Important Notices and Disclosures
FOR MORE INFORMATION ABOUT THIS NOTICE OR YOUR CURRENT PRESCRIPTION DRUG COVERAGE …
Contact the person listed below for further information . NOTE : You ’ ll get this notice each year . You will also get it before the next period you can join a Medicare drug plan , and if this coverage through Davis Behavioral Health changes . You also may request a copy of this notice at any time .
FOR MORE INFORMATION ABOUT YOUR OPTIONS UNDER MEDICARE PRESCRIPTION DRUG COVERAGE …
More detailed information about Medicare plans that offer prescription drug coverage is in the “ Medicare & You ” handbook . You ’ ll get a copy of the handbook in the mail every year from Medicare . You may also be contacted directly by Medicare drug plans .
FOR MORE INFORMATION ABOUT MEDICARE PRESCRIPTION DRUG COVERAGE : � Visit www . medicare . gov . �
Call your State Health Insurance Assistance Program ( see the inside back cover of your copy of the “ Medicare & You ” handbook for their telephone number ) for personalized help .
� Call 1.800 . MEDICARE ( 1.800.633.4227 ). TTY users should call 1.877.486.2048 .
If you have limited income and resources , extra help paying for Medicare prescription drug coverage is available . For information about this extra help , visit Social Security on the web at www . socialsecurity . gov , or call them at 1.800.772.1213 ( TTY 1.800.325.0778 ).
Remember : Keep this Creditable Coverage Notice . If you decide to join one of the Medicare drug plans , you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and , therefore , whether or not you are required to pay a higher premium ( a penalty ).
Date : July 01 , 2024 Name of Entity / Sender Contact — Position / Office : Office Address :
Davis Behavioral Health Kathi Hanson - Human Resources 934 South Main Street Layton , Utah 84041-7135 United States Phone Number : 801.336.1845
Davis Behavioral Health
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