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2017 Provider Directory for Vision/Dental/Hearing

Blue Cross Medicare Advantage (HMO)SM

Blue Cross Medicare Advantage (PPO)SM

January 1, 2017 – December 31, 2017

Last updated 0816 351819.0816

Y0096_BEN_MT_ANCDIR17

Blue Cross Medicare Advantage

2017 Provider Directory

This directory provides a list of Blue Cross Medicare Advantage’sSM network providers.

This directory is for the entire Blue Cross Medicare Advantage provider network offered to people that are Medicare eligibles and residing in Beaverhead, Big Horn, Blaine, Broadwater, Carbon, Cascade, Chouteau, Deer Lodge, Fergus, Flathead, Gallatin, Glacier, Golden Valley, Granite, Hill, Jefferson, Judith Basin, Lake, Lewis and Clark, Liberty, Lincoln, Madison, Meagher, Mineral, Missoula, Musselshell, Park, Pondera, Powell, Ravalli, Sanders, Silver Bow, Stillwater, Sweet Grass, Teton, Toole, Treasure, Wheatland, and Yellowstone counties.

This directory is current as of August 2016. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Blue Cross Medicare Advantage’s network providers in your area, you can visit getbluemt.com/mapd/providers or call our Customer Service Department at 1-877-774-8592. We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays. TTY/TDD users should call: 711.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits and/or co-payments/co-insurance may change on January 1 of each year. The provider network may change at any time. You will receive notice when necessary.

This information is available for free in other languages. Please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open between 8:00 a.m. and 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.

Esta información está disponible en otros idiomas de forma gratuita. Comuníquese a nuestro número de Servicio al cliente al 1-877-774-8592 (los usuarios de TTY/TDD deben llamar al 711). Nuestro horario es de 8 a.m. a 8 p.m., hora local, los 7 días de la semana. Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usarán tecnologías alternas (por ejemplo, correo de voz).

This document is available in other formats such as Braille and large print. For additional information, call us at 1-877-774-8592. (TTY/TDD users should call 711).

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Section 1 – Introduction This directory provides a list of Blue Cross Medicare Advantage network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage.

The “network providers” listed in this directory have agreed to provide you with your dental, vision, and hearing coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers. If you use providers within the Blue Cross Medicare Advantage network your co-pays and/or co-insurance will be less than going to non-network providers.

You do not need prior authorization to seek medical help in an urgent or emergency situation.

If an out-of-network provider asks you to pay for covered services you receive, please call Customer Service at 1-877-774-8592 (TTY/TDD 711) or send the bill(s) with a note explaining the situation to:

Blue Cross Medicare Advantage (PPO)

P.O. Box 7982

Helena, MT 59604

You should never pay any out-of-network provider more than what the provider is allowed by Medicare. Ask the out-of-network provider to bill us first. If you have already paid for the covered services, we will reimburse you for our share of the cost. If you get a bill for the services, you can send the bill to us for payment. We will pay your out-of-network provider for our share of the bill and will let you know the amount, if any, you must pay.

What is the service area for Blue Cross Medicare Advantage? The counties for the State of Montana in our service area are listed below.

• Beaverhead

• Big Horn

• Blaine

• Broadwater

• Carbon

• Cascade

• Chouteau

• Deer Lodge

• Fergus

• Flathead

• Gallatin

• Glacier

• Golden Valley

• Granite

• Hill

• Jefferson

• Judith Basin

• Lake

• Lewis and Clark

• Liberty

• Lincoln

• Madison

• Meagher

• Mineral

• Missoula

• Musselshell

• Park

• Pondera

• Powell

• Ravalli

• Sanders

• Silver Bow

• Stillwater

• Sweet Grass

• Teton

• Toole

• Treasure

• Wheatland

• Yellowstone

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How do you find Blue Cross Medicare Advantage providers in your area? The directory includes Dental, Vision, and Hearing providers participating in the Blue Cross Medicare Advantage network. Please refer to the provider listings for section names. Each section is organized alphabetically by city.

Within each city, the city and provider names are listed in alphabetical order along with the address and phone number. For the most updated Blue Cross Medicare Advantage provider information, please visit our Provider Finder at getbluemt.com/mapd/providers. Although Blue Cross Medicare Advantage has identified those providers who were offering services at the time this directory was created, the services offered may have changed. For the most current information regarding the services of provider, please contact provider you have selected at the phone number listed in this directory.

If you have questions about Blue Cross Medicare Advantage or require assistance, please call our Customer Service Department at 1-877-774-8592, 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays. TTY/TDD users should call 711. Or, visit www.getbluemt.com/mapd/providers.

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HOW TO READ THE PROVIDER LISTING Example:

HELENA (Alphabetical listing of towns and cities)

FAMILY PRACTICE (Specialty)

Smith, John, MD (Physician’s name)

(555)123-4567 (Phone number)

This information changes on a frequent basis. Please refer to the online directory or call Customer Service below for current updates.

Participation by providers in this directory is not guaranteed and may be subject to change. Please ask your provider whether he/she is still participating in the network. If you have questions about Blue Cross Medicare Advantage, please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.

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Dental Providers

Dental Care Providers DILLON – BEAVERHEAD COUNTY

DILLON BEAVERHEAD COUNTY

HARDIN BIG HORN COUNTY GENERAL DENTIST

RED LODGE CARBON COUNTY GENERAL DENTIST

GENERAL DENTIST Muir, Joshua C

Johnston Jr, George R 41 Barrett St Dillon, MT 59725(406) 683-4440Medical Group: DillonCommunity Health CtrMarcotte, Anne M 41 Barrett St Dillon, MT 59725(406) 683-4440Medical Group: DillonCommunity Health CtrMcCollum, John B 110 S Idaho St Dillon, MT 59725(406) 683-5125Medical Group: McCollum JohnBOlsen, Scott C 115 S Pacific St Dillon, MT 59725(406) 683-2671Medical Group: Scott C OlsenDDSPulfer, Sheryleen 41 Barrett St Dillon, MT 59725(406) 683-4440Medical Group: DillonCommunity Health Ctr

339 3rd St WHardin, MT 59034(406) 655-3300Medical Group: Rubicon DentalAssoc PLLCPollock, Samuel R 339 3rd St WHardin, MT 59034(406) 655-3300Medical Group: Rubicon DentalAssoc PLLCTulett, Jeffrey 339 3rd St WHardin, MT 59034(406) 655-3300Medical Group: Rubicon DentalAssoc PLLC

TOWNSEND BROADWATER COUNTY GENERAL DENTIST

West, Matthew A 422 Broadway StTownsend, MT 59644(406) 266-3402Medical Group: Matthew A WestDDS PC

Evans, David24 South OakesRed Lodge, MT 59068(406) 655-4210Medical Group: Rubicon DentalAssociates

GREAT FALLS CASCADE COUNTY GENERAL DENTIST

Ameline, Aimee R613 Park CT SGreat Falls, MT 59405(406) 761-4288Medical Group: Aimee AmelineDDS PCBuer, Bruce H2300 12th Ave SSte 109Great Falls, MT 59405(406) 761-1837Medical Group: Buer Bruce H Chinn, Meka M 3920 3rd Ave SGreat Falls, MT 59405(406) 452-5361Medical Group: Maltby Levi CDMDDachs, David D115 4th St SGreat Falls, MT 59401(406) 761-9893Medical Group: County ofCascadeDachs, David D2523 6th Ave SGreat Falls, MT 59405(406) 761-3131Medical Group: Dachs David D

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Dental Care Providers GREAT FALLS – CASCADE COUNTY

Fairhurst, Kevin J 900 10th Ave NW Great Falls, MT 59404 (406) 761-1365 Medical Group: Westside Family Dental PC Harboway, Don J 2800 11th Ave S Ste 24 Great Falls, MT 59405 (406) 453-4346 Medical Group: Harboway Family Dentistry PC Huhn, Adam J 2523 6th Ave S Great Falls, MT 59405 (406) 761-3131 Medical Group: Huhn Adam J DDS Maltby, Levi C 3920 3rd Ave S Great Falls, MT 59405 (406) 452-5361 Medical Group: Maltby Levi C DMD Messick, Douglas J 900 10th Ave NW Great Falls, MT 59404 (406) 761-1365 Medical Group: Westside Family Dental PC Neil, Robin 910 1st Ave N Great Falls, MT 59401 (406) 454-1512 Medical Group: Robin Neil Nelson, James E 114 13th St S Great Falls, MT 59401 (406) 454-3711 Medical Group: James E Nelson DDS

Nieset, Michelle R 115 4th St S Great Falls, MT 59401 (406) 761-9893 Medical Group: County of Cascade Pence, Daniel A 2605 16th Ave S Great Falls, MT 59405 (406) 727-9889 Medical Group: Pence Daniel A Sedlack, Janet 3920 3rd Ave S Great Falls, MT 59405 (406) 452-5361 Medical Group: Maltby Levi C DMD Voy, Scott E 2707 16th Ave S Great Falls, MT 59405 (406) 727-8440 Medical Group: Voy Scott E DDS PLLC Whitney, Daniel C 2714 15th Ave S Great Falls, MT 59405 (406) 727-4322 Medical Group: Northern MT Oral & Max Surg PC

ORAL SURGEON Neal, Ronald 2714 15th Ave S Great Falls, MT 59405 (406) 727-4322 Medical Group: Northern MT Oral & Max Surg PC Whitney, Steven J 2714 15th Ave S Great Falls, MT 59405 (406) 727-4322 Medical Group: Northern MT Oral & Max Surg PC

BIG SANDY CHOUTEAU COUNTY GENERAL DENTIST

Buer, Bruce H 166 Montana Ave E Big Sandy, MT 59520 (406) 761-1837 Medical Group: Buer Bruce H

FORT BENTON CHOUTEAU COUNTY GENERAL DENTIST

Labrel, Robert J 1220 Main St Fort Benton, MT 59442 (406) 622-3651 Medical Group: Robert J Labrel DDS

MILES CITY CUSTER COUNTY GENERAL DENTIST

McFarland, Garret C 520 Main St Miles City, MT 59301 (406) 874-9637 Medical Group: McFarland Garret C Yerger, Chase J 2200 Box Elder St Ste 121 Miles City, MT 59301 (406) 232-2214 Medical Group: Yerger Family Dental

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Dental Care Providers MILES CITY – CUSTER COUNTY

ORAL SURGEON Griffeth, Rod M2600 Wilson StMiles City, MT 59301(406) 259-7438Medical Group: Oral &Maxillofacial SurgLudwig, Brian R2600 Wilson StMiles City, MT 59301(406) 259-7438Medical Group: Oral &Maxillofacial SurgWinterholler, Bert2600 Wilson StMiles City, MT 59301(406) 259-7438Medical Group: Oral &Maxillofacial Surg

ANACONDA DEER LODGE COUNTY GENERAL DENTIST Bartoletti, Edward 215 Hickory StAnaconda, MT 59711(406) 563-5450Medical Group: Ed A BartolettiDMDCromwell, Andrew C 315 Oak StAnaconda, MT 59711(406) 563-3025Medical Group: CromwellAndrew CLowe, Amy K 116 W 3rd StAnaconda, MT 59711(406) 563-7666Medical Group: Lowe Amy K

Slocum, Katherine S307 E Park AveSte 308Anaconda, MT 59711(406) 563-3473Medical Group: Katherine SSlocum DDS

COLUMBIA FALLS FLATHEAD COUNTY GENERAL DENTIST Buffington, Neal J604 1st Ave WColumbia Falls, MT 59912(406) 892-4296Medical Group: Buffington Neal J Calderwood, Dean W 105 Nucleus AveColumbia Falls, MT 59912(406) 892-2104Medical Group: C Falls FamilyDental CtrMiller, John F105 Nucleus AveColumbia Falls, MT 59912(406) 892-2104Medical Group: C Falls FamilyDental Ctr

KALISPELL FLATHEAD COUNTY GENERAL DENTIST Erekson, Joshua2165 Hwy 2 ESte DKalispell, MT 59901(406) 758-0391Medical Group: Comfort Dental

Hammer, William N 1035 1st Ave WKalispell, MT 59901(406) 751-8113Medical Group: FlatheadCommunity HealthHammer, William N 140 5th St WKalispell, MT 59901(406) 755-6680Medical Group: Hammer WilliamNeilKozik, James M 720 2nd St EKalispell, MT 59901(406) 755-4766Medical Group: Kalispell FamilyDental PLLCMadsen Jr, Kenneth A 1035 1st Ave WKalispell, MT 59901(406) 751-8113Medical Group: FlatheadCommunity HealthNickisch, Wendy 1035 1st Ave WKalispell, MT 59901(406) 751-8113Medical Group: FlatheadCommunity HealthPotthoff, Ronald B 195 Commons LoopSte AKalispell, MT 59901(406) 755-5280Medical Group: Ronald B PotthoffDDSRobinson, Katerina 2165 Hwy 2 ESte DKalispell, MT 59901(406) 758-0391Medical Group: Comfort Dental

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Dental Care Providers KALISPELL – FLATHEAD COUNTY

Semrau, David D 221 Parkway CT Kalispell, MT 59901 (406) 752-2372 Medical Group: Semrau David D

ORAL SURGEON Weber, David M 115 Commons Way Ste 102 Kalispell, MT 59901

GENERAL DENTIST

Bax, Dale A 3000 Hospital Way Whitefish, MT 59937 (406) 862-3839 Medical Group: Alpenglow Dental Booth, Joel 3000 Hospital Way Whitefish, MT 59937 (406) 862-3839 Medical Group: Alpenglow Dental Larson, Robert A 3000 Hospital Way Whitefish, MT 59937 (406) 862-3839 Medical Group: Alpenglow Dental Raddatz, Laura 3000 Hospital Way Whitefish, MT 59937 (406) 862-3839 Medical Group: Alpenglow Dental

BELGRADE GALLATIN COUNTY

Mortenson, Dean C 2018 Stadium CT Bozeman, MT 59715 (406) 586-9621

GENERAL DENTIST Medical Group: Mortenson Dean Garson, Matthew L 227 Spooner Rd Belgrade, MT 59714 (406) 388-0550 Medical Group: Matthew L Garson DDS

120 N 19th Ave Ste H Bozeman, MT 59718 (406) 585-8701 Medical Group: Community Health Partners Inc Andersen, Robert J 380 Ice Center LN Ste B Bozeman, MT 59718 (406) 586-9871 Medical Group: Sager Dental Group Martin, Rachel M 120 N 19th Ave Ste H Bozeman, MT 59718 (406) 585-8701 Medical Group: Community Health Partners Inc Moos, William R 1716 W Main St Ste 8D Bozeman, MT 59715 (406) 586-4961 Medical Group: William R Moos DDS PC

C Pulfer, Sheryleen 120 N 19th Ave Ste H Bozeman, MT 59718 (406) 585-8701 Medical Group: Community Health Partners Inc Sager, Cory D 380 Ice Center LN Ste B Bozeman, MT 59718 (406) 586-9871 Medical Group: Sager Dental Group Sager, Cory D 380 Ice Center LN Ste B Bozeman, MT 59718 (406) 586-9871 Medical Group: Schmieding Dental Group

ORTHODONTIST Hansen, Gordon 2050 W Dickerson St Bozeman, MT 59718 (406) 582-1790 Medical Group: G Kristian Hansen DDS MS

(406) 755-6014 Medical Group: David M Weber DDS MD PC

WHITEFISH FLATHEAD COUNTY

BOZEMAN GALLATIN COUNTY GENERAL DENTIST Andersen, Robert J

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Dental Care Providers GALLATIN GATEWY – GALLATIN COUNTY

GALLATIN GATEWY GALLATIN COUNTY GENERAL DENTIST Schmieding, Peter J 47520 Gallatin Rd Ste 1B Gallatin Gatewy, MT 59730 (406) 586-9871 Medical Group: Schmieding Dental Group

GENERAL DENTIST Blanchard, Jonathan W 118 S 4th St Manhattan, MT 59741 (406) 284-3251 Medical Group: Jonathan W Blanchard DDS

THREE FORKS GALLATIN COUNTY GENERAL DENTIST Russell, Chad D 123 Main St Ste 1 Three Forks, MT 59752 (406) 285-5234 Medical Group: Russell Chad D

W YELLOWSTONE GALLATIN COUNTY GENERAL DENTIST Davies, Roger R 317 N Canyon St W Yellowstone, MT 59758 (406) 646-7766 Medical Group: West Yellowstone Dental

Smith, Douglas C 317 N Canyon St W Yellowstone, MT 59758 (406) 646-7766 Medical Group: West Yellowstone Dental Smith, Ryan D 317 N Canyon St W Yellowstone, MT 59758 (406) 646-7766 Medical Group: West Yellowstone Dental

MANHATTAN CUT BANK GALLATIN COUNTY GLACIER COUNTY

GENERAL DENTIST Reasch, Randall B 140 S Central Ave Cut Bank, MT 59427 (406) 873-5222 Medical Group: Glacier Community Health Ctr Van Wagoner, Jennifer 140 S Central Ave Cut Bank, MT 59427 (406) 873-5222 Medical Group: Glacier Community Health Ctr

PHILISBURG GRANITE COUNTY GENERAL DENTIST Christensen, Gregory 310 Sansome St Philisburg, MT 59858 (406) 859-3271 Medical Group: Granite County Medical Cntr

Messer, Mark S 310 Sansome St Philisburg, MT 59858 (406) 859-3271 Medical Group: Granite County Medical Cntr

HAVRE HILL COUNTY GENERAL DENTIST Harris, Alyssa 521 4th St Havre, MT 59501 (406) 265-4541 Medical Group: Bullhook Community Health Ctr Kozik, James M 337 4th Ave Havre, MT 59501 (406) 265-2500 Medical Group: Kozik James M Ramberg, Zachary C 521 4th St Havre, MT 59501 (406) 265-4541 Medical Group: Bullhook Community Health Ctr Sweeten, Joshua C 521 4th St Havre, MT 59501 (406) 265-4541 Medical Group: Bullhook Community Health Ctr Whitney, Daniel C 515 14th St W Havre, MT 59501 (406) 727-4322 Medical Group: Neal Ronald E

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Dental Care Providers HAVRE – HILL COUNTY

ORAL SURGEON Neal, Ronald 515 14th St W Havre, MT 59501(406) 727-4322Medical Group: Neal Ronald E Whitney, Steven J 515 14th St W Havre, MT 59501(406) 727-4322

GENERAL DENTIST Martin, Charissa M 211 N Main St Boulder, MT 59632(406) 225-4222Medical Group: Elkhorn FamilyDental LLC

CLANCY JEFFERSON COUNTY GENERAL DENTIST Lavoie, Joel M 2 Market StClancy, MT 59634(406) 443-5130Medical Group: Montana CityDental Clinic PCLavoie, Shailini K 2 Market StClancy, MT 59634(406) 443-5130Medical Group: Montana CityDental Clinic PC

WHITEHALL JEFFERSON COUNTY GENERAL DENTIST Sacry, Dennis 108 W 1st StWhitehall, MT 59759(406) 287-3026Medical Group: Dennis K SacryDDS PC

Medical Group: Neal Ronald E

BOULDER JEFFERSON COUNTY

POLSON LAKE COUNTY GENERAL DENTIST Bird, Jeffrey S 2 6th Ave E Polson, MT 59860(406) 883-6269Medical Group: Bird FamilyDentistryClave, William C 102 1st Ave E Polson, MT 59860(406) 883-5544Medical Group: Big Sky DentalClinicGustafson, Aimee J 102 1st Ave E Polson, MT 59860(406) 883-5544Medical Group: Big Sky DentalClinic

RONAN LAKE COUNTY GENERAL DENTIST Bagnell, Timothy H 63355 Us Highway 93Ronan, MT 59864(406) 676-8880Medical Group: Bagnell FamilyDentistry

Beard, Jonathan 63355 Us Highway 93Ronan, MT 59864(406) 676-8880Medical Group: Bagnell FamilyDentistry

HELENA LEWIS AND CLARK COUNTY GENERAL DENTIST Ahlers, Jill H 227 W Lyndale Ave Helena, MT 59601(406) 443-6464Medical Group: Nathan L AhlersDDS PCAhlers, Nathan L 227 W Lyndale Ave Helena, MT 59601(406) 443-6464Medical Group: Nathan L AhlersDDS PCBrowne, Heidi C 1930 9th Ave Helena, MT 59601(406) 457-8971Medical Group: Pureview Hlth CtrDentalChamberlain, Dale R 64 Medical Park CT Helena, MT 59601(406) 443-3747Medical Group: Chamberlain DaleRClaeys, Christian L 2600 Winne Ave Ste C Helena, MT 59601(406) 443-8000Medical Group: Claeys FamilyDentistry PC

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Dental Care Providers HELENA – LEWIS AND CLARK COUNTY

Ditchey, Thomas K 740 Helena AveHelena, MT 59601(406) 442-7980Medical Group: Walsh April SDMDElder, Travis 907 Helena AveHelena, MT 59601(406) 442-4990Medical Group: Elder Travis Fife, Michael 2619 Colonial CT Ste BHelena, MT 59601(406) 442-7831Medical Group: Nielsen DentalPCFriedman, Jonathan 1930 9th AveHelena, MT 59601(406) 457-8971Medical Group: Pureview Hlth CtrDentalHarrington, Daniel P 1930 9th AveHelena, MT 59601(406) 457-8971Medical Group: Pureview Hlth CtrDentalHicks, James R 1300 N Montana AveHelena, MT 59601(406) 449-1300Medical Group: Hicks James R Keppler Jr, Leonard W 1930 9th AveHelena, MT 59601(406) 457-8971Medical Group: Pureview Hlth CtrDentalMiller, Kevin E 505 N Sanders StHelena, MT 59601(406) 442-1130Medical Group: Miller Kevin E

Mongelli, Jessica E 1093 Helena AveHelena, MT 59601(406) 442-5930Medical Group: Mongelli JessicaENielsen, Paul K 2619 Colonial CT Ste BHelena, MT 59601(406) 442-7831Medical Group: Nielsen DentalPCSchauer, William J 740 Helena AveHelena, MT 59601(406) 442-7980Medical Group: Walsh April SDMDSpiger, Benjamin R 3003 Cabernet CTHelena, MT 59601(406) 442-8062Medical Group: Spiger BenjaminRWalsh, April S 740 Helena AveHelena, MT 59601(406) 442-7980Medical Group: Walsh April SDMDWhitney, Daniel C 2600 Winne Ave Ste EHelena, MT 59601(406) 727-4322Medical Group: Ronald E NealDDS

ORAL SURGEON

Fleischmann, Jason H 65 Medical Park CTSte 1Helena, MT 59601(406) 443-3334Medical Group: Montana OralSurg Dnt Impl CtrNeal, Ronald 2600 Winne AveSte EHelena, MT 59601(406) 727-4322Medical Group: Ronald E NealDDSWhitney, Steven J 2600 Winne AveSte EHelena, MT 59601(406) 727-4322Medical Group: Ronald E NealDDS

EUREKA LINCOLN COUNTY GENERAL DENTIST

Daniels, Eric 744 Us Highway 93 NEureka, MT 59917(406) 297-2461Medical Group: Daniels Eric

LIBBY LINCOLN COUNTY GENERAL DENTIST

Burke, Brandon J 320 E 2nd StLibby, MT 59923(406) 293-3755Medical Group: Lincoln CountyCmty Hlth Ctr

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Dental Care Providers LIBBY – LINCOLN COUNTY

Davidson, Stephen J 200 California Ave Libby, MT 59923 (406) 293-7778 Medical Group: Davidson Stephen J Karsakow, Carla K 320 E 2nd St Libby, MT 59923 (406) 293-3755 Medical Group: Lincoln County Cmty Hlth Ctr Mendenhall, Ronald E 204 E 6th St Libby, MT 59923 (406) 293-4116 Medical Group: Kootenai Family Dentistry

ENNIS MADISON COUNTY GENERAL DENTIST

Sager, Cory D 5 Sunrise Loop Ste C Ennis, MT 59729 (406) 682-3310 Medical Group: Schmieding Dental Group Schmieding, Peter J 5 Sunrise Loop Ste C Ennis, MT 59729 (406) 682-3310 Medical Group: Schmieding Dental Group

SHERIDAN MADISON COUNTY GENERAL DENTIST

Marcotte, Anne M 317 Madison St Sheridan, MT 59749 (406) 842-5103 Medical Group: Butte Silver Bow Primary Hlth

FRENCHTOWN MISSOULA COUNTY GENERAL DENTIST

Bagnell, Timothy H 15276 Belker Lane Frenchtown, MT 59834 (406) 626-5520 Medical Group: Bagnell Dental Clinic Trujillo, Joseph J 15276 Belker Lane Frenchtown, MT 59834 (406) 626-5520 Medical Group: Bagnell Dental Clinic

MISSOULA MISSOULA COUNTY GENERAL DENTIST

Byington, Joseph D 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Byington, Joseph D 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter

Hayes, Melissa A 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Hayes, Melissa A 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Hollern, Lindsey M 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Jensen, Adam G 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Kao, Chung Wei 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Kao, Chung Wei 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Lowney, Peggy S 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter

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Dental Care Providers MISSOULA – MISSOULA COUNTY

Meshack Hart, Ernest A 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Meshack Hart, Ernest A 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Messer, Mark S 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Messer, Mark S 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter Nelson, Jazmin S 1150 Sherwood St Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Center Inc Nelson, Jazmin S 401 Railroad St W Missoula, MT 59802 (406) 258-4789 Medical Group: Partnership Health Enter

ORAL SURGEON

SEELEY LAKE MISSOULA COUNTY

Nelson, Jazmin S 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789

GENERAL DENTIST Medical Group: Partners Health Byington, Joseph D 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789 Medical Group: Partners Health Center Inc Hayes, Melissa A 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789 Medical Group: Partners Health Center Inc Kao, Chung Wei 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789 Medical Group: Partners Health Center Inc Lowney, Peggy S 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789 Medical Group: Partners Health Center Inc Meshack Hart, Ernest A 3050 Highway 83 North Seeley Lake, MT 59868 (406) 258-4789 Medical Group: Partners Health Center Inc Messer, Mark S 3050 Highway 83 North Seeley Lake, MT 59868

Holtzen, Richard Frank J (406) 258-4789805 S Reserve St Medical Group: Partners Health Missoula, MT 59801 Center Inc (406) 549-6600 Medical Group: Fac Plastic Reconstructive Sur

Center Inc

ROUNDUP MUSSELSHELL COUNTY GENERAL DENTIST

Rosebush, Mark S 239 Main St Roundup, MT 59072 (406) 323-1234 Medical Group: Whiteley Joshua L DDS

LIVINGSTON PARK COUNTY GENERAL DENTIST

Martin, Rachel M 112 W Lewis St Ste 3 Livingston, MT 59047 (406) 922-0881 Medical Group: Community Health Partners Pulfer, Sheryleen 126 S Main St Livingston, MT 59047 (406) 222-1111 Medical Group: Community Health Partners Inc Wales, Joanna V 112 W Lewis St Ste 3 Livingston, MT 59047 (406) 922-0881 Medical Group: Community Health Partners

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Dental Care Providers CONRAD – PONDERA COUNTY

CONRAD PONDERA COUNTY

DEER LODGE POWELL COUNTY GENERAL DENTIST Rubink, Dustin S

(406) 375-1192 Medical Group: Canyon View Dental PC

VICTOR RAVALLI COUNTY

THOMPSON FALLS SANDERS COUNTY GENERAL DENTIST Goertzen, Roland

GENERAL DENTIST

Vandyke, Schuyler A 417 2nd Ave SWConrad, MT 59425(406) 278-3609Medical Group: Sunset DentalCare

712 4th StDeer Lodge, MT 59722(406) 846-1216Medical Group: Rubink Dustin S Starr, Jake S 1101 Maryland AveDeer Lodge, MT 59722(406) 846-3532Medical Group: Starr Jake S

HAMILTON RAVALLI COUNTY

SIDNEY RICHLAND COUNTY GENERAL DENTIST

GENERAL DENTIST Stevens, Monte C 223 N Main St Plentywood, MT 59254 (406) 765-2700GENERAL DENTIST

Crossman, Jamie M 299 Fairgrounds RdHamilton, MT 59840(406) 363-1911Medical Group: Jamie M Bacon-Crossman DdspcKehmeier, Andy B 710 S 1st StHamilton, MT 59840(406) 363-5200Medical Group: Kehmeier Andy B

Simmons, Justin D710 N 1st StSte AHamilton, MT 59840(406) 375-1192Medical Group: Canyon ViewDental PCSimmons, Stacey L710 N 1st StSte AHamilton, MT 59840

GENERAL DENTIST

Anderson, Jeremy M 2413 Meridian RdVictor, MT 59875(406) 642-3771Medical Group: Victor DentalClinic

Martineau, Paul R 401 N Central Ave

GENERAL DENTIST

Greene, Myriam N116 Main StWolf Point, MT 59201(406) 653-2890Medical Group: Wolf Point Dental

FORSYTH ROSEBUD COUNTY GENERAL DENTIST

Youngbauer, Mary R 1617 Main StForsyth, MT 59327(406) 346-2131Medical Group: Youngbauer &Youngbauer

1608 Main St EThompson Falls, MT 59873(406) 827-4681Medical Group: Goertzen Roland

PLENTYWOOD SHERIDAN COUNTY

Medical Group: Sheridan Dental Clinic

445 Centennial AveButte, MT 59701(406) 723-4075Medical Group: SouthwestMontana Community

Sidney, MT 59270 (406) 482-2423 Medical Group: Martineau Paul R

WOLF POINT ROOSEVELT COUNTY

BUTTE SILVER BOW COUNTY GENERAL DENTIST Bartoletti, Maria I

10

Dental Care Providers BUTTE – SILVER BOW COUNTY

Bartoletti, Mario 445 Centennial Ave Butte, MT 59701 (406) 723-4075 Medical Group: Southwest Montana Community Bartoletti, Michael J 1501 Holmes Ave Butte, MT 59701 (406) 494-5033 Medical Group: Michael J Bartoletti DDS Chamberlain, Dale R 445 Centennial Ave Butte, MT 59701 (406) 723-4075 Medical Group: Southwest Montana Community Gilbreath, Tara E 820 Sampson St Butte, MT 59701 (406) 494-7080 Medical Group: Butte Family Dental PLLC Gundersen, Tyson J 245 East Park Butte, MT 59701 (406) 494-7058 Medical Group: Tyson Gundersen DMD Janeke, Dennis E 2425 Cornell Ave Butte, MT 59701 (406) 782-2703 Medical Group: Dennis E Janeke DDS Johnson, Erik H 2823 Lexington Ave Butte, MT 59701 (406) 494-9300 Medical Group: Erik H Johnson DMD

Marcotte, Anne M 445 Centennial Ave Butte, MT 59701 (406) 723-4075 Medical Group: Southwest Montana Community McIntyre, Kyle S 820 Sampson St Butte, MT 59701 (406) 494-7080 Medical Group: Butte Family Dental PLLC Pulfer, Sheryleen 445 Centennial Ave Butte, MT 59701 (406) 723-4075 Medical Group: Southwest Montana Community Richards, Toby G 1240 Dewey Blvd Butte, MT 59701 (406) 494-2525 Medical Group: Richards Toby G Shearman, Aaron M 3310 Monroe Ave Butte, MT 59701 (406) 494-1316 Medical Group: Shearman Aaron M Walters, Jere P 27 Discovery CT Butte, MT 59701 (406) 782-8719 Medical Group: Ct Jere P Walters DDS PLLC Wilcox, Robert F 2823 Lexington Butte, MT 59701 (406) 494-4046 Medical Group: Robert F Wilcox DDS

CHOTEAU TETON COUNTY GENERAL DENTIST

Maltby, Samuel S 15 1st St NE Choteau, MT 59422 (406) 466-5662 Medical Group: Maltby Samuel S Selander, David B 23 7th Ave NW Choteau, MT 59422 (406) 466-2064 Medical Group: David B Selander DDS

FAIRFIELD TETON COUNTY GENERAL DENTIST

Fairhurst, Kevin J 223 Central Ave Fairfield, MT 59436 (406) 761-1365 Medical Group: Westside Family Dental PC Messick, Douglas J 223 Central Ave Fairfield, MT 59436 (406) 761-1365 Medical Group: Westside Family Dental PC

SHELBY TOOLE COUNTY GENERAL DENTIST

Haight, Bryan D 865 Oilfield Ave Shelby, MT 59474 (406) 434-3142 Medical Group: Marias Healthcare Services Inc

11

Dental Care Providers SHELBY – TOOLE COUNTY

Moore, John P 865 Oilfield AveShelby, MT 59474(406) 434-5146Medical Group: J Patrick MooreDDS

HARLOWTON WHEATLAND COUNTY GENERAL DENTIST

Smith, Tyson C 201 Division StHarlowton, MT 59036(406) 632-4511Medical Group: Deer CreekDental

BILLINGS YELLOWSTONE COUNTY GENERAL DENTIST

Andrew, Cameron 123 S 27th StBillings, MT 59101(406) 247-3333Medical Group: Yellowstone CityCounty HlthBennion, Douglas B 152 S 32nd St WSte ABillings, MT 59102(406) 245-4414Medical Group: Lambourne KevinChadBennion, Douglas B 711 W Wicks LNBillings, MT 59105(406) 245-4414Medical Group: Douglas BennionDDS

Blackburn, Charles L1232 N 30th StSte 200Billings, MT 59101(406) 238-6008Medical Group: St VincentPhysicianDowning, Michael H123 S 27th StBillings, MT 59101(406) 247-3333Medical Group: Yellowstone CityCounty HlthFreeman, Scott R993 S 24th St WSte ABillings, MT 59102(406) 652-7000Medical Group: Scott R Freeman Gustafson, Amy K 123 S 27th StBillings, MT 59101(406) 247-3333Medical Group: Yellowstone CityCounty HlthHaslam, Cody W3307 Grand AveSte 105Billings, MT 59102(406) 652-7313Medical Group: Haslam Cody W Lambourne, Kevin C 152 S 32nd St W Ste A Billings, MT 59102(406) 245-4414Medical Group: Lambourne KevinChadLuderitz, James R1537 Avenue DSte 200Billings, MT 59102(406) 248-7172Medical Group: Luderitz James R

McDonald, Ian C 730 Main StSte 101Billings, MT 59105(406) 256-2121Medical Group: BenchmarkDental PCMcQueen, Shaun 2370 Avenue CBillings, MT 59102(406) 652-3031Medical Group: Shaun McQueenDDSMoritz, Greg K 2049 Broadwater AveSte 2Billings, MT 59102(406) 656-9911Medical Group: G K Moritz DDSPCPatterson, James E 1038 Broadwater AveBillings, MT 59102(406) 896-8365Medical Group: Patterson James E Pickens, Andrew W 730 Main StSte 101Billings, MT 59105(406) 256-2121Medical Group: BenchmarkDental PCPrill, Matthew J 820 N 30th StBillings, MT 59101(406) 252-1533Medical Group: Matthew J PrillDDSPrill, Richard D 820 N 30th StBillings, MT 59101(406) 252-1533Medical Group: Richard D PrillDDS

12

Dental Care Providers BILLINGS – YELLOWSTONE COUNTY

Rosebush, Mark S 2376 Main St Ste 812 Billings, MT 59105 (406) 656-5200 Medical Group: Elite Dental Center Slade, Matthew L 1826 Grand Ave Ste B Billings, MT 59102 (406) 839-9245 Medical Group: Matthew L Slade DDS Smith, Ronald W 2716 7th Ave N Billings, MT 59101 (406) 252-1862 Medical Group: Smith Ronald W Song, Kirk D 14 Avanta Way Ste A Billings, MT 59102 (406) 655-2162 Medical Group: Kirk D Song DDS PC Sutton, Jeanne 644 Grand Ave Ste 2 Billings, MT 59101 (406) 252-4415 Medical Group: Jeanne Sutton DDS Taylor, Jacob M 2700 Grand Ave Ste E Billings, MT 59102 (406) 655-4656 Medical Group: Wassmer Kyle B Thomas, Cameron 123 S 27th St Billings, MT 59101 (406) 247-3333 Medical Group: Yellowstone City County Hlth

Thomas, Joseph P 1501 14th St West Ste 215 Billings, MT 59102 (406) 256-5165 Medical Group: Joseph Thomas DDS Tracy, Kyle D 152 S 32nd St W Ste B Billings, MT 59102 (406) 655-0170 Medical Group: Billings Oral Surgery LLC Wassmer, Kyle B 2700 Grand Ave Ste E Billings, MT 59102 (406) 655-4656 Medical Group: Wassmer Kyle B Whiteley, Joshua L 123 S 27th St Billings, MT 59101 (406) 247-3333 Medical Group: Yellowstone City County Hlth Whiteley, Joshua L 2376 Main St Ste 812 Billings, MT 59105 (406) 656-5200 Medical Group: Elite Dental Center Winterholler, Cody 3737 Grand Ave Ste 8 Billings, MT 59102 (406) 652-0505 Medical Group: Winterholler Dentistry PC

Winterholler, William B 3737 Grand Ave Ste 8 Billings, MT 59102 (406) 652-0505 Medical Group: Winterholler Dentistry PC Yates, Joseph S 933 Broadwater SQ Billings, MT 59101 (406) 252-1202 Medical Group: Joseph S Yates DMD PC

ORAL SURGEON Bennion, John W 152 S 32nd St W Ste B Billings, MT 59102 (406) 655-0170 Medical Group: Billings Oral Surgery LLC Boyce, Andrew G 152 S 32nd St W Ste B Billings, MT 59102 (406) 655-0170 Medical Group: Billings Oral Surgery LLC Burns, Gregory M 152 S 32nd St W Ste B Billings, MT 59102 (406) 655-0170 Medical Group: Billings Oral Surgery LLC Griffeth, Rod M 2675 Central Ave Ste L8 Billings, MT 59102 (406) 259-7438 Medical Group: Oral and Maxillofacial Surgery

13

Dental Care Providers BILLINGS – YELLOWSTONE COUNTY

Hull, Mackay 123 S 27th St Billings, MT 59101 (406) 247-3333 Medical Group: Yellowstone City County Hlth Hull, Mackay 2523 6th Ave S Billings, MT 59102 (406) 259-7438 Medical Group: Oral&maxillofacial Surg Hull, Mackay 2675 Central Ave Ste L8 Billings, MT 59102 (406) 259-7438 Medical Group: Oral and Maxillofacial Surgery Ludwig, Brian R 2675 Central Ave Ste L8 Billings, MT 59102 (406) 259-7438 Medical Group: Oral and Maxillofacial Surgery Winterholler, Bert 2675 Central Ave Ste L8 Billings, MT 59102 (406) 259-7438 Medical Group: Oral and Maxillofacial Surgery Winterholler, Bert 3737 Grand Ave Ste 8 Billings, MT 59102 (406) 652-0505 Medical Group: Winterholler Dentistry PC

ORTHODONTIST

Kovacs, Thomas E 2820 Central Ave Ste C Billings, MT 59102 (406) 655-9300 Medical Group: Thomas E Kovacs DDS MSD PC Williams, Richard B 1690 Rimrock Rd Ste J Billings, MT 59102 (406) 252-9555 Medical Group: Williams Orthodontics

PEDIATRIC DENTIST Bailey, David G 1690 Rimrock Rd Ste C Billings, MT 59102 (406) 248-3303 Medical Group: Brady S Keller DMD Clement, Christina 1690 Rimrock Rd Ste C Billings, MT 59102 (406) 248-3303 Medical Group: Brady S Keller DMD Keller, Brady S 1690 Rimrock Rd Ste C Billings, MT 59102 (406) 248-3303 Medical Group: Brady S Keller DMD

LAUREL YELLOWSTONE COUNTY GENERAL DENTIST

Pollock, Samuel R 15 Montana Ave Laurel, MT 59044 (406) 628-6716 Medical Group: Laurel Family Dental Winterholler, Cody 413 SE 4th St Ste G Laurel, MT 59044 (406) 628-4500 Medical Group: Winterholler Dentistry Winterholler, William B 413 SE 4th St Ste G Laurel, MT 59044 (406) 628-4500 Medical Group: Winterholler Dentistry

RED LOGE YELLOWSTONE COUNTY GENERAL DENTIST

Condon, Jacob M 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC

14

Dental Care Providers RED LOGE – YELLOWSTONE COUNTY

Dobmeier, Jordan 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC Evans, David 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC Pollock, Samuel R 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC Townsend, Remington M 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC Tulett, Jeffrey 515 N Broadway Ste 4 Red Loge, MT 59102 (406) 655-4210 Medical Group: Rubicon Dental Assoc PLLC

15

Other Facilities ALPHABETIC LISTING

Aimee Ameline DDS PC 613 Park CT S Great Falls, MT 59405(406) 761-4288

Alpenglow Dental 3000 Hospital Way Whitefish, MT 59937(406) 862-3839

Bagnell Dental Clinic 15276 Belker Lane Frenchtown, MT 59834(406) 626-5520

Bagnell Family Dentistry 63355 Us Highway 93Ronan, MT 59864(406) 676-8880

Benchmark Dental PC 730 Main St Billings, MT 59105(406) 256-2121

Big Sky Dental Clinic 102 1st Ave E Polson, MT 59860(406) 883-5544

Billings Oral Surgery LLC 152 S 32nd St W Billings, MT 59102(406) 655-0170

Bird Family Dentistry 2 6th Ave E Polson, MT 59860(406) 883-6269

Brady S Keller DMD 1690 Rimrock Rd Billings, MT 59102(406) 248-3303

Buer Bruce H 166 Montana Ave E Big Sandy, MT 59520(406) 761-1837

Buer Bruce H 2300 12th Ave SGreat Falls, MT 59405(406) 761-1837

Buffington Neal J 604 1st Ave WColumbia Falls, MT 59912(406) 892-4296

Bullhook Community Health Ctr 521 4th StHavre, MT 59501(406) 265-4541

Butte Family Dental PLLC 820 Sampson StButte, MT 59701(406) 494-7080

Butte Silver Bow Primary Hlth 317 Madison StSheridan, MT 59749(406) 842-5103

C Falls Family Dental Ctr 105 Nucleus AveColumbia Falls, MT 59912(406) 892-2104

Canyon View Dental PC 710 N 1st StHamilton, MT 59840(406) 375-1192

Chamberlain Dale R 64 Medical Park CTHelena, MT 59601(406) 443-3747

Claeys Family Dentistry PC 2600 Winne AveHelena, MT 59601(406) 443-8000

Comfort Dental 2165 Hwy 2 EKalispell, MT 59901(406) 758-0391

16


Community Health Partners Inc 120 N 19th Ave Bozeman, MT 59718(406) 585-8701

Community Health Partners Inc 126 S Main St Livingston, MT 59047(406) 222-1111

Community Health Partners 112 W Lewis St Livingston, MT 59047(406) 922-0881

County of Cascade 115 4th St S Great Falls, MT 59401(406) 761-9893

Cromwell Andrew C 315 Oak St Anaconda, MT 59711(406) 563-3025

CT Jere P Walters DDS PLLC 27 Discovery CT Butte, MT 59701(406) 782-8719

Dachs David D 2523 6th Ave S Great Falls, MT 59405(406) 761-3131

Daniels Eric 744 Us Highway 93 N Eureka, MT 59917(406) 297-2461

David B Selander DDS 23 7th Ave NW Choteau, MT 59422(406) 466-2064

David M Weber DDS MD PC 115 Commons Way Kalispell, MT 59901(406) 755-6014

Davidson Stephen J 200 California Ave Libby, MT 59923(406) 293-7778

Deer Creek Dental 201 Division St Harlowton, MT 59036(406) 632-4511

Dennis E Janeke DDS 2425 Cornell Ave Butte, MT 59701(406) 782-2703

Dennis K Sacry DDS PC 108 W 1st St Whitehall, MT 59759(406) 287-3026

Dillon Community Health Ctr 41 Barrett St Dillon, MT 59725(406) 683-4440

Douglas Bennion DDS 711 W Wicks LN Billings, MT 59105(406) 245-4414

Ed A Bartoletti DMD 215 Hickory St Anaconda, MT 59711(406) 563-5450

Elder Travis 907 Helena Ave Helena, MT 59601(406) 442-4990

Elite Dental Center 2376 Main St Billings, MT 59105(406) 656-5200

Elkhorn Family Dental LLC 211 N Main St Boulder, MT 59632(406) 225-4222

17


Erik H Johnson DMD 2823 Lexington Ave Butte, MT 59701(406) 494-9300

Fac Plastic Reconstructive Sur 805 S Reserve St Missoula, MT 59801(406) 549-6600

Flathead Community Health 1035 1st Ave W Kalispell, MT 59901(406) 751-8113

G K Moritz DDS PC 2049 Broadwater Ave Billings, MT 59102(406) 656-9911

G Kristian Hansen DDS MS 2050 W Dickerson St Bozeman, MT 59718(406) 582-1790

Glacier Community Health Ctr 140 S Central Ave Cut Bank, MT 59427(406) 873-5222

Goertzen Roland 1608 Main St E Thompson Falls, MT 59873(406) 827-4681

Granite County Medical Cntr 310 Sansome St Philisburg, MT 59858(406) 859-3271

Hammer William Neil 140 5th St W Kalispell, MT 59901(406) 755-6680

Harboway Family Dentistry PC 2800 11th Ave S Great Falls, MT 59405(406) 453-4346

Haslam Cody W 3307 Grand Ave Billings, MT 59102(406) 652-7313

Hicks James R 1300 N Montana Ave Helena, MT 59601(406) 449-1300

Huhn Adam J DDS 2523 6th Ave S Great Falls, MT 59405(406) 761-3131

J Patrick Moore DDS 865 Oilfield Ave Shelby, MT 59474(406) 434-5146

James E Nelson DDS 114 13th St S Great Falls, MT 59401(406) 454-3711

Jamie M Bacon-Crossman Ddspc 299 Fairgrounds Rd Hamilton, MT 59840(406) 363-1911

Jeanne Sutton DDS 644 Grand Ave Billings, MT 59101(406) 252-4415

Jonathan W Blanchard DDS 118 S 4th St Manhattan, MT 59741(406) 284-3251

Joseph S Yates DMD PC 933 Broadwater SQ Billings, MT 59101(406) 252-1202

Joseph Thomas DDS 1501 14th St West Billings, MT 59102(406) 256-5165

18


Kalispell Family Dental PLLC 720 2nd St E Kalispell, MT 59901(406) 755-4766

Katherine S Slocum DDS 307 E Park Ave Anaconda, MT 59711(406) 563-3473

Kehmeier Andy B 710 S 1st St Hamilton, MT 59840(406) 363-5200

Kirk D Song DDS PC 14 Avanta Way Billings, MT 59102(406) 655-2162

Kootenai Family Dentistry 204 E 6th St Libby, MT 59923(406) 293-4116

Kozik James M 337 4th Ave Havre, MT 59501(406) 265-2500

Lambourne Kevin Chad 152 S 32nd St W Billings, MT 59102(406) 245-4414

Laurel Family Dental 15 Montana Ave Laurel, MT 59044(406) 628-6716

Lincoln County Cmty Hlth Ctr 320 E 2nd St Libby, MT 59923(406) 293-3755

Lowe Amy K 116 W 3rd St Anaconda, MT 59711(406) 563-7666

Luderitz James R 1537 Avenue D Billings, MT 59102(406) 248-7172

Maltby Levi C DMD 3920 3rd Ave S Great Falls, MT 59405(406) 452-5361

Maltby Samuel S 15 1st St Ne Choteau, MT 59422(406) 466-5662

Marias Healthcare Services Inc 865 Oilfield Ave Shelby, MT 59474(406) 434-3142

Martineau Paul R 401 N Central Ave Sidney, MT 59270(406) 482-2423

Matthew A West DDS PC 422 Broadway St Townsend, MT 59644(406) 266-3402

Matthew J Prill DDS 820 N 30th St Billings, MT 59101(406) 252-1533

Matthew L Garson DDS 227 Spooner Rd Belgrade, MT 59714(406) 388-0550

Matthew L Slade DDS 1826 Grand Ave Billings, MT 59102(406) 839-9245

McCollum John B 110 S Idaho St Dillon, MT 59725(406) 683-5125

19


McFarland Garret C 520 Main St Miles City, MT 59301(406) 874-9637

Michael J Bartoletti DDS 1501 Holmes Ave Butte, MT 59701(406) 494-5033

Miller Kevin E 505 N Sanders St Helena, MT 59601(406) 442-1130

Mongelli Jessica E 1093 Helena Ave Helena, MT 59601(406) 442-5930

Montana City Dental Clinic PC 2 Market St Clancy, MT 59634(406) 443-5130

Montana Oral Surg Dnt Impl Ctr 65 Medical Park CT Helena, MT 59601(406) 443-3334

Mortenson Dean C 2018 Stadium CT Bozeman, MT 59715(406) 586-9621

Nathan L Ahlers DDS PC 227 W Lyndale Ave Helena, MT 59601(406) 443-6464

Neal Ronald E 515 14th St W Havre, MT 59501(406) 727-4322

Nielsen Dental PC 2619 Colonial CT Helena, MT 59601(406) 442-7831

Northern MT Oral & Max Surg PC 2714 15th Ave SGreat Falls, MT 59405(406) 727-4322

Oral & Maxillofacial Surg 2600 Wilson StMiles City, MT 59301(406) 259-7438

Oral and Maxillofacial Surgery 2675 Central AveBillings, MT 59102(406) 259-7438

Oral&maxillofacial Surg 2523 6th Ave SBillings, MT 59102(406) 259-7438

Partners Health Center Inc 3050 Highway 83 NorthSeeley Lake, MT 59868(406) 258-4789

Partnership Health Center Inc 1150 Sherwood StMissoula, MT 59802(406) 258-4789

Partnership Health Enter 401 Railroad St WMissoula, MT 59802(406) 258-4789

Patterson James E 1038 Broadwater AveBillings, MT 59102(406) 896-8365

Pence Daniel A 2605 16th Ave SGreat Falls, MT 59405(406) 727-9889

Pureview Hlth Ctr Dental 1930 9th AveHelena, MT 59601(406) 457-8971

20


Richard D Prill DDS 820 N 30th StBillings, MT 59101(406) 252-1533

Richards Toby G 1240 Dewey BlvdButte, MT 59701(406) 494-2525

Robert F Wilcox DDS 2823 LexingtonButte, MT 59701(406) 494-4046

Robert J Labrel DDS 1220 Main StFort Benton, MT 59442(406) 622-3651

Robin Neil 910 1st Ave NGreat Falls, MT 59401(406) 454-1512

Ronald B Potthoff DDS 195 Commons LoopKalispell, MT 59901(406) 755-5280

Ronald E Neal DDS 2600 Winne AveHelena, MT 59601(406) 727-4322

Rubicon Dental Assoc PLLC 339 3rd St WHardin, MT 59034(406) 655-3300

Rubicon Dental Assoc PLLC 515 N BroadwayRed Loge, MT 59102(406) 655-4210

Rubicon Dental Associates 24 South OakesRed Lodge, MT 59068(406) 655-4210

Rubink Dustin S 712 4th StDeer Lodge, MT 59722(406) 846-1216

Russell Chad D 123 Main StThree Forks, MT 59752(406) 285-5234

Sager Dental Group 380 Ice Center LNBozeman, MT 59718(406) 586-9871

Schmieding Dental Group 380 Ice Center LNBozeman, MT 59718(406) 586-9871

Schmieding Dental Group 5 Sunrise LoopEnnis, MT 59729(406) 682-3310

Schmieding Dental Group 47520 Gallatin RdGallatin Gatewy, MT 59730(406) 586-9871

Scott C Olsen DDS 115 S Pacific StDillon, MT 59725(406) 683-2671

Scott R Freeman 993 S 24th St WBillings, MT 59102(406) 652-7000

Semrau David D 221 Parkway CTKalispell, MT 59901(406) 752-2372

Shaun McQueen DDS 2370 Avenue CBillings, MT 59102(406) 652-3031

21


Shearman Aaron M 3310 Monroe Ave Butte, MT 59701(406) 494-1316

Sheridan Dental Clinic 223 N Main St Plentywood, MT 59254(406) 765-2700

Smith Ronald W 2716 7th Ave N Billings, MT 59101(406) 252-1862

Southwest Montana Community 445 Centennial Ave Butte, MT 59701(406) 723-4075

Spiger Benjamin R 3003 Cabernet CT Helena, MT 59601(406) 442-8062

St Vincent Physician 1232 N 30th St Billings, MT 59101(406) 238-6008

Starr Jake S 1101 Maryland Ave Deer Lodge, MT 59722(406) 846-3532

Sunset Dental Care 417 2nd Ave SW Conrad, MT 59425(406) 278-3609

Thomas E Kovacs DDS MSD PC 2820 Central Ave Billings, MT 59102(406) 655-9300

Tyson Gundersen DMD 245 East Park Butte, MT 59701(406) 494-7058

Victor Dental Clinic 2413 Meridian Rd Victor, MT 59875(406) 642-3771

Voy Scott E DDS PLLC 2707 16th Ave S Great Falls, MT 59405(406) 727-8440

Walsh April S DMD 740 Helena Ave Helena, MT 59601(406) 442-7980

Wassmer Kyle B 2700 Grand Ave Billings, MT 59102(406) 655-4656

West Yellowstone Dental 317 N Canyon St W Yellowstone, MT 59758(406) 646-7766

Westside Family Dental PC 223 Central Ave Fairfield, MT 59436(406) 761-1365

Westside Family Dental PC 900 10th Ave NW Great Falls, MT 59404(406) 761-1365

Whiteley Joshua L DDS 239 Main St Roundup, MT 59072(406) 323-1234

William R Moos DDS PC 1716 W Main St Bozeman, MT 59715(406) 586-4961

Williams Orthodontics 1690 Rimrock Rd Billings, MT 59102(406) 252-9555

22


Winterholler Dentistry PC 3737 Grand Ave Billings, MT 59102 (406) 652-0505

Winterholler Dentistry 413 Se 4th St Laurel, MT 59044 (406) 628-4500

Wolf Point Dental 116 Main St Wolf Point, MT 59201 (406) 653-2890

Yellowstone City County Hlth 123 S 27th St Billings, MT 59101 (406) 247-3333

Yerger Family Dental 2200 Box Elder St Miles City, MT 59301 (406) 232-2214

Youngbauer & Youngbauer 1617 Main St Forsyth, MT 59327 (406) 346-2131

23

Alphabetical Index Ahlers, Jill H.................................................................... 6Ahlers, Nathan L.............................................................. 6Ameline, Aimee R........................................................... 1Andersen, Robert J........................................................... 4Anderson, Jeremy M...................................................... 10Andrew, Cameron.......................................................... 12Bagnell, Timothy H..................................................... 6, 8Bailey, David G............................................................. 14Bartoletti, Edward............................................................ 3Bartoletti, Maria I.......................................................... 10Bartoletti, Mario............................................................ 11Bartoletti, Michael J....................................................... 11Bax, Dale A..................................................................... 4Beard, Jonathan................................................................ 6Bennion, Douglas B....................................................... 12Bennion, John W........................................................... 13Bird, Jeffrey S.................................................................. 6Blackburn, Charles L..................................................... 12Blanchard, Jonathan W.................................................... 5Booth, Joel....................................................................... 4Boyce, Andrew G.......................................................... 13Browne, Heidi C.............................................................. 6Buer, Bruce H.............................................................. 1, 2Buffington, Neal J............................................................ 3Burke, Brandon J............................................................. 7Burns, Gregory M.......................................................... 13Byington, Joseph D...................................................... 8, 9Calderwood, Dean W....................................................... 3Chamberlain, Dale R.................................................. 6, 11Chinn, Meka M................................................................ 1Christensen, Gregory....................................................... 5Claeys, Christian L.......................................................... 6Clave, William C............................................................. 6Clement, Christina......................................................... 14Condon, Jacob M........................................................... 14Cromwell, Andrew C....................................................... 3Crossman, Jamie M........................................................ 10Dachs, David D................................................................ 1Daniels, Eric.................................................................... 7Davidson, Stephen J......................................................... 8Davies, Roger R............................................................... 5Ditchey, Thomas K.......................................................... 7Dobmeier, Jordan........................................................... 15Downing, Michael H...................................................... 12Elder, Travis.................................................................... 7Erekson, Joshua............................................................... 3Evans, David.............................................................. 1, 15Fairhurst, Kevin J....................................................... 2, 11Fife, Michael.................................................................... 7Fleischmann, Jason H...................................................... 7Freeman, Scott R........................................................... 12

Friedman, Jonathan.......................................................... 7Garson, Matthew L.......................................................... 4Gilbreath, Tara E........................................................... 11Goertzen, Roland........................................................... 10Greene, Myriam N......................................................... 10Griffeth, Rod M......................................................... 3, 13Gundersen, Tyson J........................................................ 11Gustafson, Aimee J.......................................................... 6Gustafson, Amy K......................................................... 12Haight, Bryan D............................................................. 11Hammer, William N........................................................ 3Hansen, Gordon............................................................... 4Harboway, Don J............................................................. 2Harrington, Daniel P........................................................ 7Harris, Alyssa.................................................................. 5Haslam, Cody W............................................................ 12Hayes, Melissa A......................................................... 8, 9Hicks, James R................................................................ 7Hollern, Lindsey M.......................................................... 8Holtzen, Richard Frank J................................................. 9Huhn, Adam J.................................................................. 2Hull, Mackay................................................................. 14Janeke, Dennis E............................................................ 11Jensen, Adam G............................................................... 8Johnson, Erik H............................................................. 11Johnston Jr, George R...................................................... 1Kao, Chung Wei.......................................................... 8, 9Karsakow, Carla K........................................................... 8Kehmeier, Andy B......................................................... 10Keller, Brady S.............................................................. 14Keppler Jr, Leonard W..................................................... 7Kovacs, Thomas E......................................................... 14Kozik, James M........................................................... 3, 5Labrel, Robert J............................................................... 2Lambourne, Kevin C...................................................... 12Larson, Robert A............................................................. 4Lavoie, Joel M................................................................. 6Lavoie, Shailini K............................................................ 6Lowe, Amy K.................................................................. 3Lowney, Peggy S......................................................... 8, 9Luderitz, James R.......................................................... 12Ludwig, Brian R........................................................ 3, 14Madsen Jr, Kenneth A..................................................... 3Maltby, Levi C................................................................. 2Maltby, Samuel S........................................................... 11Marcotte, Anne M.................................................. 1, 8, 11Martin, Charissa M.......................................................... 6Martin, Rachel M......................................................... 4, 9Martineau, Paul R.......................................................... 10McCollum, John B........................................................... 1McDonald, Ian C........................................................... 12McFarland, Garret C........................................................ 2McIntyre, Kyle S........................................................... 11

24

McQueen, Shaun............................................................ 12Mendenhall, Ronald E..................................................... 8Meshack Hart, Ernest A................................................... 9Messer, Mark S............................................................ 5, 9Messick, Douglas J.................................................... 2, 11Miller, John F.................................................................. 3Miller, Kevin E................................................................ 7Mongelli, Jessica E.......................................................... 7Moore, John P................................................................ 12Moos, William R............................................................. 4Moritz, Greg K............................................................... 12Mortenson, Dean C.......................................................... 4Muir, Joshua C................................................................. 1Neal, Ronald............................................................ 2, 6, 7Neil, Robin...................................................................... 2Nelson, James E............................................................... 2Nelson, Jazmin S............................................................. 9Nickisch, Wendy.............................................................. 3Nielsen, Paul K................................................................ 7Nieset, Michelle R........................................................... 2Olsen, Scott C.................................................................. 1Patterson, James E......................................................... 12Pence, Daniel A............................................................... 2Pickens, Andrew W....................................................... 12Pollock, Samuel R................................................ 1, 14, 15Potthoff, Ronald B........................................................... 3Prill, Matthew J.............................................................. 12Prill, Richard D.............................................................. 12Pulfer, Sheryleen................................................ 1, 4, 9, 11Raddatz, Laura................................................................. 4Ramberg, Zachary C........................................................ 5Reasch, Randall B............................................................ 5Richards, Toby G........................................................... 11Robinson, Katerina.......................................................... 3Rosebush, Mark S...................................................... 9, 13Rubink, Dustin S............................................................ 10Russell, Chad D............................................................... 5Sacry, Dennis................................................................... 6Sager, Cory D.............................................................. 4, 8Schauer, William J........................................................... 7Schmieding, Peter J...................................................... 5, 8Sedlack, Janet.................................................................. 2Selander, David B.......................................................... 11Semrau, David D............................................................. 4Shearman, Aaron M....................................................... 11Simmons, Justin D......................................................... 10Simmons, Stacey L........................................................ 10Slade, Matthew L........................................................... 13Slocum, Katherine S........................................................ 3Smith, Douglas C............................................................. 5Smith, Ronald W........................................................... 13Smith, Ryan D................................................................. 5Smith, Tyson C.............................................................. 12

Song, Kirk D.................................................................. 13Spiger, Benjamin R.......................................................... 7Starr, Jake S................................................................... 10Stevens, Monte C........................................................... 10Sutton, Jeanne................................................................ 13Sweeten, Joshua C........................................................... 5Taylor, Jacob M............................................................. 13Thomas, Cameron.......................................................... 13Thomas, Joseph P.......................................................... 13Townsend, Remington M............................................... 15Tracy, Kyle D................................................................ 13Trujillo, Joseph J.............................................................. 8Tulett, Jeffrey............................................................. 1, 15Van Wagoner, Jennifer.................................................... 5Vandyke, Schuyler A..................................................... 10Voy, Scott E..................................................................... 2Wales, Joanna V.............................................................. 9Walsh, April S................................................................. 7Walters, Jere P............................................................... 11Wassmer, Kyle B........................................................... 13Weber, David M.............................................................. 4West, Matthew A............................................................. 1Whiteley, Joshua L........................................................ 13Whitney, Daniel C................................................... 2, 5, 7Whitney, Steven J.................................................... 2, 6, 7Wilcox, Robert F........................................................... 11Williams, Richard B...................................................... 14Winterholler, Bert...................................................... 3, 14Winterholler, Cody.................................................. 13, 14Winterholler, William B.......................................... 13, 14Yates, Joseph S.............................................................. 13Yerger, Chase J................................................................ 2Youngbauer, Mary R..................................................... 10

25

Vision Providers

SELECT NETWORK PROVIDER LOCATIONS

Montana

MT Big Horn County

CITY OF HARDIN HARDIN EYECARE 215 W 3RD ST 4066651204 HARDIN, MT 59034

Blaine County

CITY OF CHINOOK DR LARRY G OBIE 419 PENNSYLVANIA ST 4063573740 CHINOOK, MT 59523

Cascade County

CITY OF GREAT FALLS CASCADE OPTICIANS 4064535405

COMPLETE EYECARE 4064525322

LENSCRAFTERS 4064535737

SEARS OPTICAL 4067714076

SHOPKO EYE CARE CENTER 4062 4067279724

TREASURE STATE EYE CARE 4067279160

CITY OF MALMSTROM A F B MALMSTROM OPTICAL CENTER 4064528401

TWO FIFTH ST NORTH GREAT FALLS, MT 59401

1012 FIRST AVE NORTH GREAT FALLS, MT 59401

1200 10TH AVE S STE 25 GREAT FALLS, MT 59405

1200 10TH AVE S GREAT FALLS, MT 59405

301 NORTHWEST BYPASS GREAT FALLS, MT 59404

523 NINTH ST SOUTH GREAT FALLS, MT 59405

7200 PERIMETER RD BLDG 1340 MALMSTROM A F B, MT 59402

Deer Lodge County

CITY OF ANACONDA AMERICAN EYECARE 100 W PARK 4065636471 ANACONDA, MT 59711

Fergus County

CITY OF LEWISTOWN COMPLETE EYE CTR 611 NE MAIN 4065387703 LEWISTOWN, MT 59457

Flathead County

CITY OF KALISPELL LENSCRAFTERS 4067524468


20 N MAIN ST STE 137 KALISPELL, MT 59901

1370 HWY 2 EAST KALISPELL, MT 59901

CITY OF WHITEFISH NAOMI G BARNES OD 201 2ND ST EAST STE B 4068623346 WHITEFISH, MT 59937

Gallatin County

CITY OF BOZEMAN BOZEMAN CONTACT LENS CENTER 815 WEST COLLEGE ST STE B 4065878333 BOZEMAN, MT 59715

EYES ON MAIN 4065862173

1425 W MAIN ST STE B BOZEMAN, MT 59715

GALLATIN VALLEY VISION 4065877050

2825 W MAIN ST STE 1E BOZEMAN, MT 59718


2825 W MAIN STE 5D BOZEMAN, MT 59718

THE VISION CENTER IN WAL-MART 1500 N SEVENTH AVE 4065853758 BOZEMAN, MT 59715

Glacier County

CITY OF CUT BANK MARK R STANCHFIELD OD 226 9TH AVE SOUTHEAST 4068735623 CUT BANK, MT 59427

Hill County

CITY OF HAVRE EVANS OPTICAL 316 3 ST 4062651276 HAVRE, MT 59501

HAVRE OPTOMETRIC CLINIC PLLP 416 3RD AVE 4062651231 HAVRE, MT 59501

NORTHERN MANTANA HOSPITAL 20 13TH STREET WEST 4062622020 HAVRE, MT 59501

Jefferson County

CITY OF CLANCY ELKHORN VISION CENTER 12 OLD MONTANA STATE HWY 4064422020 CLANCY, MT 59634

Lake County

CITY OF BIGFORK BIGFORK EYE CLINIC 8111 HWY 35 STE 6 4068376883 BIGFORK, MT 59911

CITY OF POLSON AMERICAN EYECARE 11 THIRD AVE WEST 4068834733 POLSON, MT 59860

POLSON FAMILY EYECARE 410 1ST STREET EAST SUITE A 4068834355 POLSON, MT 59860

Visit www.eyemed.com for current provider information. Page 1 June 2016

SELECT NETWORK PROVIDER LOCATIONS

Montana

Lewis And Clark County Powell County

CITY OF HELENA AMERICAN EYECARE 4064498682

CAPITAL OPTOMETRIST 4064427130

HELENA EYE CLINIC 4064434040

MOUNTAIN VIEW EYECARE PC 4064423937


1600 11TH AVE HELENA, MT 59601

1234 CEDAR STREET HELENA, MT 59601

3116 SADDLE DR HELENA, MT 59601

301 SADDLE DR STE B HELENA, MT 59601

3101 MONTANA AVE HELENA, MT 59601

Missoula County

CITY OF MISSOULA AMERICAN EYECARE 4065495550

ENVISION EYECARE 4065494851


MONTANA EYE CARE 4065499413

MONTANA FAMILY VISION CARE 4065426382


1431 S HIGGIN MISSOULA, MT 59801

700 SOUTH AVE WEST STE G MISSOULA, MT 59801

2901 BROOKS ST MISSOULA, MT 59801

726 KENSINGTON MISSOULA, MT 59801

2829 GREAT NORTHERN LOOP STE 100 MISSOULA, MT 59808

2510 S RESERVE ST MISSOULA, MT 59801

Pondera County

CITY OF CONRAD DRS BONDERUD & STANCHFIELD 19 4TH AVE SW 4062715517 CONRAD, MT 59425

CITY OF DEER LODGE AMERICAN EYECARE 513 MAIN ST 4068462854 DEER LODGE, MT 59722

Silver Bow County

CITY OF BUTTE AMERICAN EYECARE 1313 HARRISON AVE 4067822359 BUTTE, MT 59701

ROBERT I NOBLE MD PC 832 S MONTANA ST 4067234004 BUTTE, MT 59701

Toole County

CITY OF SHELBY LARRY J BONDERUD OD 865 OILFIELD AVE 4064345196 SHELBY, MT 59474

Yellowstone County

CITY OF BILLINGS BILLINGS FAMILY OPTICAL PLLC 1540 LAKE ELMO DR STE 1 4062452299 BILLINGS, MT 59105

BILLINGS VISION & CONTACT LENS 111 S 24TH ST WEST STE 16 4066524141 BILLINGS, MT 59102

JESSICA L PEEL OD 4062596786

1212 GRAND AVE STE 14B BILLINGS, MT 59102

KAUTZ OPTOMETRY 4062481676

805 24TH ST WEST STE 9 BILLINGS, MT 59102


111 S 24TH ST WEST BILLINGS, MT 59102


905 S 24TH WEST BILLINGS, MT 59102

VISION OPTICAL 4066569857

1331 24TH ST W BILLINGS, MT 59102

Visit www.eyemed.com for current provider information. Page 2 June 2016

Hearing Providers

TruHearing Inc. 111 S 24th st West Ste 7 Billings, MT 59102 Hearing Instrument Specialist (844)207-1685

TruHearing Inc. 1102 Ninth St South Great Falls, MT 59405 Audiologist (844)207-1685

TruHearing Inc. 1701 11th Ave South Great Falls, MT 59405 Hearing Instrument Specialist (844)207-1685

TruHearing Inc. 1301 11th Ave S Ste 4 Great Falls, MT 59405 Hearing Instrument Specialist (844)207-1685

TruHearing Inc. 2646 Winne Ave Helena, MT 59601 Hearing Instrument Specialist (844)207-1685

TruHearing Inc. 501 E Front St Ste 513 Butte, MT 59701 Hearing Instrument Specialist (844)207-1685

TruHearing Inc. 1165 N. 14th Ave. Suite 1 Bozeman, MT 59715 Audiologist (844)207-1685

TruHearing Inc. 601 S Orange St Missoula, MT 59801 Audiologist (844)207-1685

Y0096_MRK_MT_NDNOTICE17 Accepted 09042016

Blue Cross and Blue Shield of Montana complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Blue Cross and Blue Shield of Montana does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Blue Cross and Blue Shield of Montana:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:

○ Qualified sign language interpreters

○ Written information in other formats (large print, audio, accessible electronic formats, other formats)

• Provides free language services to people whose primary language is not English, such as:

○ Qualified interpreters

○ Information written in other languages

If you need these services, contact Civil Rights Coordinator

If you believe that Blue Cross and Blue Shield of Montana has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator, Office of Civil Rights Coordinator, 300 E. Randolph St., 35th floor, Chicago, Illinois 60601, 1-855-664-7270, TTY/TDD: 1-855-661-6965, Fax: 1-855-661-6960, [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW

Room 509F, HHH Building Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

352875.0816

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call <1-877-774-8592> (TTY: <711>).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al <1-877-774-8592> (TTY: <711>).

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: <1-877-774-8592> (TTY: <711>).

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 <1-877-774-8592> (TTY: <711>)。

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。<1-877-774-8592> (TTY:<711>) まで、お電話にてご連絡ください。

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa <1-877-774-8592> (TTY: <711>).

ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le <1-877-774-8592> (ATS: <711>).

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните <1-877-774-8592> (телетайп: <711>).

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. <1-877-774-8592> (TTY: <711>) 번으로 전화해 주십시오.

لحوظ: إذا كنت تتحدث اللغة العربية، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل رقم <1-877-774-8592> (رقم هاتف الصم والبكم: <711>).

เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟร ี โทร <1-877-774-8592> (TTY: <711>).

MERK: Hvis du snakker norsk, er gratis språkassistansetjenester tilgjengelige for deg. Ring <1-877-774-8592> (TTY: <711>).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số <1-877-774-8592> (TTY: <711>).

УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером <1-877-774-8592> (телетайп: <711>).

Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call <1-877-774-8592> (TTY: <711>).

ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero <1-877-774-8592> (TTY: <711>).

1-877-774-8592 (TTY: 711).

1-877-774-8592 (TTY: 711).

1-877-774-8592 (TTY: 711).

1-877-774-8592 (TTY: 711)

1-877-774-8592

1-877-774-8592 (TTY: 711).

1-877-774-8592 (ATS: 711).

1-877-774-8592

1-877-774-8592

1-877-774-8592 (TTY: 711).

1-877-774-8592 (TTY: 711).

1-877-774-8592 (TTY: 711).

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1-877-774-8592 (TTY: 711).

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.(711

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HMO and PPO plans are provided by Blue Cross and Blue Shield of Montana, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC’s plans depends on contract renewal.

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