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At Jai Medical Systems, keeping our members informed is our top priority. Please review the information below for our newsletters, latest healthcare updates, and special announcements.
Summer Greetings,
As we move into the summer months, it’s the perfect time to stay on top of your health and wellness. We encourage all members to take advantage of this season by scheduling an appointment with your Primary Care Provider and receiving important preventive care. These visits play a key role in helping you stay healthy and catch potential concerns early.
If you have any questions regarding your benefits, need help finding a doctor, or help scheduling an appointment, please contact our Customer Service team at 1-888-JAI-1999 for support. We are here to assist you every step of the way, because your health matters.
Sincerely,
Ulysses McArthur Jr.
Director of Customer Service
IMPORTANT: CHANGES TO MARYLAND MEDICAID
Changes are coming to Maryland Medicaid in 2027, including work requirements and more frequent eligibility checks for some members. We do not want our members to lose their coverage. Be in the KNOW about these changes by keeping an eye on important communications from the State of Maryland and Jai Medical Systems.
As always, Jai Medical Systems will notify you when it is your time to renew your coverage. Please keep your contact information up-to-date and be responsive to any communications requiring you to renew your benefits to avoid a gap in your health insurance coverage.
When it is your turn to renew your coverage, you can do so in a variety of ways, including:
- Online: Maryland Health Connection
- Phone: 1-855-642-8572
- Mail: If you or a member of your household needs help renewing coverage, Certified Application Counselors (CACs) and Navigators are available.
If you have any questions about renewing your coverage, or the changes coming to Maryland Medicaid, please contact us at 1-888-524-1999.
Knowing where to get care
When you are sick or hurt, it can be hard to know where to go for care. Choosing the right place can help you get care faster and feel better sooner.
When to Use the Emergency Room
The emergency room is for serious health problems that need care right away. You should go to the emergency room if waiting could put your health in danger, cause serious harm, or threaten your life.
Examples of emergencies may include chest pain, trouble breathing, sudden weakness or numbness, seizures or pregnancy or labor-related problems.
Options for Non-Emergent Care (Primary Care and Urgent Care)
For health problems that are not emergencies, your first call should usually be to your primary care provider (PCP). Your PCP knows your health history and can help with many everyday medical needs. Your doctor may be able to offer a same-day visit, give you advice over the phone, or tell you if you should go to urgent care.
Urgent care can also be a good choice for when you need care soon, but your condition is not lifethreatening. This may be helpful if your PCP office is closed or if you cannot get an appointment quickly. Urgent care centers can often treat minor illnesses and injuries without the longer wait you may have in an emergency room.
Examples of non-emergency health problems may include a common cold, sore throat, earache, mild fever, medication refill, or routine healthcare.
Help is Available
If you are not sure where to go, help is available. Even after regular office hours, you can still call your PCP. You can also speak with a nurse 24 hours a day, 7 days a week through our Nurse Advice Line at 1-833-359-0170. A nurse can help you decide what kind of care you may need.
Medicaid Fraud and Abuse
IT IS AGAINST THE LAW TO COMMIT MEDICAID FRAUD AND/OR ABUSE!
We welcome and encourage you to report anything suspicious related to fraud you may have seen. Reporting suspected fraud or abuse will not affect your services with us.
Examples of Fraud and Abuse include:
- Prescription Fraud: Lying about a lost prescription
- Medicaid ID Fraud: Using someone else’s Medicaid ID
- Provider Fraud: When a provider bills for services not provided.
To Report Fraud and Abuse, please call our Fraud and Abuse Compliance Officer at 1-888-JAI-1999, or write us at Jai Medical Systems, Attn: Fraud and Abuse, 301 International Circle, Hunt Valley, MD 21030.
Need a New Member ID Card?
When accessing care, it is important that you always present the medical provider’s office with a copy of your Jai Medical Systems Member ID card. This important step ensures that the provider’s office is aware of your health insurance coverage and can ensure that any bills for covered services are sent to us.
If you have lost or misplaced your member ID card, you may request a replacement member ID card by calling our Customer Service Department at 1-888-JAI-1999.
Want a digital copy of your Jai Medical Systems Member ID Card? Sign-up for our member portal today by visiting www.jaimedicalsystems.com to gain access to download a copy of your Jai Medical Systems Member ID card.
Using Your Pharmacy Benefits
Your pharmacy benefits can help you get the medicines you need. Follow these steps to check drug coverage, find an in-network pharmacy, and fill prescriptions.
How to Check if a Drug Is Covered
Jai Medical Systems has a formulary/drug list. The drug list includes all covered drugs, if there are quantity limits for a drug, as well as whether a drug may require prior authorization. Prior authorization means your doctor or other prescriber may need to get approval from Jai Medical Systems. This is sometimes required for certain brand name drugs, specialty medicines, or drugs with special rules. Your doctor’s office usually sends the request and provides the information needed for review.
You can check the drug list for coverage by visiting: https://client.formularynavigator.com/.
How to Find a Pharmacy
To find a pharmacy, please visit: www.jaimedicalsystems.com/providers/pharmacy/. You can also call Customer Service at 1-888-JAI-1999 for help finding a nearby, in-network pharmacy.
When Filling or Picking up a Prescription
- Be sure to take your member ID card with you when you go to the pharmacy.
- Ask the pharmacist to bill your prescription through your pharmacy benefit.
- Co-pays may apply.
- $1.00 co-payment on new and refilled preferred Generic, Brand Name medications, and HIV/AIDS medications.
- $3.00 co-payment on new and refilled nonpreferred Brand Name medications.
What Is an Explanation of Benefits?
An Explanation of Benefits is also called an “EOB”. It is a paper or online document from your health plan. It helps you see what care you received, and what Jai Medical Systems has paid for the care. It is not a bill.
What information is on an EOB?
- Your name
- The date you got care
- The doctor or place that provided you care
- The service you received
- What Jai Medical Systems paid for your care
How to Find Your EOBs in the Member Portal
- Visit www.jaimedicalsystems.com and select the Member Portal.
- Look for a tab called Claims, Benefits, or Documents.
- Pick the visit or claim you want to see.
- View your EOB. You may also download or print a copy.
If you do not have a member portal account yet, you can sign up for an account on the member portal page. If you need help signing in or finding your EOB information in the portal, please contact Customer Service today at 1-888-JAI-1999. We are here to help.
MEMBER RESOURCES ONLINE: FIND A PROVIDER
As a member of Jai Medical Systems, you are eligible to sign- up for access to our member portal, which features exclusive content only available for our members. To sign up, please visit us at www.jaimedicalsystems.com.
Need Help Finding a Doctor?
We can help! Jai Medical Systems has a large network of specialists, including OBGYNs, Cardiologists, Surgeons and many other provider types.
Please call Customer Service at 1-888-JAI-1999 for help finding a specialist or search our online Provider Directory. Please note that most specialists may require a referral from your PCP.
SUMMER CROSSWORD FUN
