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Information for Members
2008 Evidence of Coverage
We are pleased you've chosen Essence!
Essence is a Health Maintenance Organization "HMO" for people with Medicare. It is not a "Medigap" or supplemental Medicare insurance policy.
The Evidence of Coverage (EOC) explains how to get your Medicare services through Essence. It gives the details about your Medicare health coverage and explains how to get the care you need. The Evidence of Coverage, together with your enrollment form and any amendments that we may send to you, is our contract with you. It explains your rights, benefits, and responsibilities as a member of Essence. It also explains our responsibilities to you. The information in the EOC is in effect for the time period of January 1, 2008 through December 31, 2008.
You are still covered by Original Medicare, but you are getting your Medicare services as a member of Essence. The EOC gives you the details, including:
- What is covered by Essence and what is not covered
- How to get the care you need, including some rules you must follow
- What you will have to pay for your health plan
- What to do if you are unhappy about something related to getting your covered services
- How to leave Essence, and other Medicare options that are available
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