2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 8: Your rights and responsibilities 193 · For information on the quality program for your specific health plan, call Customer Service. You may also access this information via the website (uhcmedicaresolutions.com/resources/ma- pdp-information-forms.html). Select, “Commitment to Quality.” · You can call the SHIP. For details, go to Chapter 2, Section 3. · You can contact Medicare. - You can visit the Medicare website to read or download the publication “Medicare Rights & Protections.” (The publication is available at: medicare.gov/Pubs/pdf/11534-Medicare-Rights-and-Protections.pdf) - Or, you can call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week (TTY 1-877-486-2048). Section 2 You have some responsibilities as a member of the plan Things you need to do as a member of the plan are listed below. If you have any questions, please call Customer Service. · Get familiar with your covered services and the rules you must follow to get these covered services. Use this Evidence of Coverage to learn what is covered for you and the rules you need to follow to get your covered services. - Chapters 3 and 4 give the details about your medical services. - Chapters 5 and 6 give the details about your Part D prescription drug coverage. · If you have any other health insurance coverage or prescription drug coverage in addition to our plan, you are required to tell us. Chapter 1 tells you about coordinating these benefits. · Tell your doctor and other health care providers that you are enrolled in our plan. Show your UnitedHealthcare member ID card whenever you get your medical care or Part D prescription drugs. · Help your doctors and other providers help you by giving them information, asking questions, and following through on your care. - To help get the best care, tell your doctors and other health providers about your health problems. Follow the treatment plans and instructions that you and your doctors agree upon. - Make sure your doctors know all of the drugs you are taking, including over-the-counter drugs, vitamins, and supplements. - If you have any questions, be sure to ask and get an answer you can understand. · Be considerate. We expect all our members to respect the rights of other patients. We also expect you to act in a way that helps the smooth running of your doctor’s office, hospitals, and other offices. · Pay what you owe. As a plan member, you are responsible for these payments: - You must continue to pay your Medicare Part B premium to remain a member of the plan. - For most of your medical services or drugs covered by the plan, you must pay your share of the cost when you get the service or drug.

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