Where should I go for care? Helping you choose the right care center

RUN_DATE DATA_SEQ_NO CLIENT_NUMBER UHG_TYPE DOC_ID DOC_SEQ_ID NAME MAILSET_NUMBER BROWN 6509343/000003-00 6509343/000003-01 6509343/000003-02 6509343/000004-00 6509343/000004-01 6509343/000004-02 20100812 DIG2MAG 0000004 0000645 003101 0000002 14:32:09,LANNIE

Care center

Why would I use this care center

What type of care would they provide*

What are the cost and time considerations?**

Doctor’s Office

You need routine care or treatment for a current health issue. Your primary doctor knows you and your health history, can access your medical records, provide preventive and routine care, manage your medications and refer you to a specialist, if necessary.

}} Routine checkups }} Immunizations }} Preventive services }} Manage your general health

Urgent Care Center

You may need care quickly, but it is not an emergency, and your primary physician may not be available. Urgent care centers offer treatment for non-life threatening injuries or illnesses. Staffed by physicians.

}} Sprains }} Often requires a copayment and/or }} Strains coinsurance usually higher than an }} Minor broken bones office visit (e.g.: finger) }} Walk,LANNIE in patients welcome, but RUN_DATE DATA_SEQ_NO CLIENT_NUMBER UHG_TYPE DOC_ID DOC_SEQ_ID NAME MAILSET_NUMBER BROWN 6509343/000003-00 6509343/000003-01 6509343/000003-02 6509343/000004-00 6509343/000004-01 6509343/000004-02 20100812 DIG2MAG 0000004 0000645 003101 0000002 14:32:09 }} Minor infections waiting periods may be longer as }} Minor burns patients with more urgent needs will be treated first

Emergency Room

You need immediate treatment of a very serious or critical condition. The ER is for the treatment of life-threatening or very serious conditions that require immediate medical attention. Do not ignore an emergency. If a situation seems life threatening, take action. Call 911 or your local emergency number right away.

}} Heavy bleeding }} Large open wounds }} Sudden change in vision }} Chest pain }} Sudden weakness or trouble talking }} Major burns }} Spinal injuries }} Severe head injury }} Difficulty breathing }} Major broken bones

}} Often requires a copayment and/or coinsurance }} Normally requires an appointment }} Little wait time with scheduled appointment

}} Often requires a much higher copayment and/or coinsurance }} Open 24/7, but waiting RUN_DATE DATA_SEQ_NO CLIENT_NUMBER UHG_TYPE DOC_ID DOC_SEQ_ID NAME MAILSET_NUMBER BROWN 6509343/000003-00 6509343/000003-01 6509343/000003-02 6509343/000004-00 6509343/000004-01 6509343/000004-02 20100812 DIG2MAG 0000004 0000645 003101 0000002 14:32:09 ,LANNIEperiods may be longer because patients with life-threatening emergencies will be treated first

1-866-747-4325 (TTY: 711)

Health Plan (80840) Member ID: 9999999-99 Member: BROWN, SUBSCRIBER

In an emergency medical situation, call 911, or its local equivalent, or go directly to the nearest RUN_DATE DATA_SEQ_NO CLIENT_NUMBER UHG_TYPE DOC_ID DOC_SEQ_ID NAME MAILSET_NUMBER BROWN 6509343/000003-00 6509343/000003-01 6509343/000003-02 6509343/000004-00 6509343/000004-01 6509343/000004-02 20100812 DIG2MAG 0000004 0000645 003101 0000002 14:32:09,LANNIE medical facility for treatment. If you need Urgent care services, contact your Primary Care Physicians office at the number on your health plan ID card for direction to a participating Urgent Care Center.

Primary Care For routine or primary/preventive care, it is best to go to your doctor’s office. For non-emergency situations you can call your primary care physician at the number listed on the front of your health plan ID card for assistance. Emergency

Member ID: 9999999-99 Member: BROWN, SUBSCRIBER

Group Number:

Group Number:

DOI/0501

000011

Payer ID 87726

RxBIN#: 610494 Rx Grp PCCA RxPCN#: 9999

000011

SignatureValue HMO Offered by UnitedHealthcare of California

Payer ID *This is a sample list of services and may not be all-inclusive. LMG EAST-WEST COVINA (818)707-9603 87726 **Costs and time information represents averages only and is not tied to a specific condition or treatment. Your out-of-pocket costs will vary based on your plan design. PCP EFFECTIVE DATE 11/01/2009 LMG EAST-WEST 024675 RxBIN#: 610494 Health plan coverage provided by or through UnitedHealthcare of California, UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of COVINA Oregon, Inc., UnitedHealthcare Benefits of Texas, Inc., BY PRIMARY Rx products Grp PCCA Eff Dt: UnitedHealthcare of Washington, Inc. Administrative services provided by UnitedHealthcare Services, Inc.,, Optum RX DIRECTED or OptumHealth CareMD Solutions, Inc. Behavioral health are provided by 01/01/2011 RxPCN#: 9999 Office: $25 Spec: $35 U.S. Behavioral Health Plan, California (USBHPC) or United Behavioral Health (UBH). UrgCare: $50 ER: $100 The information provided through these programs is for educational purposes only as a part of your health plan and is not a substitute for your doctor’s care. Please discuss with your doctor how the SignatureValue HMO information provided is right for you. Your personal health information is kept private in accordance with your plan’s privacy policy. DOI/0501 Offered by UnitedHealthcare of California M51278 5/12 Consumer © 2012 United HealthCare Services, Inc.

room.

Printed:

This card does not guarantee coverage. To verify benefits,view claims provider, visit the websites or call. 1-800-624 1-800-730 1-800-999 1-800-442 1-800-542 Medical Claims: P.O. Box 30968, Salt Lake City, UT 84130-0968

000011

WEST Pharmacy Claims: P.O. Box 6037, Cypress, CA 90630 For Pharmacist:

1-800-788-7871

Payer ID 87726

If you have questions or need more information RxBIN#: 610494you Rx Grp PCCA Eff Dt: can also call our Customer01/01/2011 Care representatives RxPCN#: 9999 at the number listed on the back of your health plan SignatureValue HMO ID DOI/0501 card: Offered by UnitedHealthcare of California Emergency

Eff Dt: 01/01/2011

Group Number:

RxBIN#: 610494 Rx Grp PCCA RxPCN#: 9999

LMG EAST-WEST COVINA (818)707-9603 PCP EFFECTIVE DATE 11/01/2009 LMG EAST-WEST COVINA 024675 DIRECTED BY PRIMARY MD Office: $25 Spec: $35 UrgCare: $50 ER: $100

SUBSCRIBER

LMG EAST-WEST COVINA (818)707-9603 PCP EFFECTIVE DATE 11/01/2009 LMG EAST-WEST COVINA 024675 DIRECTED BY PRIMARY MD Office: $25 Spec: $35 UrgCare: $50 ER: $100

911 or go to the nearest emergency

For Members: www.uhcwest.com Contact our primary Spanish Phone Line: Mental Health: TDD: care Fordoctor Providers: www.uhcwest.com

SignatureValue HMO Offered by UnitedHealthcare of California

DOI/0501

Group Number:

000011

Payer ID 87726

Member ID: 9999999-99 Eff Dt: 01/01/2011 Member: BROWN, SUBSCRIBER

Member: BROWN,

Services-Call

Health Plan (80840)

PCP EFFECTIVE DATE 11/01/2009 LMG EAST-WEST COVINA 024675 DIRECTED BY PRIMARY MD Office: $25 Spec: $35 UrgCare: $50 ER: $100

If you don’t have a QR reader app, go to http://gettag.mobile or text “barcode” to 313131. If you don’t have a smartphone, Health Plan (80840) program the number into your phone the old-fashioned way. Member ID: 9999999-99

24-Hour Health Information Program

Is it Urgent or an Emergency?

Health COVINA Plan (80840) LMG EAST-WEST (818)707-9603

24 Hour Health Information Program, help when you need it 24 hours a day/7 days a week You can speak with caring registered nurses for information to help you in making informed health care decisions. To download the 24 Hour Health Information phone number to your smart phone, scan this tag.

Is It Primary Care, Urgent or an Emergency?

Services-Call

911 or go to the nearest emergency

room.

Printed: 02/10/2011

This card does not guarantee coverage. To verify benefits,view claims, or find a Emergency Services-Call provider, visit the websites or call. 911 or go to the nearest emergency For Members: www.uhcwest.com 1-800-624-8822 Spanish Phone Line: 1-800-730-7270 1-800-999-9585 Mental Health: 1-800-442-8833 TDD: For Providers: www.uhcwest.com 1-800-542-8789 Medical Claims: P.O. Box 30968, Salt Lake City, UT 84130-0968

room.

Printed: 02/10/2011

Contact customer care

WEST

This cardFor does not guarantee coverage. To verify benefits,view claims, or find a Pharmacist: 1-800-788-7871 provider, visit the websites or call. For Members: www.uhcwest.com 1-800-624-8822 Spanish Phone Line: 1-800-730-7270 1-800-999-9585 Mental Health: 1-800-442-8833 TDD: For Providers: www.uhcwest.com 1-800-542-8789 Medical Claims: P.O. Box 30968, Salt Lake City, UT 84130-0968

Pharmacy Claims: P.O. Box 6037, Cypress, CA 90630

WEST Pharmacy Claims: P.O. Box 6037, Cypress, CA 90630 For Pharmacist:

1-800-788-7871