Activities of daily living (ADL): The things people do on a normal day, such as
eating, using the toilet, getting dressed, bathing, or brushing teeth.
Administrative law judge: An Administrative Law Judge (ALJ) is a judge who hears
and decides cases involving government agencies. A judge that reviews a level 3 appeal.
AIDS drug assistance program (ADAP): A program that helps eligible individuals
living with HIV/AIDS have access to life-saving HIV medications.
Ambulatory surgical center: A facility that provides outpatient surgery to patients
who don’t need hospital care and who aren’t expected to need more than 24 hours of care.
Appeal: A way for you to challenge our action if you think we made a mistake. You
can ask us to change a coverage decision by filing an appeal. Chapter 9 of this
Member Handbook explains appeals, including how to make an appeal.
Balance billing: The practice where a provider bills a patient for the difference
between the provider’s full billed charges and the amount paid by the patient’s health plan.
Behavioral health: Refers to our emotional, psychological, and social well-being.
In simpler terms: It’s about how we think, feel, and interact with others. It’s an all-inclusive
term referring to mental health and substance use disorder services.
Biological product: A drug that’s made from natural and living sources like animal
cells, plant cells, bacteria, or yeast. Biological products are more complex than other drugs and
can’t be copied exactly, so alternative forms are called biosimilars. (See also “Original biological
product” and “Biosimilar”).
Biosimilar: A biological drug that’s very similar, but not identical, to the
original biological product. Biosimilars are as safe and effective as the original biological
product. Some biosimilars may be substituted for the original biological product at the pharmacy
without needing a new prescription. (Go to “Interchangeable biosimilar”).
Brand name drug: A drug that’s made and sold by the company that originally made
the drug. Brand name drugs have the same ingredients as the generic versions of the drugs. Generic
drugs are usually made and sold by other drug companies and are generally not available until the
patent on the brand name drug has ended.
Case manager: One main person who works with you, with the health plan, and with
your care providers to make sure you get the care you need.
Care plan: Refer to “Individualized care plan.”
Care team: Refer to “Interdisciplinary care team.”
Catastrophic coverage stage: The stage in the Medicare Part D drug benefit where
our plan pays all costs of your Part D drugs until the end of the year. You begin this stage when
you (or other qualified parties on your behalf) have spent $2,400 for Part D covered drugs during
the year. You pay nothing. You may have cost-sharing for excluded drugs that are covered under our
enhanced benefit.
Centers for Medicare & Medicaid Services (CMS): The federal agency in charge of
Medicare. Chapter 2 of this Member Handbook explains how to contact CMS.
Community-Based Adult Services (CBAS): Outpatient, facility-based service program
that delivers skilled nursing care, social services, occupational and speech therapies, personal
care, family/caregiver training and support, nutrition services, transportation, and other services
to eligible members who meet applicable eligibility criteria.
Complaint: A written or spoken statement saying that you have a problem or concern
about your covered services or care. This includes any concerns about the quality of service,
quality of your care, our network providers, or our network pharmacies. The formal name for “making
a complaint” is “filing a grievance”.
Comprehensive outpatient rehabilitation facility (CORF): A facility that mainly
provides rehabilitation services after an illness, accident, or major operation. It provides a
variety of services, including physical therapy, social or psychological services, respiratory
therapy, occupational therapy, speech therapy, and home environment evaluation services.
Copay: A fixed amount you pay as your share of the cost each time you get certain
drugs. For example, you might pay $2 or $5 for a drug.
Cost-sharing: Amounts you have to pay when you get certain drugs. Cost-sharing
includes copays.
Cost-sharing tier: A group of drugs with the same copay. Every drug on the List
of Covered Drugs (also known as the Drug List) is in one of six cost-sharing tiers.
In general, the higher the cost-sharing tier, the higher your cost for the drug.
Coverage decision: A decision about what benefits we cover. This includes decisions
about covered drugs and services or the amount we pay for your health services. Chapter
9 of this Member Handbook explains how to ask us for a coverage decision.
Covered drugs: The term we use to mean all of the prescription and over-the-counter
(OTC) drugs covered by our plan.
Covered services: The general term we use to mean all the health care, long-term
services and supports, supplies, prescription and over-the-counter drugs, equipment, and other
services our plan covers.
Cultural competence training: Training that provides additional instruction for our
health care providers that helps them better understand your background, values, and beliefs to
adapt services to meet your social, cultural, and language needs.
Daily cost- sharing rate: A rate that may apply when your doctor prescribes less
than a full month’s supply of certain drugs for you and you’re required to pay a copay. A daily
cost-sharing rate is the copay divided by the number of days in a month’s supply.
Here is an example: Let’s say the copay for your drug for a full month’s supply (a 30-day supply)
is $1.35. This means that the amount you pay for your drug is less than $0.05 per day. If you get a
seven-day supply of the drug, your payment is less than $0.05 per day multiplied by seven days, for
a total payment less than $0.35.
Department of Health Care Services (DHCS): The state department in California that
administers the Medicaid Program (known as Medi-Cal).
Department of Managed Health Care (DMHC): The state department in California
responsible for regulating most health plans. DMHC helps people with appeals and complaints about
Medi-Cal services. DMHC also conducts Independent Medical Reviews (IMR).
Disenrollment: The process of ending your membership in our plan. Disenrollment may
be voluntary (your own choice) or involuntary (not your own choice).
Drug Management Program (DMP): A program that helps make sure members safely use
prescription opioids and other frequently abused medications.
Drug tiers: Groups of drugs on our Drug List. Generic, brand name, or
over-the-counter (OTC) drugs are examples of drug tiers. Every drug on the Drug List is in
one of six tiers.
Dual eligible special needs plan (D-SNP): Health plan that serves individuals who
are eligible for both Medicare and Medicaid. Our plan is a D-SNP.
Durable medical equipment (DME): Certain items your doctor orders for use in your
own home. Examples of these items are wheelchairs, crutches, powered mattress systems, diabetic
supplies, hospital beds ordered by a provider for use in the home, IV infusion pumps, speech
generating devices, oxygen equipment and supplies, nebulizers, and walkers.
Emergency: A medical emergency when you, or any other person with an average
knowledge of health and medicine, believe that you have medical symptoms that need immediate medical
attention to prevent death, loss of a body part, or loss of or serious impairment to a bodily
function (and if you’re a pregnant woman, loss of an unborn child). The medical symptoms may be an
illness, injury, severe pain, or a medical condition that’s quickly getting worse.
Emergency care: Covered services given by a provider trained to give emergency
services and needed to treat a medical or behavioral health emergency.
Exception: Permission to get coverage for a drug not normally covered or to use the
drug without certain rules and limitations.
Excluded services: Services that aren’t covered by this health plan.
Extra Help: Medicare program that helps people with limited incomes and resources
reduce Medicare Part D drug costs, such as premiums, deductibles, and copays. Extra Help is also
called the “Low-Income Subsidy”, or “LIS.”
Generic drug: A drug approved by the FDA to use in place of a brand name drug. A
generic drug has the same ingredients as a brand name drug. It’s usually cheaper and works just as
well as the brand name drug.
Grievance: A complaint you make about us or one of our network providers or
pharmacies. This includes a complaint about the quality of your care or the quality of service
provided by your health plan.
Health Insurance Counseling and Advocacy Program (HICAP): A program that provides
free and objective information and counseling about Medicare. Chapter 2 of this
Member Handbook explains how to contact HICAP.
Health plan: An organization made up of doctors, hospitals, pharmacies, providers
of long-term services, and other providers. It also has case managers to help you manage all your
providers and services. All of them work together to provide the care you need.
Health risk assessment (HRA): A review of your medical history and current
condition. It’s used to learn about your health and how it might change in the future.
Home health aide: A person who provides services that don’t need the skills of a
licensed nurse or therapist, such as help with personal care (like bathing, using the toilet,
dressing, or carrying out the prescribed exercises). Home health aides don’t have a nursing license
or provide therapy.
Hospice: A program of care and support to help people who have a terminal prognosis
live comfortably. A terminal prognosis means that a person has been medically certified as
terminally ill, meaning having a life expectancy of six months or less.
An enrollee who has a terminal prognosis has the right to elect hospice.
A specially trained team of professionals and caregivers provide care for the whole person,
including physical, emotional, social, and spiritual needs.
We’re required to give you a list of hospice providers in your geographic area.
Improper/inappropriate billing: A situation when a provider (such as a doctor or
hospital) bills you more than our cost-sharing amount for services. Call Member Services if you get
any bills you don’t understand.
Because we pay the entire cost for your services, you don’t owe any cost-sharing.
Providers shouldn’t bill you anything for these services.
In-Home Supportive Services (IHSS): The IHSS Program will help pay enrolled care
providers for services provided to you so that you can remain safely in your own home. IHSS is an
alternative to out-of-home care, such as nursing homes or board and care facilities. To receive
services, an assessment is conducted to determine which types of services may be authorized for each
participant based on their needs. The types of services which can be authorized through IHSS are
housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel
and bladder care, bathing, grooming and paramedical services), accompaniment to medical
appointments, and protective supervision for the mentally impaired. County social service agencies
administer IHSS.
Independent Medical Review (IMR): If we deny your request for medical services or
treatment, you can make an appeal. If you disagree with our decision and your problem is about a
Medi-Cal service, including DME supplies and drugs, you can ask the California Department of Managed
Health Care for an IMR. An IMR is a review of your case by experts who aren’t part of our plan. If
the IMR decision is in your favor, we must give you the service or treatment you asked for. You pay
no costs for an IMR.
Independent review organization (IRO): An independent organization hired by
Medicare that reviews a level 2 appeal. It isn’t connected with us and isn’t a government agency.
This organization decides whether the decision we made is correct or if it should be changed.
Medicare oversees its work. The formal name is the Independent Review Entity.
Individualized care plan (ICP or Care Plan): A plan for what services you’ll get
and how you’ll get them. Your plan may include medical services, behavioral health services, and
long-term services and supports.
Initial coverage stage: The stage before your total Medicare Part D drug expenses
reach $2,400. This includes amounts you paid, what our plan paid on your behalf, and the low-income
subsidy. You begin in this stage when you fill your first prescription of the year. During this
stage, we pay part of the costs of your drugs, and you pay your share.
Inpatient: A term used when you’re formally admitted to the hospital for skilled
medical services. If you’re not formally admitted, you may still be considered an outpatient instead
of an inpatient even if you stay overnight.
Integrated D-SNP: A dual-eligible special needs plan that covers Medicare and most
or all Medicaid services under a single health plan or affiliated health plans for certain groups of
individuals eligible for both Medicare and Medicaid. These individuals are known as full-benefit
dually eligible individuals.
Interchangeable biosimilar: A biosimilar that may be substituted at the pharmacy
without needing a new prescription because it meets additional requirements about the potential for
automatic substitution. Automatic substitution at the pharmacy is subject to state law.
Interdisciplinary care team (ICT or care team): A care team may include doctors,
nurses, counselors, or other health professionals who are there to help you get the care you need.
Your care team also helps you make a care plan.
List of Covered Drugs (Drug List): A list of prescription and
over-the-counter (OTC) drugs we cover. We choose the drugs on this list with the help of doctors and
pharmacists. The Drug List tells you if there are any rules you need to follow to get your
drugs. The Drug List is sometimes called a “formulary”.
Long-term services and supports (LTSS): Long-term services and supports help
improve a long-term medical condition. Most of these services help you stay in your home so you
don’t have to go to a nursing facility or hospital. LTSS covered by our plan include Community-Based
Adult Services (CBAS), also known as adult day health care, Nursing Facilities (NF), and Community
Supports. IHSS and 1915(c) waiver programs are Medi-Cal LTSS provided outside our plan.
Low-income subsidy (LIS): Refer to “Extra Help”
Mail-order program: Some plans may offer a mail-order program that allows you to
get up to a three-month supply of your covered prescription drugs sent directly to your home. This
may be a cost-effective and convenient way to fill prescriptions you take regularly.
Medicaid (or Medical Assistance): A program run by the federal government and the
state that helps people with limited incomes and resources pay for long-term services and supports
and medical costs. Medi-Cal is the Medicaid program for the State of California.
Medi-Cal: This is the name of California’s Medicaid program. Medi-Cal is managed by
the state and is paid for by the state and the federal government.
It helps people with limited incomes and resources pay for long-term services and supports and
medical costs.
It covers extra services and some drugs not covered by Medicare.
Medicaid programs vary from state to state, but most health care costs are covered if you
qualify for both Medicare and Medi-Cal.
Medi-Cal plans: Plans that cover only Medi-Cal benefits, such as long-term services
and supports, medical equipment, and transportation. Medicare benefits are separate.
Medically necessary: This describes services, supplies, or drugs you need to
prevent, diagnose, or treat a medical condition or to maintain your current health status. This
includes care that keeps you from going into a hospital or nursing facility. It also means the
services, supplies, or drugs meet accepted standards of medical practice.
Medicare: The federal health insurance program for people 65 years of age or older,
some people under age 65 with certain disabilities, and people with end-stage renal disease
(generally those with permanent kidney failure who need dialysis or a kidney transplant). People
with Medicare can get their Medicare health coverage through Original Medicare or a managed care
plan (refer to “Health plan”).
Medicare Advantage: A Medicare program, also known as “Medicare Part C” or “MA”,
that offers MA plans through private companies. Medicare pays these companies to cover your Medicare
benefits.
Medicare Appeals Council (Council): A council that reviews a level 4 appeal. The
Council is part of the Federal government.
Medicare-covered services: Services covered by Medicare Part A and Medicare Part B.
All Medicare health plans, including our plan, must cover all the services covered by Medicare
Part A and Medicare Part B.
Medicare Diabetes Prevention Program (MDPP): A structured health behavior change
program that provides training in long-term dietary change, increased physical activity, and
strategies for overcoming challenges to sustaining weight loss and a healthy lifestyle.
Medicare-Medi-Cal enrollee: A person who qualifies for Medicare and Medicaid
coverage. A Medicare- Medicaid enrollee is also called a “dually eligible individual”.
Medicare Part A: The Medicare program that covers most medically necessary
hospital, skilled nursing facility, home health, and hospice care.
Medicare Part B: The Medicare program that covers services (such as lab tests,
surgeries, and doctor visits) and supplies (such as wheelchairs and walkers) that are medically
necessary to treat a disease or condition. Medicare Part B also covers many preventive and screening
services.
Medicare Part C: The Medicare program, also known as “Medicare Advantage” or “MA”,
that lets private health insurance companies provide Medicare benefits through an MA Plan.
Medicare Part D: The Medicare drug benefit program. We call this program “Part D”
for short. Medicare Part D covers outpatient drugs, vaccines, and some supplies not covered by
Medicare Part A or Medicare Part B or Medicaid. Our plan includes Medicare Part D.
Medicare Part D drugs: Drugs covered under Medicare Part D. Congress specifically
excludes certain categories of drugs from coverage under Medicare Part D. Medicaid may cover some of
these drugs.
Medication Therapy Management (MTM): A Medicare Part D program for complex health
needs provided to people who meet certain requirements or are in a Drug Management Program. MTM
services usually include a discussion with a pharmacist or health care provider to review
medications. Refer to Chapter 5 of this Member Handbook for more
information.
Medi-Medi Plan: A Medi-Medi Plan is a type of Medicare Advantage plan. It’s for
people who have both Medicare and Medi-Cal, and combines Medicare and Medi-Cal benefits into one
plan. Medi-Medi Plans coordinate all benefits and services across both programs, including all
Medicare and Medi-Cal covered services.
Member (member of our plan, or plan member): A person with Medicare and Medi-Cal
who qualifies to get covered services, who has enrolled in our plan, and whose enrollment has been
confirmed by the Centers for Medicare & Medicaid Services (CMS) and the state.
Member Handbook and disclosure information: This document, along with your
enrollment form and any other attachments, or riders, which explain your coverage, what we must do,
your rights, and what you must do as a member of our plan.
Member services: A department in our plan responsible for answering your questions
about membership, benefits, grievances, and appeals. Refer to Chapter 2 of this
Member Handbook for more information about Member Services.
Network pharmacy: A pharmacy (drug store) that agreed to fill prescriptions for our
plan members. We call them “network pharmacies” because they agreed to work with our plan. In most
cases, we cover your prescriptions only when filled at one of our network pharmacies.
Network provider: Are providers who work with our plan. These providers agree to
accept our payment as full payment. We arranged for these providers to deliver covered services to
you. Network providers bill us directly for care they give you. When you use a network provider, you
usually pay nothing for covered services. “Provider” is the general term we use for doctors, nurses,
and other people who give you services and care. The term also includes hospitals, home health
agencies, clinics, and other places that give you health care services, medical equipment, and
long-term services and supports.
Nursing home or facility: A facility that provides care for people who can’t get
their care at home but don’t need to be in the hospital.
Ombudsperson: An office in your state that works as an advocate on your behalf.
They can answer questions if you have a problem or complaint and can help you understand what to do.
The ombudsperson’s services are free. You can find more information in Chapters 2
and 9 of this Member Handbook.
Organization determination: Our plan makes an organization determination when we,
or one of our providers, decide about whether services are covered or how much you pay for covered
services. Organization determinations are called “coverage decisions”. Chapter 9 of
this Member Handbook explains coverage decisions.
Original biological product: A biological product that has been approved by the FDA
and serves as the comparison for manufacturers making a biosimilar version. It’s also called a
reference product.
Original Medicare (traditional Medicare or fee-for-service Medicare): The
government offers Original Medicare. Under Original Medicare, services are covered by paying
doctors, hospitals, and other health care providers amounts that Congress determines.
You can use any doctor, hospital, or other health care provider that accepts Medicare. Original
Medicare has two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical
insurance).
Original Medicare is available everywhere in the United States.
If you don’t want to be in our plan, you can choose Original Medicare
Out-of-network pharmacy: A pharmacy that hasn’t agreed to work with our plan to
coordinate or provide covered drugs to members of our plan. Our plan doesn’t cover most drugs you
get from out-of-network pharmacies unless certain conditions apply.
Out-of-network provider or Out-of-network facility: A provider or facility that
isn’t employed, owned, or operated by our plan and isn’t under contract to provide covered services
to members of our plan. Chapter 3 of this Member Handbook explains
out-of-network providers or facilities.
Out-of-pocket costs: The cost- sharing requirement for members to pay for part of
the services or drugs they get is also called the “out-of-pocket” cost requirement. Refer to the
definition for “cost-sharing” above.
Over-the-counter (OTC) drugs: Over-the-counter drugs are drugs or medicines that a
person can buy without a prescription from a health care professional.
Part A: Refer to “Medicare Part A.”
Part B: Refer to “Medicare Part B.”
Part C: Refer to “Medicare Part C.”
Part D: Refer to “Medicare Part D.”
Part D drugs: Refer to “Medicare Part D drugs.”
Personal health information (also called Protected health information) (PHI):
Information about you and your health, such as your name, address, social security number, physician
visits, and medical history. Refer to our Notice of Privacy Practices for more information about how
we protect, use, and disclose your PHI, as well as your rights with respect to your PHI.
Preventive services: Health care to prevent illness or detect illness at an early
stage, when treatment is likely to work best (for example, preventive services include Pap tests,
flu shots, and screening mammograms).
Primary care provider (PCP): The doctor or other provider you use first for most
health problems. They make sure you get the care you need to stay healthy.
They also may talk with other doctors and health care providers about your care and refer you
to them.
In many Medicare health plans, you must use your primary care provider before you use any other
health care provider.
Refer to Chapter 3 of this Member Handbook for information about
getting care from primary care providers.
Prior authorization (PA): An approval you must get from us before you can get a
specific service or drug or use an out-of-network provider. Our plan may not cover the service or
drug if you don’t get approval first.
Our plan covers some network medical services only if your doctor or other network provider gets PA
from us.
Our plan covers some drugs only if you get PA from us.
Program of All-Inclusive Care for the Elderly (PACE): A program that covers
Medicare and Medicaid benefits together for people age 55 and over who need a higher level of care
to live at home.
Prosthetics and orthotics: Medical devices ordered by your doctor or other health
care provider that include, but aren’t limited to, arm, back, and neck braces; artificial limbs;
artificial eyes; and devices needed to replace an internal body part or function, including ostomy
supplies and enteral and parenteral nutrition therapy.
Providers: Are doctors, nurses, and other people who give you services and care and
are licensed by the state. Providers also include hospitals, home health agencies, clinics, and
other places that give you health care services, behavioral health services, medical equipment, and
certain LTSS.
Quality improvement organization (QIO): A group of doctors and other health care
experts who help improve the quality of care for people with Medicare. The federal government pays
the QIO to check and improve the care given to patients. Refer to Chapter 2 of this
Member Handbook for information about the QIO.
Quantity limits: A limit on the amount of a drug you can have. We may limit the
amount of the drug that we cover per prescription.
Real Time Benefit Tool: A portal or computer application in which enrollees can
look up complete, accurate, timely, clinically appropriate, enrollee-specific covered drugs and
benefit information. This includes cost-sharing amounts, alternative drugs that may be used for the
same health condition as a given drug, and coverage restrictions (prior authorization, step therapy,
quantity limits) that apply to alternative drugs.
Referral: A referral is your primary care provider’s (PCP’s) or our approval to use
a provider other than your PCP. If you don’t get approval first, we may not cover the services. You
don’t need a referral to use certain specialists, such as women’s health specialists. You can find
more information about referrals in Chapters 3 and 4 of this Member
Handbook.
Rehabilitation services: Treatment you get to help you recover from an illness,
accident, or major operation. These services include inpatient rehabilitation care, physical therapy
(outpatient), speech and language therapy, and occupational therapy. Refer to Chapter
4 of this Member Handbook to learn more about rehabilitation services.
Sensitive services: Services related to mental or behavioral health, sexual and
reproductive health, family planning, sexually transmitted infections (STIs), HIV/AIDS, sexual
assault and abortions, substance use disorder, gender affirming care, and intimate partner violence.
Service area: A geographic area where a health plan accepts members if it limits
membership based on where people live. For plans that limit which doctors and hospitals you may use,
it’s generally the area where you can get routine (non-emergency) services. Only people who live in
our service area can enroll in our plan.
Share of cost: The portion of your health care costs that you may have to pay each
month before your benefits become effective. The amount of your share of cost varies depending on
your income and resources.
Skilled nursing facility (SNF): A nursing facility with the staff and equipment to
give skilled nursing care and, in most cases, skilled rehabilitative services and other related
health services.
Skilled nursing facility (SNF) care: Skilled nursing care and rehabilitation
services provided on a continuous, daily basis, in a skilled nursing facility. Examples of skilled
nursing facility care include physical therapy or intravenous (IV) injections that a registered
nurse or a doctor can give.
Specialist: A doctor who treats certain types of health care problems. For example,
an orthopedic surgeon treats broken bones; an allergist treats allergies; and a cardiologist treats
heart problems. In most cases, a member will need a referral from their PCP to go to a specialist.
Specialized pharmacy: Refer to Chapter 5 of this Member
Handbook to learn more about specialized pharmacies.
State hearing: If your doctor or other provider asks for a Medi-Cal service that we
won’t approve, or we won’t continue to pay for a Medi-Cal service you already have, you can ask for
a State Hearing. If the State Hearing is decided in your favor, we must give you the service you
asked for.
Step therapy: A coverage rule that requires you to try another drug before we cover
the drug you ask for.
Supplemental Security Income (SSI): A monthly benefit Social Security pays to
people with limited incomes and resources who are disabled, blind, or age 65 and over. SSI benefits
aren’t the same as Social Security benefits.
Urgently needed care: Care you get for an unforeseen illness, injury, or condition
that isn’t an emergency but needs care right away. You can get urgently needed care from
out-of-network providers when you can’t get to them because given your time, place, or
circumstances, it isn’t possible, or it’s unreasonable to get services from network providers (for
example when you’re outside our plan’s service area and you require medically needed immediate
services for an unseen condition but it isn’t a medical emergency).
CommuniCare Advantage Member Services
| Type | Details |
|---|
CALL
| 1-888-244-4430 Calls to this number are free. We are available 24 hours a day, 7 days a week. Member Services also has free language interpreter services available for non-English
speakers.
|
TTY
| 1-855-266-4584 This number requires special telephone equipment and is only for people who have
difficulties with hearing or speaking. Calls to this number are free. We are available 24 hours a day, 7 days a week.
|
FAX
| 1-619-426-9437
|
WRITE
| Community Health Group Member Services Department 2420 Fenton Street, Suite 100 Chula Vista, CA 91914
|
WEBSITE
| www.chgsd.com
|
PRA Disclosure Statement:
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-1444. If you have comments or suggestions for
improving this form, write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer,
Mail Stop C4-26-05, Baltimore, Maryland 21244-1850
shows the preventive
services in the Benefits Chart.
