2010 Molina Medicare Healthy Advantage (HMO) Evidence of Coverage
The information in this booklet is in effect from January 1, 2010 through December 31, 2010.

This EOC, along with your enrollment form and amendments, is Healthy Advantage’s contract with you. It explains your rights, benefits, and responsibilities as a member of Healthy Advantage. It also explains our responsibilities to you.

• What is covered and what is not covered.
• How to get the care you need, including rules you must follow.
• What you pay for your health plan.
• What to do if you are unhappy about something related to getting your covered services.
• How to leave Healthy Advantage and other Medicare options that are available.
• Your rights as a member of our plan, including treatment decisions and using advance directives.
• Our responsibility to treat patients with dignity, fairness and respect.
• Your rights and responsibilities upon disenrollment.

If you need to receive this booklet in a different format (such as Spanish), please call us so we can send you a copy at 866-472-9479 (TDD/TTY 1-800-346-4128) 8 a.m. - 8 p.m., Monday through Sunday.

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