Qualified Medical Child SupportOrders
Coverage will be provided to any of your dependent child( ren) if a Qualified Medical Child Support Order( QMCSO) is issued, regardless of whether the child( ren) currently reside with you. A QMCSO may be issued by a court of law or issued by a state agency as a National Medical Support Notice( NMSN), which is treated as a QMCSO. If a QMCSO is issued, the child or children shall become an alternate recipient treated as provisions, and procedures as all other plan participants.
Patient Protections Disclosure
The Unified Fire Authority Health Plan generally allows the designation of a primary care provider. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. Until you make this designation, SelectHealth designates one for you. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact SelectHealth at 800.538.5038 or www. selecthealth. org.
For children, you may designate a pediatrician as the primary care provider. You do not need prior authorization from SelectHealth or from any other person( including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact SelectHealth at 800.538.5038 or www. selecthealth. org.
Preventive Care
Certain preventive care services must be provided by non-grandfathered group health plans without member cost-sharing( such as deductibles or copays) when these services are provided by a network provider. Please refer to your insurance company for more information. Contact information is listed under“ Contacts” in this Guide.
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