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Why Does My Card Now Say I Am On An HMO?
You may have noticed that there have been some changes to your blue Medical Services Administration (MSA) card. It now lists Upper Peninsula Health Plan (UPHP) as an HMO. Your card also now has a “level of care” code
7, which has replaced the 11 on your old card. Due to the negative news reports on TV, you may have some concerns about this change. This is understandable. UPHP would like you to know that the changes to your MSA
card are the only changes that you should notice. Although we have been licensed as an HMO since June of 2000, we have not changed any of your benefits or doctors that you can see. The change to your “level of care”
code represents UPHP’s change from a clinic plan to an HMO. It does not mean that your care has changes.
 We would like to explain what an HMO is and how we, as an HMO, can benefit you. HMO stands for Health Maintenance Organization. As an HMO,
UPHP is a health care system that contracts with providers in the Upper Peninsula (UP) to provide medical services to it members. UPHP providers include
over 500 doctors, 14 hospitals and many other health professionals across the UP. As a member of UPHP, you choose a Primary Care Provider (PCP) from a list of doctors
that participate with UPHP. This PCP organized your care and services. Some of the services that you may receive are routine office visits, physical exams, well-child visits,
and immunizations. A large focus of your health care should include preventive care. Preventive care can reduce or prevent future health problems. It can also save you time
and money in the future, as well as keep you healthy. The Center for Disease Control (CDC) reports that members of HMOs tend to receive more preventive care than other types of insurance.
To be an HMO, UPHP must follow specific guidelines set by the state of Michigan and the National Committee for Quality Assurance (NCQA). The purpose of these
guidelines is to assure that UPHP members receive accessible, high-quality health care. To be sure that these guidelines are met, the state and NCQA do regular reviews of
UPHP processes and procedures. If we do not continue to meet the guidelines, we can not remain licensed as an HMO. If you should ever have any questions or concerns
regarding your health care, call UPHP at 1-800-835-2556. Our Customer Service staff is here to help!
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Resuscitation (CPR), smoking
cessation, or prenatal classes. Call your local Health Department or hospital to learn more. You can even check them out on the Internet by visiting our web site, 
r 70 percent of all injuries. Please see the checklist below for safety ideas.
children to trip on.
bills because the providers office
needs more insurance information. Be sure that they have the most current information on file. (If you present a card that does not have the most current information on it , you
may be responsible for the bill.) If you continue to be billed, call UPHP Customer Service at 1-800-835-2556. We may be able to help resolve the problem. Remember that if you get care that is not a
covered benefit or has not been approved by UPHP, you will have to pay for this care.
Merck-Medco recently bought Pro-Vantage. Now, prescribed
medicines will be processed through Merck-Medco. You should have received a survey and a new pharmacy card in June. You do not have to fill out the survey, but must start
presenting your new pharmacy card. If you have not received your card or if you have any questions, please contact UPHP Customer Service right away at 1-800-835-2556.