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~r . ... ,... ... ~ . ~ ~ . ~ , . uC~ICTl'LT,, r':TVT'TTTSRt.+Q ~"_'~ :V ~1T;~ : ----Qrr,7 ---- -- ~~ reimbursement fro any motor veh~c:le liability i er required by said law. ~ '~ ~~6 ' . .. . . r 4 . . . . ' ' • ' Mem~er shall f. sh information concerning medi~al _ a ents in p ym surance to . ~.O.H.:S.~upon request. The uninsured.motorist coverage of said member and/or his dependents shall be consider.ed a third party, and such insurance benefits under uninsured motorist coverage shall be first applied toward medi.cal expense before G.O.H.S, shall be required to pay any medical expenses under this contract. MEMBERS ELIGIBLE FOR MEDICARE It is expressly understood that any member eligible for hospital, doctor and related medical benefits of 'Medicare' is automatically eligible to continue his membership in G.O.H.S. Benefits available through enrollment in the. Medicare Program shall first be applied'to the medical expenses incurred. G.O.H.S.~ shall make payment to the extent of balances unpaid by the Government provisions of 'Medicare', to the limits .of benefits provided by this agreement. Any amount saved G.O.H.S, through payment by 'Medicare' may be applied to other allied medical expense as follows: Prescription drugs, appliances, rental of equipment, necessary ambulance, private duty nursing by licensed registered nurses or licensed practical nurses not rela~ted to the patient, and balances owing for services rendered in Extended Care Facilities recogni2ed by the.government for reimbursement.under the Medicare program, all of which occurs within 180 days following dismissal from the hospital. Benefits will be reduced to the extent that such benefits are provided, on would have been provided, had the SubSCriber or family members enrolled, applied, maintained eligibility, paid any required premium and made claims for such benefits under U..S. Public Law 89-97, also known as the Social Security Amendments of 1965, including amendments and supplements thereto. RIGHT TO EXAMINE RECORDS G.O:H.S, shall be entitled to receive from physicians or hospitals such information and records. relating to attendance of examination of or treatment rendered to Subscriber or dependent as may be required in, the administration of claims under this agree_ment. PETITION TO REVIEW In the event a member shall feel that G.O.H.S, has erred in applying the terms and provisions of his membership to any claim submitted for payment, and he is not satisfied with payment offered, he may, within 90 days of the date of final decision, petition for a review of the payment proposed. A review of said decision will~be commericed within 30 days following by a review panel of three persons, one to be selected by G.O.H.S., one to be selected by the member, and a third by the other two. A ma~ority decision of said review panel shall be final and binding upon both G.O.H.S, and the member. - 14