HMO Basic (HMO) / HMO 40 (HMO) / HMO 20 (HMO) Summary of Benefits
|
|
- Douglas Quinn
- 6 years ago
- Views:
Transcription
1 / / Summary of Benefits January 1, 2015 December 31, 2015 Call toll-free a.m. to 8 p.m. daily October 1 to February 15 and 8 a.m. to 8 p.m. weekdays the rest of the year. TTY/TDD 711 HealthAllianceMedicare.org med-hmosob-0814 H1463_15_21457 H1463_15_21456 H1463_15_21454
2 SECTION I INTRODUCTION TO SUMMARY OF BENEFITS 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 is run directly by the Federal government. Another choice is to get your Medicare benefits by joining a Medicare health plan (such as HMO Basic [HMO], HMO 40 [HMO] or HMO 20 [HMO]). TIPS FOR COMPARING YOUR MEDICARE CHOICES This Summary of Benefits booklet gives you a summary of what, and cover and what you pay. If you want to compare our plan with other Medicare health plans, ask the other plans for their Summary of Benefits booklets. Or, use the Medicare Plan Finder on If you want to know more about the coverage and costs of Original Medicare, look in your current Medicare & You handbook. View it online at or get a copy by calling MEDICARE ( ), 24 hours a day, 7 days a week. TTY users should call SECTIONS IN THIS BOOKLET Things to Know About, or Monthly Premium, Deductible and Limits on How Much You Pay for Covered Services Covered Medical and Hospital Benefits This document is available in other formats such as Braille and large print. This document may be available in a non-english language. For additional information, call us at or, for TTY users, 711. THINGS TO KNOW ABOUT HEALTH ALLIANCE MEDICARE HMO BASIC (HMO), AND HOURS OF OPERATION From October 1 to February 14, you can call us 7 days a week from 8:00 a.m. to 8:00 p.m. Central time. From February 15 to September 30, you can call us Monday through Friday from 8:00 a.m. to 8:00 p.m. Central time. HEALTH ALLIANCE MEDICARE HMO BASIC (HMO), AND PHONE NUMBERS AND WEBSITE If you are a member of this plan, call toll-free or, for TTY users, 711. If you are not a member of this plan, call toll-free or, for TTY users, 711. Our website: 1
3 WHO CAN JOIN? To join, or, you must be entitled to Medicare Part A, be enrolled in Medicare Part B and live in our service area. Our service area includes the following counties in Illinois: Boone, Bureau, Cass, Champaign, Christian, Coles, De Witt, DeKalb, Douglas, Ford, Franklin, Henry, Jackson, Johnson, Kankakee, Knox, Logan, Macon, Macoupin, Marshall, Mason, McLean, Menard, Mercer, Montgomery, Morgan, Moultrie, Peoria, Perry, Piatt, Putnam, Rock Island, Saline, Sangamon, Scott, Stark, Tazewell, Vermilion, Williamson, Winnebago, and Woodford. WHICH DOCTORS AND HOSPITALS CAN I USE?, and have a network of doctors, hospitals and other providers. If you use the providers that are not in our network, the plan may not pay for these services. You can see our plan s provider directory at our website ( Or, call us and we will send you a copy of the provider directory. WHAT DO WE COVER? Like all Medicare health plans, we cover everything that Original Medicare covers and more. Our plan members get all of the benefits covered by Original Medicare. For some of these benefits, you may pay more in our plan than you would in Original Medicare. For others, you may pay less. Our plan members also get more than what is covered by Original Medicare. Some of the extra benefits are outlined in this booklet., and cover Part B drugs including chemotherapy and some drugs administered by your provider. However, these plans do not cover Part D prescription drugs. 2
4 If you have any questions about this plan s benefits or costs, please contact Health Alliance Medical Plans for details. SECTION II SUMMARY OF BENEFITS MONTHLY PREMIUM, DEDUCTIBLE AND LIMITS ON HOW MUCH YOU PAY FOR COVERED SERVICES How much is the monthly premium? How much is the deductible? Is there any limit on how much I will pay for my covered services? $0 per month. In addition, you must keep paying your Medicare Part B premium. This plan does not have a deductible. Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care. $39 per month. In addition, you must keep paying your Medicare Part B premium. This plan does not have a deductible. Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care. $85 per month. In addition, you must keep paying your Medicare Part B premium. This plan does not have a deductible. Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care. Your yearly limit(s) in this plan: $6,700 for services you receive from in-network providers. Your yearly limit(s) in this plan: $4,500 for services you receive from in-network providers. Your yearly limit(s) in this plan: $3,400 for services you receive from in-network providers. Is there a limit on how much the plan will pay? If you reach the limit on out-ofpocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums. No. There are no limits on how much our plan will pay. If you reach the limit on out-ofpocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums. No. There are no limits on how much our plan will pay. If you reach the limit on out-ofpocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums. No. There are no limits on how much our plan will pay. is an HMO plan with a Medicare Contract. Enrollment in HMO depends on contract renewal. 3
5 COVERED MEDICAL AND HOSPITAL BENEFITS NOTE: Services with a 1 may require prior authorization. Services with a 2 may require a referral from your doctor. OUTPATIENT CARE AND SERVICES Acupuncture and Not covered Not covered Not covered Other Alternative Therapies Ambulance $200 copay $100 copay $100 copay Chiropractic Care 1, 2 Manipulation of the spine to correct a subluxation (when 1 or more of the bones of your spine move out of position): $20 copay Manipulation of the spine to correct a subluxation (when 1 or more of the bones of your spine move out of position): $20 copay Manipulation of the spine to correct a subluxation (when 1 or more of the bones of your spine move out of position): $20 copay Dental Services Limited dental services (this does not include services in connection with care, treatment, filling, removal, or replacement of teeth):$35 copay Limited dental services (this does not include services in connection with care, treatment, filling, removal, or replacement of teeth):$25 copay Limited dental services (this does not include services in connection with care, treatment, filling, removal, or replacement of teeth):$20 copay Preventive dental services: Cleaning (for up to 1 every year): Oral exam (for up to 1 every year): $20 copay When scheduling your annual dental cleaning, please be clear whether or not you would like the oral exam that often follows. The copay for the oral exam is listed above. Preventive dental services: Cleaning (for up to 1 every year): Oral exam (for up to 1 every year): $25 copay When scheduling your annual dental cleaning, please be clear whether or not you would like the oral exam that often follows. The copay for the oral exam is listed above. Preventive dental services: Cleaning (for up to 1 every year): Oral exam (for up to 1 every year): $20 copay When scheduling your annual dental cleaning, please be clear whether or not you would like the oral exam that often follows. The copay for the oral exam is listed above. 4
6 Diabetes Supplies and Services Diabetes monitoring supplies: 10-20% of the cost, depending on the supply Diabetes monitoring supplies: 10-20% of the cost, depending on the supply Diabetes monitoring supplies: 10-20% of the cost, depending on the supply Diabetes self-management training: Diabetes self-management training: Diabetes self-management training: Therapeutic shoes or inserts: 20% of the cost Therapeutic shoes or inserts: 20% of the cost Therapeutic shoes or inserts: 20% of the cost Diagnostic Tests, Lab and Radiology Services and X-rays Diagnostic radiology services (such as MRIs, CT scans): 20% of the cost Diagnostic tests and procedures: 20% of the cost Lab services: 20% of the cost Outpatient X-rays: 20% of the cost Therapeutic radiology services (such as radiation treatment for cancer): 20% of the cost Diagnostic radiology services (such as MRIs, CT scans): $150 copay Diagnostic tests and procedures: $5 copay Lab services: $5 copay Outpatient X-rays: $10 copay Therapeutic radiology services (such as radiation treatment for cancer): 20% of the cost Diagnostic radiology services (such as MRIs, CT scans): Diagnostic tests and procedures: Lab services: Outpatient X-rays: Therapeutic radiology services (such as radiation treatment for cancer): Doctor s Office Visits 2 Primary care physician visit: $10 copay Primary care physician visit: $10 copay Primary care physician visit: $20 copay Durable Medical Equipment (wheelchairs, oxygen, etc.) 1 Specialist visit: $50 copay Specialist visit: $45 copay Specialist visit: $40 copay 20% of the cost 20% of the cost 20% of the cost 5
7 Emergency Care $65 copay $65 copay $65 copay If you are immediately admitted to the hospital, you do not have to pay your share of the cost for emergency care. See the Inpatient Hospital Care section of this booklet for other costs. Foot exams and treatment if you have diabetes-related nerve damage and/or meet certain conditions: $50 copay Exam to diagnose and treat hearing and balance issues: $35 copay If you are immediately admitted to the hospital, you do not have to pay your share of the cost for emergency care. See the Inpatient Hospital Care section of this booklet for other costs. Foot exams and treatment if you have diabetes-related nerve damage and/or meet certain conditions: $45 copay Exam to diagnose and treat hearing and balance issues: $25 copay If you are immediately admitted to the hospital, you do not have to pay your share of the cost for emergency care. See the Inpatient Hospital Care section of this booklet for other costs. Foot exams and treatment if you have diabetes-related nerve damage and/or meet certain conditions: $40 copay Exam to diagnose and treat hearing and balance issues: $20 copay Foot Care (Podiatry Services) 2 Hearing Services Routine hearing exam (for up to 1 every year): $35 copay Routine hearing exam (for up to 1 every year): $25 copay Home Health Care 1 Routine hearing exam (for up to 1 every year): $20 copay 6
8 Mental Health Care 1, 2 Inpatient visit: Our plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. The inpatient hospital care limit applies to inpatient mental services provided in a general hospital. Inpatient visit: Our plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. The inpatient hospital care limit applies to inpatient mental services provided in a general hospital. Inpatient visit: Our plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. The inpatient hospital care limit applies to inpatient mental services provided in a general hospital. Our plan covers 90 days for an inpatient hospital stay. Our plan covers 90 days for an inpatient hospital stay. Our plan covers 90 days for an inpatient hospital stay. Our plan also covers 60 lifetime reserve days. These are extra days that we cover. If your hospital stay is longer than 90 days, you can use these extra days. But once you have used up these extra 60 days, your inpatient hospital coverage will be limited to 90 days. Our plan also covers 60 lifetime reserve days. These are extra days that we cover. If your hospital stay is longer than 90 days, you can use these extra days. But once you have used up these extra 60 days, your inpatient hospital coverage will be limited to 90 days. Our plan also covers 60 lifetime reserve days. These are extra days that we cover. If your hospital stay is longer than 90 days, you can use these extra days. But once you have used up these extra 60 days, your inpatient hospital coverage will be limited to 90 days. $215 copay per day for days 1 through 7 per day for days 8 through 60 $100 copay per day for days 61 through 90 $175 copay per day for days 1 through 7 per day for days 8 through 60 $75 copay per day for days 61 through 90 $100 copay per day for days 1 through 7 per day for days 8 through 60 $50 copay per day for days 61 through 90 Outpatient group therapy visit: $40 copay Outpatient group therapy visit: $30 copay Outpatient group therapy visit: $20 copay Outpatient individual therapy visit: $40 copay Outpatient individual therapy visit: $30 copay Outpatient individual therapy visit: $20 copay 7
9 Outpatient Rehabilitation 1 Cardiac (heart) rehab services (for a maximum of 2 one-hour sessions per day for up to 36 sessions up to 36 weeks): Cardiac (heart) rehab services (for a maximum of 2 one-hour sessions per day for up to 36 sessions up to 36 weeks): 10% of the cost Cardiac (heart) rehab services (for a maximum of 2 one-hour sessions per day for up to 36 sessions up to 36 weeks): Occupational therapy visit: $40 copay Occupational therapy visit: $40 copay Occupational therapy visit: $40 copay Physical therapy and speech and language therapy visit: $40 copay Physical therapy and speech and language therapy visit: $40 copay Physical therapy and speech and language therapy visit: $40 copay Outpatient Substance Abuse 1 Group therapy visit: 20% of the cost Individual therapy visit: 20% of the cost Group therapy visit: 10% of the cost Individual therapy visit: 10% of the cost Group therapy visit: $20 copay Individual therapy visit: $20 copay Outpatient Surgery Ambulatory surgical center: 20% of the cost Ambulatory surgical center: $150 copay Ambulatory surgical center: $100 copay Over-the-Counter Items Prosthetic Devices (Braces, Artificial Limbs, etc.) 1 Outpatient hospital: 20% of the cost Outpatient hospital: $150 copay Outpatient hospital: $100 copay Not covered Not covered Not covered Prosthetic devices: 20% of the cost Related medical supplies: 20% of the cost Prosthetic devices: 20% of the cost Related medical supplies: 20% of the cost Renal Dialysis 20% of the cost Transportation Not covered Not covered Not covered Urgent Care $65 copay $40 copay $20 copay Prosthetic devices: 20% of the cost Related medical supplies: 20% of the cost 8
10 Vision Services Exam to diagnose and treat diseases and conditions of the eye (including yearly glaucoma screening): $35 copay Exam to diagnose and treat diseases and conditions of the eye (including yearly glaucoma screening): $25 copay Exam to diagnose and treat diseases and conditions of the eye (including yearly glaucoma screening): $20 copay Routine eye exam (for up to 1 every year): $35 copay Routine eye exam (for up to 1 every year): $25 copay Routine eye exam (for up to 1 every year): $20 copay Eyeglasses or contact lenses after cataract surgery: Eyeglasses or contact lenses after cataract surgery: Eyeglasses or contact lenses after cataract surgery: 9
11 Preventive Care Our plan covers many preventive services, including: Abdominal aortic aneurysm screening Alcohol misuse counseling Bone mass measurement Breast cancer screening (mammogram) Cardiovascular disease (behavioral therapy) Cardiovascular screenings Cervical and vaginal cancer screening Colonoscopy Colorectal cancer screenings Depression screening Diabetes screenings Fecal occult blood test Flexible sigmoidoscopy HIV screening Medical nutrition therapy services Obesity screening and counseling Prostate cancer screenings (PSA) Sexually transmitted infections screening and counseling Tobacco use cessation counseling (counseling for people with no sign of tobaccorelated disease) Vaccines, including Flu shots, Hepatitis B shots, Pneumococcal shots Welcome to Medicare preventive visit (one-time) Yearly Wellness visit Our plan covers many preventive services, including: Abdominal aortic aneurysm screening Alcohol misuse counseling Bone mass measurement Breast cancer screening (mammogram) Cardiovascular disease (behavioral therapy) Cardiovascular screenings Cervical and vaginal cancer screening Colonoscopy Colorectal cancer screenings Depression screening Diabetes screenings Fecal occult blood test Flexible sigmoidoscopy HIV screening Medical nutrition therapy services Obesity screening and counseling Prostate cancer screenings (PSA) Sexually transmitted infections screening and counseling Tobacco use cessation counseling (counseling for people with no sign of tobaccorelated disease) Vaccines, including Flu shots, Hepatitis B shots, Pneumococcal shots Welcome to Medicare preventive visit (one-time) Yearly Wellness visit 10 Our plan covers many preventive services, including: Abdominal aortic aneurysm screening Alcohol misuse counseling Bone mass measurement Breast cancer screening (mammogram) Cardiovascular disease (behavioral therapy) Cardiovascular screenings Cervical and vaginal cancer screening Colonoscopy Colorectal cancer screenings Depression screening Diabetes screenings Fecal occult blood test Flexible sigmoidoscopy HIV screening Medical nutrition therapy services Obesity screening and counseling Prostate cancer screenings (PSA) Sexually transmitted infections screening and counseling Tobacco use cessation counseling (counseling for people with no sign of tobaccorelated disease) Vaccines, including Flu shots, Hepatitis B shots, Pneumococcal shots Welcome to Medicare preventive visit (one-time) Yearly Wellness visit
12 Preventive Care (continued) Any additional preventive services approved by Medicare during the contract year will be covered. for hospice care from a Medicare-certifi ed hospice. You may have to pay part of the cost for drugs and respite care. Any additional preventive services approved by Medicare during the contract year will be covered. for hospice care from a Medicare-certifi ed hospice. You may have to pay part of the cost for drugs and respite care. Any additional preventive services approved by Medicare during the contract year will be covered. for hospice care from a Medicare-certifi ed hospice. You may have to pay part of the cost for drugs and respite care. Hospice INPATIENT CARE Inpatient Hospital Care Our plan covers an unlimited number of days for an inpatient hospital stay. Our plan covers an unlimited number of days for an inpatient hospital stay. Our plan covers an unlimited number of days for an inpatient hospital stay. $235 per day for days 1 through 8 $0 copay per day for days 9 through 60 $100 copay per day for days 61 through 90 per day for days 91 and beyond For inpatient mental health care, see the Mental Health Care section of this booklet. Our plan covers up to 100 days in a SNF. $175 per day for days 1 through 7 $0 copay per day for days 8 through 60 $75 copay per day for days 61 through 90 per day for days 91 and beyond For inpatient mental health care, see the Mental Health Care section of this booklet. Our plan covers up to 100 days in a SNF. $100 per day for days 1 through 7 $0 copay per day for days 8 through 60 $50 copay per day for days 61 through 90 per day for days 91 and beyond For inpatient mental health care, see the Mental Health Care section of this booklet. Our plan covers up to 100 days in a SNF. Inpatient Mental Health Care Skilled Nursing Facility (SNF) 1 $0 copay per day for days 1 through 20 $150 copay per day for days 21 through 100 $0 copay per day for days 1 through 20 $150 copay per day for days 21 through 100 $25 copay per day for days 1 through 20 $125 copay per day for days 21 through
13 PRESCRIPTION DRUG BENEFITS How much do I pay? For Part B drugs such as chemotherapy drugs: 20% of the cost Other Part B drugs: 20% of the cost Our plan does not cover Part D prescription drugs. For Part B drugs such as chemotherapy drugs: 20% of the cost Other Part B drugs: 20% of the cost Our plan does not cover Part D prescription drugs. For Part B drugs such as chemotherapy drugs: 10% of the cost Other Part B drugs: 10% of the cost Our plan does not cover Part D prescription drugs. 12
14 ABOUT US has served Illinois for over 30 years. We have more than 17,000 Medicare members, and 96 percent of them stay with us year after year. TRUE SERVICE When you call, you ll speak with a helpful member services representative based out of Champaign. Most have been with us for years and know our plans inside and out. They will: Answer your questions. Sign you up for a seminar. Arrange for someone to meet with you. Help you enroll over the phone. Stop by 8 a.m. to 5 p.m. weekdays in the Champaign-Urbana area. We re at 206 W. Anthony Drive, near Alexander s Steakhouse just off Interstate 74 at Neil Street. Prospect Ave. I-74 Lincoln Ave. Neil St. KEEP YOUR DOCTOR With so many doctors in our network and more being added all the time chances are you can keep seeing the doctors you know and trust. Use our provider search at HealthAllianceMedicare.org or call today to learn more. With our HMO plans, your Primary Care Physician (PCP) helps you keep track of the care you need and connects you with specialists when you need them. EXTRAS SilverSneakers means free fitness club membership or at-home exercise kits. Information and support at SilverSneakers.com, too. Assist America helps with access to medical services while traveling. This free feature helps replace lost prescriptions and get members back home if they get sick. Plus, our members can call our 24-hour Anytime Nurse Line when their doctor s office is closed. 13
Signal Advantage HMO (HMO) Summary of Benefits
Signal Advantage HMO (HMO) Summary of Benefits January 1, 2016 December 31, 2016 The provider network may change at any time. You will receive notice when necessary. This information is available for free
More informationSummary of Benefits Report SENIOR CARE PLUS: VALUE BASIC PLAN (HMO)-009 January 1, 2015 December 31, 2015 WASHOE COUNTY, NEVADA
SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS 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).
More informationSelect Summary YOU HAVE CHOICES ABOUT HOW TO GET YOUR MEDICARE BENEFITS TIPS FOR COMPARING YOUR MEDICARE CHOICES
INTRODUCTION TO THE SUMMARY OF BENEFITS FOR January 1, 2015 - December 31, 2015 Central Alabama and Mobile Area SECTION I INTRODUCTION TO THE SUMMARY OF BENEFITS This booklet gives you a summary of what
More informationJanuary 1, 2015 December 31, Maintenance Organization (HMO) offered by HEALTHNOW NEW YORK INC. with a Medicare contract)
BLUECROSS BLUESHIELD SENIOR BLUE 601 (HMO), BLUECROSS BLUESHIELD SENIOR BLUE HMO SELECT (HMO) AND BLUECROSS BLUESHIELD SENIOR BLUE HMO 651 PARTD (HMO) (a Medicare Advantage Health Maintenance Organization
More informationINTRODUCTION 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: Fresno, Merced, Stanislaus and San Joaquin Counties H5928_15_029_SB_CTCA_2
More informationSUMMARY OF BENEFITS. Cigna-HealthSpring. Advantage SMS (HMO) H January 1, December 31, Cigna H4407_16_32690 Accepted
SUMMARY OF BENEFITS January 1, 2016 - December 31, 2016 Cigna-HealthSpring Advantage SMS (HMO) H4407-011 2015 Cigna H4407_16_32690 Accepted SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS This booklet
More information2016 Summary of Benefits
2016 Summary of Benefits Health Net Jade (HMO SNP) Kern, Los Angeles and Orange counties, CA Benefits effective January 1, 2016 H0562 Health Net of California, Inc. H0562_2016_0175 CMS Accepted 09082015
More informationSummary of Benefits 2018
SM Summary of Benefits 2018 bluecareplus.bcbst.com H3259_18_SB Accepted 08282017 This is a summary of drug and health services covered by BlueCare Plus (HMO SNP) SM health plan January 1, 2018 - December
More informationExplorer Plan (HMO-POS) SunSaver Plan (HMO-POS)
January 1, 2015 December 31, 2015 Explorer Plan SunSaver Plan SECTION I INTRODUCTION 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 informationClassic Plan (HMO-POS) Value Plan (HMO) Rewards Plan (HMO)
January 1, 2016 December 31, 2016 Classic Plan Value Plan Rewards Plan SECTION I INTRODUCTION This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover
More informationCorrection Notice. Health Partners Medicare Special Plan
Correction Notice Special Plan Following are corrections that apply to both the English and Spanish versions of the 2015 for Special (HMO SNP): Original Information Page 1, under the heading SECTIONS IN
More informationMedicare Plus Blue SM Group PPO. Summary of Benefits. Michigan Public School Employees Retirement System
2018 Medicare Plus Blue SM Group Summary of Benefits January 1, 2018 December 31, 2018 Michigan Public School Employees Retirement System www.bcbsm.com/mpsers This information is a summary document and
More informationExplorer Plan (HMO-POS) SunSaver Plan (HMO-POS)
January 1, 2016 December 31, 2016 Explorer Plan SunSaver Plan SECTION I INTRODUCTION 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 informationSummary of Benefits for Anthem MediBlue Dual Advantage (HMO SNP)
Summary of Benefits for Available in: Select Counties* in Maine *See Page 2 for a list of counties. Plan year: January 1, 2018 December 31, 2018 In this section, you ll learn about some of the benefits
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Nursing Home Plan (HMO SNP) H5253-042 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationOur service area includes the following county in: Florida: Miami-Dade.
2018 SUMMARY OF BENEFITS Overview of your plan Medica HealthCare Plans MedicareMax (HMO) H5420-001 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More information2018 SUMMARY OF BENEFITS
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Group Medicare Advantage (PPO) H2001-827 Group Name: North Carolina State Health Plan for Teachers and State Employees Group Numbers: 12309,
More informationBlue Cross Medicare Private Fee For Service. Summary of Benefits. January 1, 2018 December 31, 2018
Blue Cross Medicare Private Fee For Service Summary of Benefits January 1, 2018 December 31, 2018 This information is not a complete description of benefits. Contact the plan for more information. To get
More informationSummary Of Benefits. WASHINGTON Pierce and Snohomish
Summary Of Benefits WASHINGTON Pierce and Snohomish 2018 Molina Medicare Choice (HMO SNP) (800) 665-1029, TTY/TDD 711 7 days a week, 8 a.m. 8 p.m. local time H5823_18_1099_0007_WAChoSB Accepted 9/26/2017
More informationOur service area includes these counties in: North Carolina: Durham, Wake.
2018 SUMMARY OF BENEFITS Overview of your plan AARP MedicareComplete (HMO) H5253-039 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer Service or go
More informationGet More Than. Original Medicare. Summary of Benefits MA Special Needs Plan (HMO SNP) 014. H5826_MA_193_2016_v_01_SB014 Accepted.
Get More Than Original Medicare Offered by 2016 Summary of Benefits MA Special Needs Plan (HMO SNP) 014 H5826_MA_193_2016_v_01_SB014 Accepted Section I Introduction to the Summary of Benefits for Community
More informationOF BENEFITS. Cigna-HealthSpring TotalCare (HMO SNP) H Cigna H3949_15_19921 Accepted
agesummary OF BENEFITS Cover erage Cigna-HealthSpring TotalCare (HMO SNP) H3949-009 2014 Cigna H3949_15_19921 Accepted SECTION I - INTRODUCTION TO SUMMARY OF BENEFITS You have choices about how to get
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H0432-009 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationOur service area includes the 50 United States, the District of Columbia and all US territories.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Group Medicare Advantage (PPO) Group Name (Plan Sponsor): NEW ENGLAND ANNUAL CONF OF THE METHODIST CHURCH Group Number: 13850 H2001-816 Look
More information2017 Summary of Benefits
H5209 004_DSB9 23 16 File & Use 10/14/2016 DHS Approved 10 7 2016 This is a summary of drug and health services covered by Care Wisconsin Medicare Dual Advantage Plan (HMO SNP) January 1, 2017 to December
More information2018 SUMMARY OF BENEFITS
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Senior Care Options (HMO SNP) H2226-001 Look inside to learn more about the plan and the health and drug services it covers. Call Customer
More informationOur service area includes these counties in: Arizona: Apache, Coconino, Maricopa, Mohave, Navajo, Pinal, Yavapai.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete ONE (HMO SNP) H0321-004 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationOur service area includes these counties in: Texas: Aransas, Kleberg, Nueces, San Patricio.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete Focus (HMO SNP) H4527-004 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationExtra Value Summary YOU HAVE CHOICES ABOUT HOW TO GET YOUR MEDICARE BENEFITS TIPS FOR COMPARING YOUR MEDICARE CHOICES
INTRODUCTION TO THE SUMMARY OF BENEFITS FOR January 1, 2016 - December 31, 2016 Central Alabama and Mobile Area SECTION I INTRODUCTION TO THE SUMMARY OF BENEFITS This booklet gives you a summary of what
More informationY0021_H4754_MRK1427_CMS File and Use PacificSource Community Health Plans, Inc. is a health plan with a Medicare contract
Y0021_H4754_MRK1427_CMS File and Use 08262012 PacificSource Community Health Plans, Inc. is a health plan with a Medicare contract Section I - Introduction to Summary of s Thank you for your interest in.
More informationOur service area includes the following county in: Delaware: New Castle.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H3113-011 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationOur service area includes these counties in: Florida: Broward, Miami-Dade.
2018 SUMMARY OF BENEFITS Overview of your plan Preferred Medicare Assist (HMO SNP) H1045-012 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer Service
More informationSummary of Benefits. New Mexico Bernalillo, Chaves, Dona Ana, Luna, McKinley, Otero, Sandoval, San Juan, Santa Fe, Sierra, Torrance and Valencia
Summary of Benefits New Mexico Bernalillo, Chaves, Dona Ana, Luna, McKinley, Otero, Sandoval, San Juan, Santa Fe, Sierra, Torrance and Valencia 2016 Molina Medicare Options Plus HMO SNP Member Services
More informationH1463-HMO 20 (HMO) HMO 20 (HMO) / HMO 20Rx (HMO) Summary of Benefits
H1463- / Summary of Benefits January 1, 2014 December 31, 2014 Call us 8 a.m. to 8 p.m. daily Toll-free 1-800-965-4022 TTY/TDD 1-800-526-0844 www.healthalliancemedicare.org med-hmo20sob-0713 H1463_14_8837
More informationSummary Of Benefits. Molina Medicare Options Plus (HMO SNP) (866) , TTY/TDD days a week, 8 a.m. 8 p.m. local time
Summary Of Benefits OHIO Brown, Butler, Clark, Clermont, Clinton, Columbiana, Delaware, Fairfield, Fayette, Franklin, Greene, Hamilton, Highland, Hocking, Lake, Madison, Miami, Montgomery, Morrow, Perry,
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete ONE (HMO SNP) H3113-012 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationOur service area includes Florida.
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP) R7444-013 Look inside to learn more about the health services and drug coverages the plan provides.
More informationSummary Of Benefits. FLORIDA Broward, Hillsborough, Miami-Dade, Palm Beach, Pinellas, and Polk
Summary Of Benefits FLORIDA Broward, Hillsborough, Miami-Dade, Palm Beach, Pinellas, and Polk 2018 Molina Medicare Options Plus (HMO SNP) (866) 553-9494, TTY/TDD 711 7 days a week, 8 a.m. 8 p.m. local
More informationVIVA MEDICARE Select (HMO)
INTRODUCTION TO THE SUMMARY OF BENEFITS FOR VIVA MEDICARE January 1, 2014 - December 31, 2014 Central Alabama and Mobile Area Thank you for your interest in. Our plan is offered by Viva Health, Inc., which
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H7464-001 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationSummary of Benefits for Simply Level (HMO SNP)
Summary of Benefits for Available in: Hernando, Hillsborough, Pasco and Pinellas Counties Plan year: January 1, 2018 December 31, 2018 In this section, you ll learn about some of the benefits and services
More informationSummary Of Benefits. IDAHO Ada, Bannock, Bingham, Bonner, Bonneville, Canyon, Kootenai, Nez Perce, and Twin Falls
Summary Of Benefits IDAHO Ada, Bannock, Bingham, Bonner, Bonneville, Canyon, Kootenai, Nez Perce, and Twin Falls 2018 Molina Medicare Options Plus (HMO SNP) (844) 239-4913, TTY/TDD 711 7 days a week, 8
More information2018 Summary of Benefits
2018 Summary of Benefits H5209-004_MDASB 9-13-17 Accepted 9/18/2018 DHS Approved 09/13/2017 This is a summary of drug and health services covered by Care Wisconsin Medicare Dual Advantage Plan (HMO SNP)
More informationVNSNY CHOICE. Monthly Premium, Deductible, and Limits on how much you pay for Covered Services
Medicare Advantage-Classic Program (HMO): The Medicare Classic service area includes the following counties in New York: Albany, Bronx, Kings (Brooklyn), Nassau, New York, Queens, Rensselaer, Richmond
More informationSelect Summ ary. VIVA MEDICARE Plus Select (HMO) INTRODUCTION TO THE SUMMARY OF BENEFITS FOR. You have choices in your health care.
INTRODUCTION TO THE SUMMARY OF BENEFITS FOR VIVA MEDICARE Plus January 1, 2013 - December 31, 2013 Central Alabama and Mobile Area Thank you for your interest in. Our plan is offered by Viva Health, Inc./,
More informationSummary Of Benefits. NEW MEXICO Bernalillo, Chaves, Dona Ana, Luna, McKinley, Otero, San Juan, Sandoval, Santa Fe, Sierra, Torrance, and Valencia
Summary Of Benefits NEW MEXICO Bernalillo, Chaves, Dona Ana, Luna, McKinley, Otero, San Juan, Sandoval, Santa Fe, Sierra, Torrance, and Valencia 2018 Molina Medicare Options Plus (HMO SNP) (866) 440-0127,
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H5253-041 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationHealthPartners Freedom Plan (Cost) 2011 Medical Summary of Benefits Wisconsin
HealthPartners Freedom Plan 2011 Medical Summary of Benefits Wisconsin HealthPartners Wisconsin Freedom Plan I HealthPartners Wisconsin Freedom Plan II 420421 (10/10) H2462_SB WI_151 CMS Approved 10/5/10
More informationINTRODUCTION 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: Alameda,,,, San Francisco and Counties H5928_15_029_SB_TD_2 INTRODUCTION
More informationSummary of Benefits. Texas Bexar, Cameron, Collin, Dallas, El Paso, Harris, Hidalgo and Webb
Summary of Benefits Texas Bexar, Cameron, Collin, Dallas, El Paso, Harris, Hidalgo and Webb 2016 Molina Medicare Options Plus HMO SNP Member Services (866) 440-0012, TTY/TDD 711 7 days a week, 8 a.m. -
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan AARP MedicareComplete Essential (HMO) H5253-040 Look inside to learn more about the health services the plan provides. Call Customer Service or go online
More informationSummary of benefits Health Net. seniority plus green. Benefits effective January 1, 2009 H0562 Medicare Advantage HMO
2009 Health Net Summary of benefits Los Angeles, Orange, Riverside and San Bernardino counties s effective January 1, 2009 H0562 Medicare Advantage HMO Material ID H0562-09-0041 CMS Approval 9/08 Section
More informationBenefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH PLANS INC.
Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN FEATURES Network Providers Annual Maximum Out-of-Pocket Amount $2,500 The maximum out-of-pocket limit applies to all
More informationSummary Of Benefits. CALIFORNIA Imperial, Los Angeles, Riverside (partial), San Bernardino (partial), and San Diego
Summary Of Benefits CALIFORNIA Imperial, Los Angeles, Riverside (partial), San Bernardino (partial), and San Diego 2018 Molina Medicare Options Plus (HMO SNP) (800) 665-0898, TTY/TDD 711 7 days a week,
More informationHEALTH CARE BENEFITS YOU CAN COUNT ON. Retired Employees Health Program (REHP)
HEALTH CARE BENEFITS YOU CAN COUNT ON 2014 Retired Employees Health Program () PEBTF_2014 Thank you for your interest in Geisinger Gold Classic. Our plan is offered by Geisinger Health Plan/Geisinger Gold
More informationBenefits are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
PLAN FEATURES Annual Deductible The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Hearing aid reimbursement does not apply to the out-of-pocket
More informationSummary of Benefits. Effective January 1, 2018 December 31, 2018 H2256_S_2018_4 Accepted
Tufts HEALth Plan Senior care Options (hmo snp) 2018 Summary of Benefits The benefit information provided is a summary of what we cover and what you pay. It does not list every service that we cover or
More informationSUMMARY OF BENEFITS. Advantage (HMO) H
SUMMARY OF BENEFITS January 1, 2017 - December 31, 2017 Cigna-HealthSpring Advantage (HMO) H4513-009 Our service area includes the following counties in Texas: Angelina, Brazoria, Cameron, Chambers, Fort
More informationSummary of Benefits. for Blue Medicare Access Value SM (Regional PPO) Available in Ohio
Summary of Benefits for SM Available in Ohio Anthem Blue Cross and Blue Shield is a Health plan with a Medicare contract.anthem Insurance Companies, Inc. (AICI) is the legal entity that has contracted
More informationSUMMARY OF BENEFITS. Medi-Pak Advantage MA (PFFS), Medi-Pak Advantage MA-PD (PFFS) Area 1
SUMMARY OF BENEFITS MA, MA-PD Area 1 H4213_ADV_SOB_AREA1_COMBO Accepted Introduction to the Summary of Benefits for AR Blue Cross - MA and MA-PD January 1, 2014 - December 31, 2014 NORTHWEST, SOME EASTERN
More informationSummary of Benefits. for Anthem Medicare Preferred Premier (PPO)
Summary of Benefits for Available in Androscoggin, Cumberland, Franklin, Hancock, Kennebec, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, and Washington Counties, ME Anthem Blue
More informationSummary of Benefits. Tufts Medicare Preferred HMO PLANS Tufts Medicare Preferred HMO GIC
Tufts Medicare Preferred HMO PLANS 2018 Summary of Benefits Tufts Medicare Preferred HMO GIC The benefit information provided is a summary of what we cover and what you pay. It does not list every service
More informationSummary of Benefits Empire MediBlue Dual Advantage (HMO SNP) Plan year:
Summary of Benefits for Empire MediBlue Dual Advantage (HMO SNP) Available in: New York City* Area *See Page 2 for a list of counties. Plan year: January 1, 2017 December 31, 2017 In this section, you
More informationMEDICARE CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS.
ine 1-800-544-0088 www.care1st.com CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS MEDICARE 2009 COUNTIES: LOS ANGELES - ORANGE - SAN BERNARDINO - SAN DIEGO H5928_09_004_SNP_SB 10/2008 Section I Introduction
More informationBenefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Primary Care Physician Selection Optional There is no requirement for member pre-certification.
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete (HMO SNP) H5008-010 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More informationFREEDOM BLUE PPO R CO 307 9/06. Freedom Blue PPO SM Summary of Benefits and Other Value Added Services
FREEDOM BLUE PPO R9943 2007 CO 307 9/06 Freedom Blue PPO SM Summary of Benefits and Other Value Added Services Introduction to Summary of Benefits for Freedom Blue January 1, 2007 - December 31, 2007 California
More informationKeystone First VIP Choice (HMO-SNP) 2018 Summary of Benefits
Keystone First VIP Choice (HMO-SNP) 2018 Summary of Benefits Y0093_SOB_2497 _ACCEPTED_09052017 January 1, 2018- December 31, 2018 Summary of Benefits This booklet gives you a summary of what we cover
More informationBenefits are effective January 01, 2017 through December 31, 2017
Benefits are effective January 01, 2017 through December 31, 2017 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY PLAN FEATURES Network & Out-of- Annual Deductible $0 This is the amount
More informationSummary Of Benefits January 1, December 31, 2014 Optima Medicare Optima Medicare Basic HMO Optima Medicare Enhanced HMO
Summary Of Benefits January 1, 2014 - December 31, 2014 Optima Medicare Optima Medicare Basic HMO Optima Medicare Enhanced HMO www.optimahealth.com/medicare Table of Contents 3 Letter from Michael Dudley,
More informationSUMMARY OF BENEFITS 2009
HEALTH NET VIOLET OPTION 1, HEALTH NET VIOLET OPTION 2, HEALTH NET SAGE, AND HEALTH NET AQUA SUMMARY OF BENEFITS 2009 Southern Oregon Douglas, Jackson, and Josephine Counties, Oregon Benefits effective
More informationBenefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN FEATURES Network & Out-of- Annual Deductible This is the amount you have to pay out of pocket before the plan will pay
More informationSummary of Benefits For Advantage Health NY - SNP (HMO SNP)
Summary of Benefits For Advantage Health NY - SNP January 1, 2014 December 31, 2014 Summary of Benefits, H2773-003 Advantage Health NY - SNP H2773_QHPNY0658 Accepted Advantage Health NY - SNP 1 SECTION
More informationSummary of Benefits for SmartValue Classic (PFFS)
Summary of Benefits for SmartValue Classic (PFFS) Available in Select Counties in Nevada A health plan with a Medicare contract. Rocky Mountain Hospital and Medical Service, Inc. has contracted with the
More informationTrue Blue Special Needs Plan (HMO SNP)
True Blue Special Needs Plan (HMO SNP) 2012 Summary of Benefits You think about finding the perfect health insurance plan. We think about providing you with seamless service and affordable benefits. Serving
More informationSummary of Benefits. New York: Bronx, Kings, New York, Queens and Richmond Counties
Summary of Benefits New York: Bronx, Kings, New York, Queens and Richmond Counties January 1, 2006 - December 31, 2006 You ve earned the right to live life on your own terms. And that includes the right
More informationFLEX RETIREE MAP (Over 65 Flex Retirees) 2018 Benefits PROFESSIONAL SERVICES. Visit to a physician, physician assistant or nurse practitioner at a PPG
PROFESSIONAL SERVICES Visit to a physician, physician assistant or nurse practitioner at a PPG Periodic health evaluations/preventive services - Applies when the only service(s) provided is a Medicare
More information2012 Summary of Benefits
2012 Summary of Benefits San Francisco County, CA Benefits effective January 1, 2012 H0562 Health Net of California, Inc. Material ID # H0562_2012_0055 CMS Approved 08122011 SECTION I Introduction to
More informationSection I Introduction to Summary of Benefits
Section I Introduction to Summary of Benefits Thank you for your interest in + Rx Classic (PPO) and. Our plans are offered by Regence BlueShield, a Medicare Advantage Preferred Provider Organization (PPO)
More informationSUMMARY OF BENEFITS. H5649_090412_1065_SB CMS Accepted
2013 SUMMARY OF BENEFITS H5649_090412_1065_SB CMS Accepted Introduction Section I Introduction to the for MEDICARE PLAN (HMO), MEDI-MEDI PLAN (HMO SNP), and PREMIER PLAN (HMO) January 1 - December 31
More informationInformation for Dual-Eligible Members with Secondary Coverage through California Regular Medi-Cal (Fee-for-Service)
Information for Dual-Eligible Members with Secondary Coverage through California January 1, 2011 December 31, 2011 Los Angeles County This publication is a supplement to the 2011 Positive (HMO SNP) Evidence
More informationHealthPartners Minnesota Senior Health Options (MSHO) (HMO SNP)
2013 HealthPartners MSHO Summary of Benefits HealthPartners Minnesota Senior Health Options (MSHO) (HMO SNP) 420089 Individual MSHO (9/12) H2422_54016 CMS Accepted 9/1/2012 H2422 American Indian Language
More informationSummary of Benefits Advantra Freedom PEBTF
Advantra Freedom is a Medicare Advantage Private Fee-For-Service (PFFS) Plan. This Summary of Benefits tells you some features of our Plan. It doesn't list every service that we cover or list every limitation
More informationBenefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
Benefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN FEATURES Network & Out-of- Annual Deductible This is the amount you have to pay out of pocket before the plan will pay
More information2012 Summary of Benefits
North Carolina Network Private-Fee-For-Service 2012 N12SB42680102 Charlotte Rale SB Combo 001-002 001 - Patriot (PFFS) 002 - Patriot Plus (PFFS) Counties: Caswell, Cleveland, Durham, Granville, Guilford,
More informationSummary of Benefits. AARP MedicareComplete Choice (PPO) January 1, 2012 December 31, 2012 H
Summary of Benefits January 1, 2012 December 31, 2012 AARP MedicareComplete Choice H5516-001 North Carolina: Alamance, Chatham, Davidson, Davie, Forsyth, Guilford, Mecklenburg, Orange, Randolph, Rockingham,
More information2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits
2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits For Oregon counties: Clackamas, Clatsop, Columbia, Jackson, Josephine, Multnomah, Tillamook, Washington and Yamhill H5859_1099_CO_1018 CMS
More informationSummary of Benefits. Medicare Advantage Plan (PPO) January 1, 2013 December 31, Medicare Solution. A UnitedHealthcare
2013 Summary of Benefits January 1, 2013 December 31, 2013 Medicare Advantage Plan (PPO) A UnitedHealthcare Medicare Solution The service area for this plan includes select counties in South Carolina.
More informationIllustrative Benefits, Value Added Services and Premiums are effective January 1, 2016 through December 31, 2016
PLAN FEATURES Combined In and Out of Network Deductible (Plan Level/includes Network Deductible) Network & Out-of-Network Providers $0 Member Coinsurance N/A Applies to all expenses unless otherwise stated.
More informationMedicare & Medicare Supplemental Insurance (Medigap)
Elder Law Basics Medicare & Medicare Supplemental Insurance (Medigap) Steven A. Kass, Esq., CELA Law Office of Steven A. Kass, PC 105 Maxess Road, Suite N116 Melville, New York 11747 What is Medicare?
More information2019 Summary of Benefits
2019 Summary of Benefits H6345 This is a summary of drug and health services covered by January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization)
More informationSummary of Benefits. Available in the Bronx, Kings, New York, Queens, and Richmond Counties in New York
Summary of Benefits for Empire MediBlue Plus SM (HMO) Available in the Bronx, Kings, New York, Queens, and Richmond Counties in New York This plan is an HMO plan with a Medicare contract. Services provided
More informationFreedom Blue PPO SM Summary of Benefits
Freedom Blue PPO SM Summary of Benefits R9943-206-CO-308 10/05 Introduction to the Summary of Benefits for Freedom Blue PPO Plan January 1, 2006 - December 31, 2006 California YOU HAVE CHOICES IN YOUR
More informationspecial needs plan (hmo snp) MEDICARE advantage plan summary of benefits Serving Members in Douglas & Klamath Counties
special needs plan (hmo snp) 2017 MEDICARE advantage plan summary of benefits Serving Members in Douglas & Klamath Counties Table of Contents About the Summary of Benefits... 2 Who Can Join?... 2 Which
More informationSmartSaver. A Medicare Advantage Medical Savings Account Plan. Summary of Benefits and Other-Value Added Services. From Blue Cross of California
SmartSaver From Blue Cross of California A Medicare Advantage Medical Savings Account Plan Service Area C Summary of Benefits and Other-Value Added Services H5769 2007 CO 415 09/22/06 Introduction to the
More informationOur service area includes these counties in:
2018 SUMMARY OF BENEFITS Overview of your plan UnitedHealthcare Dual Complete LP1 (HMO SNP) H3794-002 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
More information2019 Summary of Benefits
2019 Summary of Benefits H7511 This is a summary of drug and health services covered by Great Plains Medicare Advantage (HMO SNP) January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO
More informationSummary of Benefits. Regence MedAdvantage + Rx Classic (PPO) GROUP RETIREE PLAN
2013 Summary of Benefits GROUP RETIREE PLAN Regence MedAdvantage + Rx Classic (PPO) Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association ORMARXG-05761
More informationSUMMARY OF BENEFITS. January 1, December 31, 2017 Cigna-HealthSpring TotalCare (HMO SNP)
SUMMARY OF BENEFITS January 1, 2017 - December 31, 2017 H4528-002 Our service area includes the following counties in Texas: Bexar, Collin, Dallas, Denton, El Paso, Hood, Johnson, Parker, Tarrant, and
More information2014 Summary of Benefits. Health Net Seniority Plus (Employer HMO) Benefits effective January 1, 2014 and later (Medical plan 9XN)
2014 Summary of Benefits Health Net Benefits effective January 1, 2014 and later (Medical plan 9XN) Material ID# H0562_EG_2014_0008_ Compliance Approved 08132013 Introduction to the Summary of Benefits
More information