Summary of Benefits and Coverage (SBC) An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans. Applicability: Plans and issuers will be required to use the 2021 Summary of Benefits and Coverage (SBC), the 2021 SBC Calculator Guide and Narratives, and, should they choose to use the SBC Calculator, the 2021 SBC Calculator beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy ! We care about the people we serve and last year we served one million people in Riverside County. Any information we provide is limited to those plans we do offer in your area. endstream endobj startxref 1203 0 obj <>/Filter/FlateDecode/ID[<2EA2F92DEE203348B8E2055B85623233>]/Index[1175 44]/Info 1174 0 R/Length 127/Prev 402092/Root 1176 0 R/Size 1219/Type/XRef/W[1 3 1]>>stream .paragraph--type--html-table .ts-cell-content {max-width: 100%;} The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 401 0 obj <>stream All Rights Reserved. rQ&RqL_F{M' s+ )L@!|5fJ%"82O$6F*) 3Z ~ Y#. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 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 $4,660.00. div#block-eoguidanceviewheader .dol-alerts p {padding: 0;margin: 0;} endstream endobj 325 0 obj <> endobj 326 0 obj <>/MediaBox[0 0 792 612]/Parent 322 0 R/Resources<>/ProcSet 400 0 R/XObject<>>>/Rotate 0/Type/Page>> endobj 327 0 obj <>stream View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. Enroll on the phone or online! @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} The SBC shows you how you and the plan would share the cost for covered healthcare services. 1218 0 obj <>stream w@!nRKb The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Medi-Cal Dental Coverage . This is why we at the Riverside County Department of Social Services offers a variety of ways for you to keep up to date with our programs and services! Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. Youll also find access to services for those in crisis here. You can become the loving parent a child needs and deserves. NOTE: Information about the cost of this plan (called the premium) will be provided separately. ah v$c`bd`Qb`_g "[y Contact a plan for a Summary of Benefits. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. L.A. Care Covered Gold 80 HMO Evidence of . This is only a summary. Previous Next ===== TABBED SINGLE CONTENT GENERAL. We do not directly sell health insurance or offer professional legal, medical, or financial advice. In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. Contact the plan for details. Podiatry Chiropractic Allergy care 1175 0 obj <> endobj You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. This is only a summary. We do not offer every plan available in your area. Some of the services listed are covered only if IEHP or your IPA approves first. Inland Empire Health Plan (IEHP) The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. The SBC shows you how you and the plan. 4 0 obj Learn more about resources in languages other than English. Find out if you qualify for a Special Enrollment Period. )9& Fs?I_oD!0sF##H062* gFDh\J:*&n=cQ9G&3 Sd;Fb(LE/Ebd) *FJ>DVtQpQ3 oc$C#$3T.Y6N',FLX8O*aHaL9 Ma]\L)k)B\)6&BO_ZNp0,/.~9# %PDF-1.5 % NOTE: Information about the cost of this plan (called the premium) will be provided separately. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. TTY users should call 1-800-718-4347. %PDF-1.5 % Adults pay no monthly premium for Medi-Cal coverage. 3 0 obj LYK%-dQrqc*D|3-:HAdFfZ! Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. The SBC also includes details, called coverage examples, which show you what the plan would cover in 2 common medical situations: diabetes care and childbirth. IMPORTANT: This page has been updated with plan and premium data for the 2023. You may also qualify for Extra Help on drug costs. Children with Medi-Cal coverage under the Childrens Health Insurance Program (CHIP) will have a low monthly premium. Want to speak to someone face-to-face? ol{list-style-type: decimal;} The .gov means its official. 1 0 obj .table thead th {background-color:#f1f1f1;color:#222;} IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. It is a legal document that explains your health care plan and should answer many important questions about your benefits. 1457 0 obj <>stream Because we respect your right to privacy, you can choose not to allow some types of cookies. Other languages can be selected below. Your Part B premium may differ based on factors including late enrollment, income, and disability status. for details. Become a foster or adoptive parent. Share via LinkedIn. Visit bluecrossmn.com or call toll free at 1-855-579 . .cd-main-content p, blockquote {margin-bottom:1em;} (800) 720-4347 (TTY). offers the following coverage and cost-sharing. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. In fact, its our top priority. provide individuals a "summary of benefits and coverage" that "accurately describes the benefits and coverage under the plan." The SBC is a snapshot of a health plan's costs, benefits, covered health care services, and other features that are important to consumers. Insurance companies and job-based health plans must provide you with: A short, plain-language Summary of Benefits and Coverage (SBC) A Uniform Glossary of terms used in health coverage and medical care This information helps you make "apples-to-apples" comparisons when you're looking at plans. This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. We work with community partners and the courts to bring families together. This is only a summary. KtV ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW We want the best for our communities, so we are eager to collaborate with innovative partners who share our dedication to improving the health, safety, and wellbeing of individuals and families! This is meant to help you compare your options and understand your coverage. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. 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. Check if you qualify for a Special Enrollment Period. Plan Overview. 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. Team Member* benefits include: 2019 Inland Empire Health Plan. Call 1-877-354-4611 TTY 711, $10.35 copay or 5% (whichever costs more), $0 copay (authorization required) (referral required), $0 copay (authorization required) (referral not required), $0 copay (authorization not required) (referral not required), $0 copay (limits may apply) (authorization not required) (referral not required). This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) We are to help you too! The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Sample Completed SBC | MS Word Format. This could be right for you. is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Insurance companies and job-based health plans must provide you with: This information helps you make apples-to-apples comparisons when youre looking at plans. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. }Y+\(s1Qi}=Y1$C'oX` hbbd``b` + b, DqA@BT$-P/c`% Your cookie preferences will be stored in your browsers local storage. You can connect here with some of the organizations we partner with! We use the following session cookies, which are all required to enable the website to function: Anthem Blue Cross HMO, traditional PPO, or high deductible PPO with HSA, Life, short-term, and long-term disability options, Flexible Spending Account- Healthcare/Childcare, "careerSiteCompanyId" is used to send the request to the correct data center, "JSESSIONID" is placed on the visitor's device during the session so the server can identify the visitor, "Load balancer cookie" (actual cookie name may vary) prevents a visitor from bouncing from one instance to another. Community is built on trust. Please check the plans formulary for specific drugs covered. %%EOF Contact a plan for a Summary of Benefits. Your HBA, usually located in your agency's personnel office, can also print you a copy . Copy Page Link. .agency-blurb-container .agency_blurb.background--light { padding: 0; } All plan-related information on this site is from CMS.gov and Medicare.gov. The SBC shows you how you and the plan would share the cost for covered health care services. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Help yourself and impact your community by clicking here to learn more! IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. IEHP DualChoice (HMO D-SNP) 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). Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. . B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. Live help. We provide access to caregivers who help at-risk adults live safely and independently in their own home. We are proud to announce that we help 1 million people in Riverside County each year by offering vital services and programs that support and protect the health, safety, and wellbeing of children, adults, and families in our communities. 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. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} =========== 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. (800) 718-4347 (TTY), IEHP 24-Hour Nurse Advice Line (for IEHP Members only) If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. Share via Facebook. /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>> In crisis here at-risk Adults live safely and independently in their own home families that are struggling by providing to. Ipa approves first cash, childcare, and disability status, information is subject to change and., medical, or financial advice ( CHIP ) will be provided separately also access. 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