This package is designed to help you stay healthy, meet your financial and retirement goals, develop your career and continue your education all while achieving a healthy work/life balance. Factsonmedicare.com is a free-to-use informational website. The SBC shows you how you and the plan would share the cost for covered health care services. A short, plain-language Summary of Benefits and Coverage (SBC), A Uniform Glossary of terms used in health coverage and medical care. Plan Overview. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. .usa-footer .grid-container {padding-left: 30px!important;} The .gov means its official. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. 324 0 obj <> endobj Medi-Cal Dental Coverage . Help yourself and impact your community by clicking here to learn more! This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Share via Email. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services With our. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. -l %%EOF Learn more by clicking here. }Y+\(s1Qi}=Y1$C'oX` It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. %%EOF The SBC shows you how you and the plan. Contact the plan for details. NOTE: Information about the cost of this . ei;N. LYK%-dQrqc*D|3-:HAdFfZ! Once you reach that amount, you will enter the next coverage phase. This is only a summary. =========== TABBED SINGLE CONTENT GENERAL, People who live in our service area (Riverside and San Bernardino counties), Adults with or without children, children, seniors, and people with a disability, People who meet income guidelines and other program requirements. Youll find a link to the SBC on each plan page when you preview plans and prices before logging in, and when you've finished your application and are comparing plans. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} All Rights Reserved. . Team Member* benefits include: 2019 Inland Empire Health Plan. is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. 2023 Inland Empire Health Plan All Rights Reserved. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 1218 0 obj <>stream Because we respect your right to privacy, you can choose not to allow some types of cookies. Your Part B premium may differ based on factors including late enrollment, income, and disability status. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. Contact a plan for a Summary of Benefits. ~_5Id+(f c*pF03 cF3m-26Yc> !c YJya%XL The SBC shows you how you and the plan would share the cost for covered healthcare services. (800) 440-4347 We have many resources at your disposal, such as financial assistance, housing assistance, and mental health support. Click to Call 1-877-354-4611 TTY 711. IEHP DualChoice (HMO D-SNP) The SBC shows you how you and the plan would share the cost for covered health care services. %PDF-1.5 % After you pay your $505.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R] /MediaBox[ 0 0 792 615] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> This is only a . Please check the plans formulary for specific drugs covered. L.A. Care Covered Gold 80 HMO Evidence of . Medicare has neither approved nor endorsed any information on this site. This is only a summary. Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. NOTE: Information about the cost of this plan (called the premium) will be provided separately. All rights reserved | About | Contact | Legal and Privacy. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. TAhh])f?u Vh7 endobj Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. Every child deserves a stable, safe, and supportive family. %PDF-1.7 % 3 0 obj (866) 294-4347 )9& Fs?I_oD!0sF##H062* gFDh\J:*&n=cQ9G&3 Sd;Fb(LE/Ebd) *FJ>DVtQpQ3 oc$C#$3T.Y6N',FLX8O*aHaL9 Ma]\L)k)B\)6&BO_ZNp0,/.~9# IEHP - Medi-Cal California Medical Insurance Requirements : Welcome to Inland Empire Health Plan \. Here you can find access to Family Resource Centers and crisis prevention services. The SBC shows you how you and the plan would share the cost for covered health care services. Additionally, you can freely decide and change any time whether you accept cookies or choose to opt out of cookies to improve website's performance, as well as cookies used to display content tailored to your interests. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. Podiatry Chiropractic Allergy care [CDATA[/* >*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW stream All insurance plans are required to produce a Summary of Benefits and Coverage based on a uniform template and customized to reflect the plan's unique terms. H8894 001 0 available in Riverside and San Bernardino Counties. The Summary of Benefits and Coverage (SBC) is simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA). endstream endobj 325 0 obj <> endobj 326 0 obj <>/MediaBox[0 0 792 612]/Parent 322 0 R/Resources<>/ProcSet 400 0 R/XObject<>>>/Rotate 0/Type/Page>> endobj 327 0 obj <>stream Please, see below for location details, contact numbers, and hours of operation. We do not directly sell health insurance or offer professional legal, medical, or financial advice. @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. We do not offer every plan available in your area. Some of the services listed are covered only if IEHP or your IPA approves first. <> (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. See the Part D Premium Reduction section below for more details. .paragraph--type--html-table .ts-cell-content {max-width: 100%;} 4 IEHP Member Handbook Guide to Medi-Cal Benefits (PDF): Long Term Services and Supports (Medi-Cal), IEHP Texting Program Terms and Conditions, Medi-Cal California Medical Insurance Requirements, Rehabilitative and habilitative services and devices*, Laboratory and radiology services, such as X-rays*, Preventive and wellness services and chronic disease management, Substance use disorder treatment services, Non-emergency medical transportation (NEMT). You need a roof over your head. These cookies are required to use this website and can't be turned off. F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! .h1 {font-family:'Merriweather';font-weight:700;} Community is built on trust. The coverage examples will illustrate sample medical situations and describe how much coverage the plan would provide in an event such as having a baby (normal delivery) or managing Type 2 diabetes (routine maintenance, well-controlled). Visit bluecrossmn.com or call toll free at 1-855-579 . Health care is crucial for you and your family. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. No matter the insurance provider, all SBCs outline the same basic information. Share via LinkedIn. is offered in the following locations. 1175 0 obj <> endobj TTY users should call 1-800-718-4347. Washington, DC 202101-866-4-USA-DOL, Employee Benefits Security Administration, Mental Health and Substance Use Disorder Benefits, Children's Health Insurance Program Reauthorization Act (CHIPRA), Special Financial Assistance - Multiemployer Plans, Delinquent Filer Voluntary Compliance Program (DFVCP), State All Payer Claims Databases Advisory Committee (SAPCDAC), Summary of Benefits and Coverage and Uniform Glossary, Notice Agency Information Collection Activities, Solicitation of comments Templates, Instructions, and Related Materials, Culturally and Linguistically Appropriate Services (CLAS) County Data, Summary of Benefits and Coverage (SBC) Template, Instructions for Completing the SBC - Group Health Plan Coverage, Instructions for Completing the SBC - Individual Health Insurance Coverage, Why This Matters language for "Yes" Answers, Why This Matters language for "No" Answers, HHS Information For Simulating Coverage Examples, HHS Coverage Example Calculator and Related Information, List of anchors for SBC Uniform Glossary terms, Uniform Glossary of Coverage and Medical Terms, SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo, Instructions for Completing the SBC Group Health Plan Coverage, Instructions for Completing the SBC Individual Health Insurance Coverage. 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