Part 8 – Other Health Plan Provisions (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 82 Mandates for Residents or Services Outside of Massachusetts When you live or receive health care services or supplies in a state other than Massachusetts, your coverage and other requirements for health care services you receive in that state may be different from those described in this Subscriber Certificate. In this case, you may be entitled to receive additional coverage under this health plan as required by that state’s law. You should call the Blue Cross Blue Shield HMO Blue customer service office for more help if this applies to you. Member Cooperation You agree to provide Blue Cross Blue Shield HMO Blue with information it needs to comply with federal and/or state law and regulation. If you do not do so in a timely manner, your claims may be denied and/or your coverage in this health plan may be affected. Pre-Existing Conditions Your coverage in this health plan is not limited based on medical conditions that are present on or before your effective date. This means that your health care services will be covered from the effective date of your coverage in this health plan without a pre-existing condition restriction or a waiting period. But, benefits for these health care services are subject to all the provisions of this health plan. Quality Assurance Programs Blue Cross Blue Shield HMO Blue uses quality assurance programs. These programs are designed to improve the quality of health care and the services that are provided to Blue Cross Blue Shield HMO Blue members. These programs affect different aspects of health care. This may include, for example, health promotion. From time to time, Blue Cross Blue Shield HMO Blue may add or change the programs that it uses. Blue Cross Blue Shield HMO Blue will do this to ensure that it continues to provide you and your family with access to high-quality health care and services. For more information, you can call the Blue Cross Blue Shield HMO Blue customer service office. The toll free phone number to call is shown on your ID card. Some of the clinical programs that Blue Cross Blue Shield HMO Blue uses are:  A breast cancer screening program. It encourages female members who are over 50 to have mammograms.  A cervical cancer screening program. It helps to get more female members who are age 18 and older to have a Pap smear test.  A program that furnishes outreach and education to pregnant members. It adds to the care that the member gets from an obstetrician or nurse midwife.  A program that promotes timely postnatal checkups.  Diabetes management and education. This helps diabetic members to self-manage their diabetes. It also helps to identify high-risk members and helps to assess their ongoing needs.  Congestive heart failure disease management, education, and monitoring.