance does not apply to contact lenses, add-ons, replacement eyewear or sunglasses.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Extra dental services

If you are age 21 and older covered only by Medicaid you can get dental services such as:

• Oral examinations

• X-rays

• Cleaning

• Restorative services

• Simple extractions

A $500 annual maximum limit applies to all services. You can visit a participating dentist to get services. A primary doctor referral is not needed.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

$30 gift card for Good Health Rewards

If you are covered by only Medicaid you can get a $30 gift card for getting your annual well visit with certain tests, labs or immunizations.

Limit 1 gift card per year.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

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The following benefits are available to Cigna-HealthSpring STAR+PLUS Members who are pregnant or new mothers.

PREGNANT MEMBERS OR NEW MOTHERS Extra dental services

If you are pregnant covered only by Medicaid you can get dental services such as:

• Oral examinations

• X-rays

• Cleaning

• Restorative services

• Simple extractions

A $500 annual maximum limit applies to all services. You can visit a participating dentist directly to get services. A primary doctor referral is not needed.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Pregnancy book

If you are pregnant you can get a book to help you understand pregnancy.

Limit 1 book per year.

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

Home health visit

If you are a new mother covered only by Medicaid you can get the following:

• Self-care and baby-care information

• 1 home health care visit within a 12-month period

Call Member Services at:

1-877-653-0327 (TTY: 7-1-1)

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Notice of Nondiscrimination: Discrimination is Against the LawCigna-HealthSpring complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Cigna-HealthSpring does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.Cigna-HealthSpring:• Provides free aids and services to people with

disabilities to communicate effectively with us, such as: § Qualifiedsignlanguageinterpreters § 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:

§ Qualifiedinterpreters § Information written in other languages

If you need these services, contact Member Services.If you believe that Cigna-HealthSpring has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability,orsex,youcanfileagrievancewith:

Cigna-HealthSpring Attention: Appeals, Complaints, and Grievances Department P.O. Box 211088 Bedford, Texas 76095

1-877-653-0327 (TTY: 7-1-1) 7 days a week 8 a.m. to 8 p.m. Central Time Fax: 877-809-0783

Youcanfileagrievanceinwritingbymailorfax.Ifyouneedhelpfilingagrievance,Member Services is available to help you.YoucanalsofileacivilrightscomplaintwiththeU.S.DepartmentofHealthandHumanServices,OfficeforCivilRights,electronicallythroughtheOfficeforCivilRights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S.DepartmentofHealthandHumanServices200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, D.C. 202011-800-368-1019, 800-537-7697 (TDD)Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including HealthSpring Life & Health Insurance Company, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. © 2018 Cigna