Orange County Benefit Highlights. Orange County. SCAN Classic (HMO), SCAN Balance (HMO SNP), and Heart First (HMO SNP) 2015 Benefit Highlights

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Orange County Benefit Highlights. Orange County. SCAN Classic (HMO), SCAN Balance (HMO SNP), and Heart First (HMO SNP) 2015 Benefit Highlights"

Transcription

1 Orange County Benefit Highlights Orange County SCAN Classic (HMO), SCAN Balance (HMO SNP), and Heart First (HMO SNP) 2015 Benefit Highlights

2 Orange County Benefit Highlights Comprehensive Care SCAN CLASSIC SCAN BALANCE Heart First Monthly Plan Premium Primary Care Office Visits Specialist Office Visits Diabetic Self-Management Training Diabetic Supplies (Lancets, Test Strips, Monitor) Annual Physical Exam Preventive Services (Medicare-Covered Screenings) SCAN Classic is a Medicare Advantage Plan including comprehensive preventive and hospital care plus complete prescription drug coverage. It s our most popular plan designed around the benefits and services that people use most. SCAN Balance is a Chronic Special Needs Plan available to anyone with Medicare who has been diagnosed with Diabetes Mellitus. Heart First is a Chronic Special Needs Plan available to anyone with Medicare who has been diagnosed with Cardiovascular Disorder or Chronic or Congestive Heart Failure. Lab Services Diagnostic Tests and Procedures X-rays Durable Medical Equipment - 20% - 20% - 20% Outpatient Rehabilitation $10 $10 $10 Diagnostic Radiology (e.g. MRI, C.T.) $100 $100 $100 Therapeutic Radiology $50 $50 $50 Maximum Out of Pocket (MOOP) $3,400 $3,400 $3,400 Hospital and Emergency Care SCAN CLASSIC SCAN BALANCE Heart First Inpatient Hospital Care (unlimited days) (unlimited days) (unlimited days) Skilled Nursing Facility (Days 1-20) (Days 1-20) (Days 1-20) Outpatient Surgery $50 - $100 $25 - $75 $75 - $100 Emergency Care ( if admitted immediately) ( if admitted immediately) ( if admitted immediately) Urgent Care Services $20 (Worldwide) $20 (Worldwide) $20 (Worldwide) Ambulance Services $200 (per one-way trip) $200 (per one-way trip) $200 (per one-way trip)

3 Prescription Drug Coverage Initial Coverage Stage SCAN Contracted Pharmacy (1-month/31-Day Supply of Drugs) SCAN CLASSIC Tier 1: Preferred Generic drugs $5 Tier 2: Non-Preferred Generic drugs $10 Tier 6: Select Care drugs $10 SCAN Balance Tier 1: Preferred Generic drugs $3 Tier 2: Non-Preferred Generic drugs $7 Tier 6: Select Care drugs HEART FIRST Tier 1: Preferred Generic drugs $3 Tier 2: Non-Preferred Generic drugs $7 Tier 6: Select Care drugs Savings Opportunity Order a 3-month supply (90 days) of Tier 1, Tier 2 and Tier 6 drugs through SCAN Mail-Order Pharmacy and only pay for two months

4 Additional Benefits and Services SCAN CLASSIC SCAN Balance Heart First Vision Services (Routine) Eye Exam (1 per year) (1 per year) (1 per year) Glasses or Contacts Copay $35 (every two $35 (every two $35 (every two Coverage for Frames or Contacts Hearing Services (Routine) Hearing Exam (1 per year) (1 per year) (1 per year) Coverage for Hearing Aids Transportation (Routine) (12 one-way trips) (20 one-way trips) (20 one-way trips) Podiatry Services (Routine) Not Covered (6 visits per year) (6 visits per year) Health Club Membership Home Delivered Meals Not Covered (criteria and limitations apply) (criteria and limitations apply) Optional Supplemental Plans SCAN CLASSIC SCAN Balance Heart First Basic Dental Plan $8 per month $8 per month $8 per month Enhanced Dental Plan $16 per month $16 per month $16 per month

5 For more information, contact your Authorized SCAN Representative or call the number below: 3800 Kilroy Airport Way, Suite 100 Long Beach, CA Sales Information : a.m. 8 p.m., Monday through Friday, Pacific Time (8 a.m. 8 p.m., 7 days a week, Pacific Time, October 1 through February 14) TTY Users : 711 OR Visit our web site SCAN Classic (HMO), SCAN Balance (HMO SNP) and Heart First (HMO SNP) are HMO plans with a Medicare contract. Enrollment in SCAN Health Plan depends on contract renewal. You must continue to pay your Medicare Part B premium. Heart First is available to anyone with Medicare who has been diagnosed with Chronic or Congestive Heart Failure, Cardiac Arrhythmia, Coronary Artery Disease, Peripheral Vascular Disease, or Chronic Venous Thromboembolic Disorder. SCAN Balance is available to anyone with Medicare who has been diagnosed with Diabetes Mellitus. The benefit information provided herein is a brief summary, not a complete description of benefits. Benefits, formulary, provider/pharmacy network, premium, co-payments and/or co-insurance may change on January 1 of each year. Limitations, copayments, and restrictions may apply. For more information contact the plan. Calling the agent number will direct you to a licensed insurance agent. You can get prescription drugs shipped to your home through our network mail-order delivery program. Typically, you should expect to receive your prescription drugs within 14 days from the time the mail-order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact SCAN Member Services at (Medicare and Medi-Cal eligible members should call the SCAN Personal Assistance Line PAL at ), 8 a.m. 8 p.m., 7 days a week. TTY users should call 711. This information is available for free in other languages. Please call our customer service number at , 8 a.m. 8 p.m., seven days a week. TTY users call 711. Esta información está disponible gratuitamente en otros idiomas. Llame a nuestro número de servicio al cliente , 8 a.m. 8 p.m., siete días a la semana. Los usuarios de TTY deben llamar al 711. Y0057_SCAN_8798_2014F File & Use Accepted G /14 15C-BHL401

Napa and Sonoma Counties

Napa and Sonoma Counties Napa and Sonoma Counties Benefit Highlights Napa and Sonoma Counties SCAN Classic (HMO), SCAN Balance (HMO SNP), and Heart First (HMO SNP) 2015 Benefit Highlights Napa and Sonoma Counties Benefit Highlights

More information

San Diego County. 2015 Benefit Highlights

San Diego County. 2015 Benefit Highlights San Diego County Scripps Classic offered by SCAN Health Plan(HMO) Scripps Signature offered by SCAN Health Plan (HMO) Scripps Heart First offered by SCAN Health Plan (HMO SNP) 2015 Benefit Highlights San

More information

Quick Guide 2016. Peoples Health Choices 65 #14 (HMO) Jefferson, Orleans and Plaquemines parishes

Quick Guide 2016. Peoples Health Choices 65 #14 (HMO) Jefferson, Orleans and Plaquemines parishes Quick Guide 2016 $0 mium* Plan Pre Peoples Health Choices 65 #14 (HMO) Jefferson, Orleans and Plaquemines parishes *You must continue to pay your Medicare Part B premium. H1961_PH16C65S1QG Accepted Thank

More information

Sales Presentation The Michigan Medicare Plans Designed Around YOU

Sales Presentation The Michigan Medicare Plans Designed Around YOU Sales Presentation The Michigan Medicare Plans Designed Around YOU HARBOR MEDICARE (HMO) HARBOR MEDICARE SELECT (HMO) H7960_003-2016 Approved WHAT YOU CAN EXPECT FROM THIS PRESENTATION PART 1 Introduction

More information

Gateway Health Medicare Assured RubySM (HMO SNP) $6,700 out-of-pocket limit for Medicare-covered services. No No No No. Days 1-6: $0 or $225 copay per

Gateway Health Medicare Assured RubySM (HMO SNP) $6,700 out-of-pocket limit for Medicare-covered services. No No No No. Days 1-6: $0 or $225 copay per Assured RubySM (HMO Premium $0 monthly plan $0 - $33.90 monthly plan Assured GoldSM (HMO $12.40 - $46.30 monthly plan $43.90 - $77.80 monthly plan In Network Maximum Out-of-Pocket $3,400 out-of-pocket

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option II (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Freedom (HMO).

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 1 Cigna-HealthSpring Preferred Plus HMO offered by Cigna HealthCare of Arizona, Inc. Annual Notice of Changes for 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred Plus. Next

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Central Health Focus Plan (HMO SNP) offered by Central Health Plan of California Annual Notice of Changes for 2016 You are currently enrolled as a member of Central Health Focus Plan. Next year, there

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits January 1, 2015 December 31, 2015 City of Houston Y0067_PRE_COH_SB_1014 IA 11/06/2014 HMO-COH-SB 2015 Section I Introduction to Summary of Benefits You have choices about how to

More information

Tribute. 2015 Summary of Benefits. Health Plan of Oklahoma. Tribute Health Plan of Oklahoma HMO SNP

Tribute. 2015 Summary of Benefits. Health Plan of Oklahoma. Tribute Health Plan of Oklahoma HMO SNP Tribute Health Plan of Oklahoma Tribute Health Plan of Oklahoma HMO SNP 2015 Summary of Benefits This booklet gives you a summary of what we cover and what you pay. It doesn t list every service that we

More information

HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted

HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted HARBOR ADVANTAGE (HMO) H7960-002-2015 Accepted IMPORTANT This presentation is for the exclusive use of Authorized Plan Representatives of Harbor Advantage (HMO). Harbor Health Plan is an HMO plan with

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits January 1, 2015 December 31, 2015 Houston/Beaumont Area Y0067_PRE_H4506_SETX_SB41_0814 CMS Accepted 09/13/2014 HMO-SETX-SB K41 2015 Section I Introduction to Summary of Benefits

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option Il (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Rx Option Il

More information

SCAN Classic (HMO) San Joaquin County 2016 Summary of Benefits. Y0057_SCAN_9240_2015F File & Use Accepted

SCAN Classic (HMO) San Joaquin County 2016 Summary of Benefits. Y0057_SCAN_9240_2015F File & Use Accepted SCAN Classic (HMO) San Joaquin County 2016 Summary of Benefits Y0057_SCAN_9240_2015F File & Use Accepted SCAN Classic (HMO) (a Medicare Advantage Health Maintenance Organization (HMO) offered by SCAN Health

More information

Summary of Benefits. Service To Seniors (HMO) and OC Preferred (HMO) It s Personal. Medicare Specialist Scott Pratt Se Habla Español.

Summary of Benefits. Service To Seniors (HMO) and OC Preferred (HMO) It s Personal. Medicare Specialist Scott Pratt Se Habla Español. 2015 Summary of Benefits Service To Seniors (HMO) and OC Preferred (HMO) Medicare Specialist Scott Pratt Se Habla Español. It s Personal. H0545_RAY2012_xxx CMS Approved: xx/xx/2012 H0545_FUY2015_18 Accepted

More information

2015 SUMMARY OF BENEFITS Phoenix Advantage (HMO) Phoenix Advantage Select (HMO) January 1, 2015 December 31, 2015. H5985_009-2015 Accepted

2015 SUMMARY OF BENEFITS Phoenix Advantage (HMO) Phoenix Advantage Select (HMO) January 1, 2015 December 31, 2015. H5985_009-2015 Accepted 2015 SUMMARY OF BENEFITS Phoenix Advantage (HMO) Phoenix Advantage Select (HMO) January 1, 2015 December 31, 2015 H5985_009-2015 Accepted SUMMARY OF BENEFITS JANUARY 1, 2015 - DECEMBER 31, 2015 This booklet

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna HealthSpring TotalCare (HMO SNP) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna HealthSpring TotalCare (HMO SNP). Next year, there

More information

Allegian Advantage (HMO) H8554_001-2015 Accepted

Allegian Advantage (HMO) H8554_001-2015 Accepted Allegian Advantage (HMO) H8554_001-2015 Accepted IMPORTANT This presentation is for the exclusive use of Allegian Advantage (HMO) Allegian Health Plans is an HMO plan with a Medicare contract. Enrollment

More information

FHCP s Medvantage (HMO-POS) offered by Florida Health Care Plans

FHCP s Medvantage (HMO-POS) offered by Florida Health Care Plans FHCP s Medvantage (HMO-POS) offered by Florida Health Care Plans Annual Notice of Changes for 2016 You are currently enrolled as a member of FHCP s Medvantage plan. Next year, there will be some changes

More information

Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company

Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company Geisinger Gold Preferred Complete Rx (PPO) offered by Geisinger Indemnity Insurance Company Annual Notice of Changes for 2016 You are currently enrolled as a member of Geisinger Gold Preferred Complete

More information

2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted

2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted 2015 Plan Guide ALLEGIAN ADVANTAGE (HMO) H8554_013-2015 Accepted Allegian Advantage is an HMO plan. We proudly serve Texas residents in Cameron, Hidalgo and Willacy counties, offering doctor, hospital

More information

INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS

INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS January 1, 2015 - December 31, 2015 CARE1ST HEALTH PLAN California:,, San Bernardino and Counties Coordinated Choice California: Alameda,

More information

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Value Plan (HMO) H3312-060 H3312.060.1

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Value Plan (HMO) H3312-060 H3312.060.1 January 1, 2016 December 31, 2016 Summary of Benefits H3312-060 H3312.060.1 Y0001_2016_H3312_060 Accepted 9/2015 Summary of Benefits January 1, 2016 December 31, 2016 This booklet gives you a summary of

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Health Net Ruby Select (HMO) Placer and Sacramento counties, CA Benefits effective January 1, 2015 H0562 Health Net of California, Inc. Material ID # H0562_2015_0285_B_CMS Accepted

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Health Net Healthy Heart (HMO) Placer and Sacramento counties, CA Benefits effective January 1, 2015 H0562 Health Net of California, Inc. Material ID # H0562_2015_0273 CMS Accepted

More information

2015 Orange County HICAP Medicare Advantage Special Needs Plans Comparison Chart

2015 Orange County HICAP Medicare Advantage Special Needs Plans Comparison Chart Brand New Day Brand New Day Brand New Day Brand New Day Bridges Drug Savings Bridges Extra Care Harmony Healthy Heart Drug Savings dementia. dementia. chronic and disabling mental health conditions. chronic

More information

INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS

INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS INTRODUCTION TO SUMMARY OF BENEFITS SECTION 1 SUMMARY OF BENEFITS January 1, 2015 - December 31, 2015 CARE1ST HEALTH PLAN Care1st AdvantageOptimum Plan (HMO) Texas: El Paso County H5928_15_029_SB_EP INTRODUCTION

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

More information

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Prime Plan (HMO) H3931-087 H3931.087.1

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Prime Plan (HMO) H3931-087 H3931.087.1 January 1, 2016 December 31, 2016 Summary of Benefits H3931-087 H3931.087.1 Y0001_2016_H3931_087 Accepted 9/2015 Summary of Benefits January 1, 2016 December 31, 2016 This booklet gives you a summary of

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 HMO Prime No Rx (Medicare Advantage HMO) offered by Tufts Health Plan Medicare Preferred Annual Notice of Changes for 2016 You are currently enrolled as a member of Tufts Medicare Preferred HMO Prime No

More information

2015 Annual Notice of Change

2015 Annual Notice of Change 2015 Annual Notice of Change Colorado Access Advantage Peak Plan (HMO) COLORADO ACCESS ADVANTAGE PEAK PLAN (HMO) offered by Colorado Access Annual Notice of Changes for 2015 You are currently enrolled

More information

Classic Plan (HMO-POS)

Classic Plan (HMO-POS) Classic Plan (HMO-POS) Offered by Health First Health Plans You are currently enrolled as a member of the Classic Plan (HMO-POS). Next year, there will be some changes to the plan s costs and benefits.

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred KNX (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred KNX (HMO). Next year, there

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Cigna-HealthSpring Advantage (HMO) offered by Cigna-HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna-HealthSpring Advantage (HMO). Next year, there will be

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Cigna HealthSpring Premier (HMO POS) offered by Cigna HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna HealthSpring Premier (HMO POS). Next year, there will

More information

SCAN Health Plan. 2015 Summary of Benefits

SCAN Health Plan. 2015 Summary of Benefits SCAN Health Plan 2015 Summary of Benefits Y0057_SCAN_8712_2014F File & Use Accepted 09032014 ( a Medicare Advantage Health Maintenance Organization (HMO) offered by SCAN Health Plan with a Medicare contract)

More information

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Select Plan (HMO) H3623-018 58.06.360.1-OH3 B

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Select Plan (HMO) H3623-018 58.06.360.1-OH3 B January, 205 December 3, 205 Summary of Benefits H3623-08 58.06.360.-OH3 B Y000_205_H3623_08_OH Accepted 9/204 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of what

More information

2016 Riverside Medical Clinic Contracted Medicare Advantage Health Plan Benefit Comparison

2016 Riverside Medical Clinic Contracted Medicare Advantage Health Plan Benefit Comparison Riverside Medical Clinic Contracted Medicare Advantage Health Plan AARP Medicare Complete Plan 1 [Secure Horizons] 1-877-596-3258 Anthem MediBlue Select 1-800-797-6438 Health Net Healthy Heart ** 1-800-

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Health Net Ruby (HMO) Benton, Clackamas, Lane, Linn, Marion, Multnomah, Polk, Washington and Yamhill counties, OR Benefits effective January 1, 2015 H6815 Health Net Health Plan

More information

L.A. Care s Medicare Advantage Special Needs Plan

L.A. Care s Medicare Advantage Special Needs Plan L.A. Care s Medicare Advantage Special Needs Plan Summary of Benefits 2008 for people with Medicare and Medi-Cal Thank you for your interest in L.A. Care Health Plan. Our plan is offered by L.A. CARE

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Health Net Ruby Select (HMO) Maricopa and Pinal counties Benefits effective January 1, 2015 H0351 Health Net of Arizona, Inc. Material ID # H0351_2015_0258 CMS Accepted 08302014

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Healthy Advantage Plus HMO offered by Molina Healthcare of Utah Annual Notice of Changes for 2016 You are currently enrolled as a member of Healthy Advantage Plus HMO. Next year, there will be some changes

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3952 Y0041_H3952_KS_15_18734 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare. Annual Notice of Changes for 2014

Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare. Annual Notice of Changes for 2014 Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare Annual Notice of Changes for 2014 You are currently enrolled as a member of Essentials Rx 15 (HMO) Plan. Next year, there will be some changes

More information

SCAN Health Plan. 2015 Summary of Benefits

SCAN Health Plan. 2015 Summary of Benefits SCAN Health Plan 2015 Summary of Benefits Y0057_SCAN_8713_2014F File & Use Accepted 09032014 SCAN Classic (HMO) (a Medicare Advantage Health Maintenance Organization (HMO) offered by SCAN Health Plan with

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 SCAN Connections at Home (HMO SNP) offered by SCAN Health Plan Annual Notice of Changes for 2016 You are currently enrolled as a member of SCAN Connections at Home. Next year, there will be some changes

More information

Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network

Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network 2016 Medicare Advantage Plans Comparison Chart This comparison chart is a side-by-side representation of services offered through the AvMed, Cigna, UHC, and Humana Medicare Advantage Plans for both in-network

More information

BlueCHiP for Medicare Group Plus (HMO) Summary of Benefits. January 1, 2015 - December 31, 2015

BlueCHiP for Medicare Group Plus (HMO) Summary of Benefits. January 1, 2015 - December 31, 2015 BlueCHiP for Medicare Group Plus (HMO) Summary of Benefits January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list every service that we

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 BlueCHiP for Medicare Plus (HMO) offered by Blue Cross & Blue Shield of Rhode Island Annual Notice of Changes for 2015 You are currently enrolled as a member of BlueCHiP for Medicare Plus. Next year, there

More information

2016 Summary of Benefits

2016 Summary of Benefits 2016 Summary of Benefits Health Net Violet Option 3 (PPO) Douglas and Josephine counties, OR Benefits effective January 1, 2016 H5520 Health Net Life Insurance Company H5520_2016_0202 CMS Accepted 09162015

More information

Blue Shield 65 Plus Choice Plan (HMO) Blue Shield 65 Plus (HMO) summary of benefits

Blue Shield 65 Plus Choice Plan (HMO) Blue Shield 65 Plus (HMO) summary of benefits summary of benefits Los Angeles (partial) & Orange Counties January 1, 2015 to December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list every service that we

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Cigna HealthSpring Preferred (HMO) offered by Cigna HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna HealthSpring Preferred (HMO). Next year, there will be

More information

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Connect Plus (HMO) H3931-088 H3931.088.1

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Connect Plus (HMO) H3931-088 H3931.088.1 January 1, 2016 December 31, 2016 Summary of Benefits H3931-088 H3931.088.1 Y0001_2016_H3931_088 Accepted 9/2015 Summary of Benefits January 1, 2016 December 31, 2016 This booklet gives you a summary of

More information

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Premier Plan (PPO) H5521-081 58.06.362.1-NC1

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Premier Plan (PPO) H5521-081 58.06.362.1-NC1 January, 205 December 3, 205 Summary of Benefits H552-08 58.06.362.-NC Y000_205_H552_08_NC Accepted 9/20 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of what we cover

More information

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Premier Plan (PPO) H5521-081 58.06.362.1-NC1

January 1, 2015 December 31, 2015. Summary of Benefits. Aetna Medicare Premier Plan (PPO) H5521-081 58.06.362.1-NC1 January 1, 2015 December 31, 2015 Summary of Benefits H5521-081 58.06.362.1-NC1 Y0001_2015_H5521_081_NC Accepted 9/2014 Summary of Benefits January 1, 2015 December 31, 2015 This booklet gives you a summary

More information

Annual Notice of Change 2015

Annual Notice of Change 2015 Clear Touchstone Health Medicare Clear Plan Annual Notice of Change 2015 Bronx, Kings, New York, Queens, Richmond and Westchester Counties www.touchstoneh.com Y0064_H3327_THPSMK_2374 Accepted Touchstone

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 Advocare Spirit Rx (HMO-POS) offered by Security Health Plan of Wisconsin, Inc. Annual Notice of Changes for 2014 You are currently enrolled as a member of Advocare Spirit Rx (HMO-POS). Next year there

More information

[2015] SUMMARY OF BENEFITS H1189_2015SB

[2015] SUMMARY OF BENEFITS H1189_2015SB [2015] SUMMARY OF BENEFITS H1189_2015SB Section I You have choices in your health care One choice is to get your Medicare benefits through Original Medicare (fee-for-service Medicare). Original Medicare

More information

Scripps Classic offered by SCAN Health Plan (HMO) Scripps Signature offered by SCAN Health Plan (HMO)

Scripps Classic offered by SCAN Health Plan (HMO) Scripps Signature offered by SCAN Health Plan (HMO) Scripps Classic offered by (HMO) Scripps Signature offered by (HMO) Evidence of Coverage for 2015 San Diego County Y0057_SCAN_8642_2014F File & Use Accepted 08272014 G8659 09/14 January 1 December 31,

More information

Choose the Medicare Advantage Plan That s Right for You

Choose the Medicare Advantage Plan That s Right for You Choose the Medicare Advantage Plan That s Right for You Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Other pharmacies/physicians/providers are available

More information

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc.

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Annual Notice of Changes for 2015 You are currently enrolled as a member of Piedmont WellStar Medicare Choice HMO.

More information

Summary of Benefits. Health Partners Medicare Special (HMO SNP) 153967 HPM-415-15 SNP Benefits Book.indd 1

Summary of Benefits. Health Partners Medicare Special (HMO SNP) 153967 HPM-415-15 SNP Benefits Book.indd 1 2016 Health Partners Medicare 901 Market Street, Suite 500 Philadelphia, PA 19107 Visit us at HPPMedicare.com Summary of Benefits Health Partners Medicare Special (HMO SNP) H9207_HPM-415-16 Accepted 9/2015

More information

Napa County. Medicare Advantage Plans. (Medicare Part C Plans) Compliments of HICAP. (Health Insurance Counseling and Advocacy Program)

Napa County. Medicare Advantage Plans. (Medicare Part C Plans) Compliments of HICAP. (Health Insurance Counseling and Advocacy Program) 2015 Napa County Medicare Advantage Plans (Medicare Part C Plans) HICAP Volunteer Counselors are available to help compare health plans in an objective and unbiased manner. They can help consumers understand

More information

Companion Basic Rx (HMO) / Companion Rx (HMO) / Companion Plus Rx (HMO)

Companion Basic Rx (HMO) / Companion Rx (HMO) / Companion Plus Rx (HMO) / / Summary of Benefits January 1, 2016 December 31, 2016 The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. s pharmacy network offers

More information

Health Partners Plans Provider Manual Health Partners Plans Medicare Benefits Summary

Health Partners Plans Provider Manual Health Partners Plans Medicare Benefits Summary 5 Health Partners Plans Provider Manual Health Partners Plans Medicare Benefits Summary Purpose: This chapter provides a benefit summary for Health Partners Plans Medicare members, by plan. Topics: Health

More information

January 1, 2015 December 31, 2015 Summary of Benefits. Altius Advantra (HMO) H8649-003 80.06.361.1-UTWY A

January 1, 2015 December 31, 2015 Summary of Benefits. Altius Advantra (HMO) H8649-003 80.06.361.1-UTWY A January, 205 December 3, 205 Summary of Benefits H8649-003 80.06.36.-UTWY A Y0022_205_H8649_003_UT_WYa Accepted /204 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Central Health Medicare Plan (HMO) offered by Central Health Plan of California Annual Notice of Changes for 2016 You are currently enrolled as a member of Central Health Medicare Plan. Next year, there

More information

January 1, 2016 December 31, 2016. Summary of Benefits. Coventry Medicare Advantage Total Care (HMO) H2672-009 H2672.009.1

January 1, 2016 December 31, 2016. Summary of Benefits. Coventry Medicare Advantage Total Care (HMO) H2672-009 H2672.009.1 January 1, 2016 December 31, 2016 Summary of Benefits H2672-009 H2672.009.1 Y0001_2016_H2672_009 Accepted 9/2015 Summary of Benefits January 1, 2016 December 31, 2016 This booklet gives you a summary of

More information

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan

UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan UPMC for Life HMO Deductible with Rx (HMO) offered by UPMC Health Plan Annual Notice of Changes for 2016 You are currently enrolled as a member of UPMC for Life HMO Deductible with Rx. Next year, there

More information

Introduction to Summary of Benefits

Introduction to Summary of Benefits Introduction to Summary of Benefits Section I CENTRAL HEALTH MEDICARE PLAN (HMO), CENTRAL HEALTH MEDI-MEDI PLAN (HMO SNP), CENTRAL HEALTH PREMIER PLAN (HMO), and CENTRAL HEALTH FOCUS PLAN (HMO SNP) (a

More information

Summary of Benefits Community Advantage (HMO)

Summary of Benefits Community Advantage (HMO) Summary of Benefits Community Advantage (HMO) January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover or list

More information

Independent Health s Medicare Passport Advantage (PPO)

Independent Health s Medicare Passport Advantage (PPO) Independent Health s Medicare Passport Advantage (PPO) (a Medicare Advantage Preferred Provider Organization Option (PPO) offered by INDEPENDENT HEALTH BENEFITS CORPORATION with a Medicare contract) Summary

More information

PROVIDENCE MEDICARE ADVANTAGE PLANS. 2015 Plan Comparison Western Oregon and Clark County Washington H9047_2015PHP40_ACCEPTED

PROVIDENCE MEDICARE ADVANTAGE PLANS. 2015 Plan Comparison Western Oregon and Clark County Washington H9047_2015PHP40_ACCEPTED PROVIDENCE MEDICARE ADVANTAGE PLANS 2015 Plan Comparison Western Oregon and Clark County Washington H9047_2015PHP40_ACCEPTED Service area map Columbia River Washington Oregon Clark Providence Medicare

More information

!nnual Notice of Changes for 2015

!nnual Notice of Changes for 2015 Central Health Medi-Medi Plan (HMO SNP) offered by Central Health Plan of California!nnual Notice of Changes for 2015 You are currently enrolled as a member of Central Health Medi-Medi Plan (HMO SNP).

More information

Summary of Benefits. King, Pierce, Snohomish, Spokane and Thurston Counties. premera.com/ma

Summary of Benefits. King, Pierce, Snohomish, Spokane and Thurston Counties. premera.com/ma Summary of Benefits 2016 HMO King, Pierce, Snohomish, Spokane and Thurston Counties premera.com/ma Plus Section 1 Introduction to the and Plus This booklet gives you a summary of what we cover and what

More information

January 1, 2015 December 31, 2015 Summary of Benefits. Advantra (HMO) H3928-001 80.06.360.1-LA1

January 1, 2015 December 31, 2015 Summary of Benefits. Advantra (HMO) H3928-001 80.06.360.1-LA1 January, 205 December 3, 205 Summary of Benefits H3928-00 80.06.360.-LA Y0022_205_H3928_00_LA Accepted 9/204 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of what we

More information

HNE Premier 1 (HMO) and HNE Premier 2 (HMO)

HNE Premier 1 (HMO) and HNE Premier 2 (HMO) 2016 Medicare Advantage Summary of Benefits HNE Premier 1 (HMO) and HNE Premier 2 (HMO) January 1, 2016 - December 31, 2016 H8578_2016_429 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2016 SECTION I

More information

FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits. FirstMedicare Direct PPO Plus (PPO)

FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits. FirstMedicare Direct PPO Plus (PPO) FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties 1 P age SECTION I - INTRODUCTION TO SUMMARY

More information

DECISION GUIDE. 2015 Regence Medicare Advantage PPO Plans

DECISION GUIDE. 2015 Regence Medicare Advantage PPO Plans DECISION GUIDE 2015 Regence Medicare Advantage PPO Plans Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna HealthSpring Preferred KNX (HMO) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna HealthSpring Premier KNX (HMO POS). Next year, there

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna HealthSpring Preferred NGA (HMO) offered by Cigna HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna HealthSpring Premier NGA (HMO POS). Next year, there

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Premier (HMO-POS) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Premier (HMO-POS). Next year, there will

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 P.O. Box 52424, Phoenix, AZ 85072-2424 SilverScript Choice (PDP) offered by SilverScript Insurance Company Annual Notice of Changes for 2016 You are currently enrolled as a member of SilverScript Choice

More information

Health Partners Plans Provider Manual Health Partners Medicare Benefits Summary

Health Partners Plans Provider Manual Health Partners Medicare Benefits Summary 5 Health Partners Plans Provider Manual Health Partners Medicare Benefits Summary Purpose: This chapter provides a benefit summary for Health Partners Medicare members, by plan. Topics: Health Partners

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Plans 003 and 004 H6298_14_027 accepted Summary of Benefits January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list

More information

2016 Medicare Advantage Special Needs Plans (SNP) Full Dual Medicare & Medicaid Maricopa County

2016 Medicare Advantage Special Needs Plans (SNP) Full Dual Medicare & Medicaid Maricopa County 2016 Medicare Advantage Special Needs Plans (SNP) Full Dual Medicare & Medicaid Maricopa County Special Needs Plans for Dual Eligible beneficiaries are an HMO plan that limits their membership to people

More information

San Diego County. SCAN Health Plan. Evidence of Coverage. Scripps Signature offered by SCAN Health Plan (HMO)

San Diego County. SCAN Health Plan. Evidence of Coverage. Scripps Signature offered by SCAN Health Plan (HMO) San Diego County 2016 SCAN Health Plan Evidence of Coverage Scripps Signature offered by SCAN Health Plan (HMO) Y0057_SCAN_9180_2015F File & Use Accepted G9308 09/15 16C-EOC701 January 1 December 31,

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits January 1, 2015 December 31, 2015 Kit 02 Y0067_PRE_H2816_SBK02_0814 CMS Accepted 09/13/2014 NPFFS-SB K02 2015 Section I Introduction to Summary of Benefits You have choices about

More information

Annual Notice of Changes for 2015

Annual Notice of Changes for 2015 Keystone 65 Select Medical-Only (HMO) offered by Independence Blue Cross Annual Notice of Changes for 2015 You are currently enrolled as a member of Keystone 65 Select Medical-Only. Next year, there will

More information

H3954_14238_3 File and Use 8/31/14

H3954_14238_3 File and Use 8/31/14 Introduction to Summary Of s You have choices about how to get your Medicare benefits. One choice is to get your Medicare benefits through Original Medicare (fee-for-service Medicare). Original Medicare

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 First Health Part D Premier Plus (PDP) offered by Cambridge Life Insurance Company Annual Notice of Changes for 2014 Dear Member, You are currently enrolled as a member of First Health Part D Premier Plus

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3909 Y0041_H3909_PC_15_18889 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

MEDICARE MYSTERY. Taking the OUT OF. Your how-to guide for finding the right plan for your needs

MEDICARE MYSTERY. Taking the OUT OF. Your how-to guide for finding the right plan for your needs Taking the MYSTERY OUT OF MEDICARE Your how-to guide for finding the right plan for your needs S6506_071015_B01a CMS Accepted 08/15/2015 H0302_565_2016 CMS Accepted 08/15/2015 An independent licensee of

More information

Summary of Benefits January 1, 2016 December 31, 2016. FirstMedicare Direct PPO Plus (PPO)

Summary of Benefits January 1, 2016 December 31, 2016. FirstMedicare Direct PPO Plus (PPO) Summary of Benefits January 1, 2016 December 31, 2016 FIRSTCAROLINACARE INSURANCE COMPANY FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties This booklet

More information

SCAN Classic (HMO) offered by SCAN Health Plan Evidence of Coverage for 2015 Los Angeles, Orange, Riverside and San Bernardino Counties

SCAN Classic (HMO) offered by SCAN Health Plan Evidence of Coverage for 2015 Los Angeles, Orange, Riverside and San Bernardino Counties SCAN Classic (HMO) offered by SCAN Health Plan Evidence of Coverage for 2015 Los Angeles, Orange, Riverside and San Bernardino Counties Y0057_SCAN_8636_2014F File & Use Accepted 08262014 G8653 09/14 January

More information

PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH INC

PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH INC PLAN FEATURES Deductible (per calendar year) $0 Deductible Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Deductible is NOT applicable to Hearing Aid Reimbursement,

More information

2016 Summary of Benefits

2016 Summary of Benefits 2016 Summary of Benefits Health Net Healthy Heart (HMO) Alameda and Stanislaus counties, CA Benefits effective January 1, 2016 H0562 Health Net of California, Inc. H0562_2016_0171 CMS Accepted 09172015

More information

2015 Medicare Advantage Summary of Benefits

2015 Medicare Advantage Summary of Benefits 2015 Medicare Advantage Summary of Benefits HNE Medicare Premium No Rx and HNE Medicare Basic No Rx January 1, 2015 - December 31, 2015 H8578_2015_034 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2015

More information

Annual Notice of Changes for 2016

Annual Notice of Changes for 2016 Care N Care Health Plan I MA-Only (PPO) offered by Care N Care Insurance Company, Inc. Annual Notice of Changes for 2016 You are currently enrolled as a member of Care N Care Health Plan I MA-Only. Next

More information