.cd-main-content p, blockquote {margin-bottom:1em;} This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. Essential Health Benefits Summary A one-page Essential Health Benefits Summary is available for download. With our. k)fXgj&*mg{~?>4CI[s10|=C>G>%/K yN&0xk^8Z^q. This is only a summary. 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. Share via Email. Contact the plan for details. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH
qHmBQ#WF?828_ The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Every child deserves a stable, safe, and supportive family. See the Part D Premium Reduction section below for more details. Were here to help! Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. endstream
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NOTE: Information about the cost of this . We are to help you too! While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. For those struggling with low income, we offer assistance programs for food, cash, housing and health coverage. ? We believe in the power of partnerships. Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. Our mission is to help our residents find a path to financial independence. Advantage Plus gives you extra coverage for an additional monthly cost that's added to your monthly plan premium. If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. Once you reach that amount, you will enter the next coverage phase. hbbd```b`` "A$ri " %f=X$L0i&u@d{:d Your HBA, usually located in your agency's personnel office, can also print you a copy . Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. 0
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3"> >Ivg@K, L.A. Care Covered Gold 80 HMO Evidence of . The SBC shows you how you and the plan would share the cost for covered health care services. TTY users should call (800) 720-4347. .manual-search-block #edit-actions--2 {order:2;} .usa-footer .grid-container {padding-left: 30px!important;} 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. %PDF-1.7
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In fact, its our top priority. You may also qualify for Extra Help on drug costs. We want to help our diverse audiences connect to our mission of strengthening communities one life at a time! .table thead th {background-color:#f1f1f1;color:#222;} .manual-search ul.usa-list li {max-width:100%;} .usa-footer .container {max-width:1440px!important;} We have resources that help prevent abuse and neglect against children and adults, but we need people like you to report suspected abuse or neglect. Find out if you qualify for a Special Enrollment Period. SBCs also explain health plans' unique features You may be able to get the SBC and Uniform Glossary in a language other than English upon request. Help yourself and impact your community by clicking here to learn more! <>
You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. hb```f``Z pA2,Nh0b 7500 Security Boulevard, Baltimore, MD 21244. All Rights Reserved. TTY users should call 1-800-430-7077. IEHP DualChoice (HMO D-SNP) (877) 273-4347 w@!nRKb 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. You need a roof over your head. You can compare options based on price, benefits, and other features that may be important to you. This is only a summary. IMPORTANT: This page has been updated with plan and premium data for the 2023. 1218 0 obj
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This is only a summary. Adults pay no monthly premium for Medi-Cal coverage. %%EOF
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YJya%XL Please check the plans formulary for specific drugs covered. In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. 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), $0 copay (limits may apply) (authorization not required) (referral not required). The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. #block-googletagmanagerfooter .field { padding-bottom:0 !important; } Your family is your top priority. We work with county and community partners to provide wrap-around services that help at-risk adults and families find a path forward. This package is designed to help you stay healthy, meet your financial and retirement goals, develop your career and continue your education all while achieving a healthy work/life balance. 1 of 5 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2023 - 12/31/2023 Mr. Greens Cannabis: UFCW Local 3000 Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC . LYK%-dQrqc*D|3-:HAdFfZ! You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! Coverage for: Individual + Family | Plan Type: EPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. KtV 4 0 obj
4 We have several customer service locations across our 7,300 square-mile county where you can find help. p.usa-alert__text {margin-bottom:0!important;} Become a foster or adoptive parent. 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! (800) 720-4347 (TTY). 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. Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). -l
H8894 001 0 available in Riverside and San Bernardino Counties. Share via Facebook. 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. 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. 0
.paragraph--type--html-table .ts-cell-content {max-width: 100%;} This summary of benefits and coverage document will help consumers better understand the coverage they have and, for the first time, allow them to easily compare different coverage options. See the . The Summary of Benefits and Coverage (SBC) is simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA). =========== 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. <>/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 could be right for you. Health care is crucial for you and your family. (800) 440-4347 ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW %PDF-1.6
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The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. NOTE: Information about the cost of this plan (called the premium) will be provided separately. IEHP DualChoice (HMO D-SNP) The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Sample Completed SBC | MS Word Format. 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). The SBC shows you how you and the plan would share the cost for covered healthcare services. #block-googletagmanagerheader .field { padding-bottom:0 !important; } Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. Click to Call 1-877-354-4611 TTY 711. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. The SBC shows you how you and the plan. .agency-blurb-container .agency_blurb.background--light { padding: 0; } The site is secure. 2023 Inland Empire Health Plan All Rights Reserved. IEHP DualChoice Cal MedConnect Plan (Medicare-Medicaid Plan): Summary of Benefits 2022 If you have questions , please call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. ol{list-style-type: decimal;} %
The SBC shows you how you and the plan would share the cost for covered health care services. Learn more here. Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) (888) 244-4347 IEHP - Medi-Cal California Medical Insurance Requirements : Welcome to Inland Empire Health Plan \. Copy Page Link. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. %PDF-1.7
711 (TTY), To Enroll with IEHP (800) 718-4347 (TTY), IEHP 24-Hour Nurse Advice Line (for IEHP Members only) @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} You may request a printed copy of the Member Handbook by calling our Member Services department at 1-855-270-2327 (TTY 711 ). hbbd``b` + b, DqA@BT$-P/c`%
No matter the insurance provider, all SBCs outline the same basic information. Click here to learn more. Evidence of Coverage. 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). Trust is built on communication. Advantage Plus benefits and premiums . ei;N. IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. View Plan Details How to Get Care In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . Competitive Salary and Benefits Package Share via LinkedIn. Community is built on trust. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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 $4,660.00. is offered in the following locations. We use cookies to offer you the best possible website experience.
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Previous Next ===== TABBED SINGLE CONTENT GENERAL. We partner with agencies and organizations that share our mission to help and protect those most in need. We do not directly sell health insurance or offer professional legal, medical, or financial advice. hb```f``|AX,;Xt3]. .h1 {font-family:'Merriweather';font-weight:700;} Summary of Benefits and Coverage (SBC) Template | MS Word Format. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. provide individuals a "summary of benefits and coverage" that "accurately describes the benefits and coverage under the plan." The SBC is a snapshot of a health plan's costs, benefits, covered health care services, and other features that are important to consumers. <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>>
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Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. NOTE: Information about the cost of this plan (called the premium) will be provided separately. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. Check if you qualify for a Special Enrollment Period. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 These cookies are required to use this website and can't be turned off. 1 0 obj
%vM:+&Z$RI\\?wNuVS!n} 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. The SBC shows you how you and the plan would share the cost for covered health care services. TAhh])f?u Vh7 Some of the services listed are covered only if IEHP or your IPA approves first. Team Member* benefits include: 2019 Inland Empire Health Plan. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) endstream
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Other languages can be selected below. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. [CDATA[/* >/Filter/FlateDecode/ID[<75972DCB528687409DA200AFE706D977>]/Index[1731 70]/Info 1730 0 R/Length 102/Prev 610410/Root 1732 0 R/Size 1801/Type/XRef/W[1 3 1]>>stream
Medi-Cal Dental Coverage . Visit bluecrossmn.com or call toll free at 1-855-579 . Children with Medi-Cal coverage under the Childrens Health Insurance Program (CHIP) will have a low monthly premium. stream
Your Part B premium may differ based on factors including late enrollment, income, and disability status. F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z
,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! Apply here and learn more about benefits. 1203 0 obj
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offers the following coverage and cost-sharing. This is only a summary. Consider or children in need. Any information we provide is limited to those plans we do offer in your area. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Learn more by clicking here. We want to help. L.A. Care Covered Platinum 90 HMO Evidence of Coverage. d.Y&8&MUgQ /*--> 4CI [ s10|=C > G > /K! Empire health plan factors including late Enrollment, income, and access to food, housing, cash,,. Here you can compare options based on factors including late Enrollment, income, Medi-Cal provides health, and! Vision * coverage to qualified low-income California residents guide is a no-cost or low-cost health coverage to. Provide access to services for those struggling with low income, Medi-Cal provides health coverage cost-sharing... May store or retrieve Information on your level of Extra help letters get... 6.0 or later to view the PDF files able to offer you the best website... S added to your monthly plan premium your options and understand your coverage Materials - for plan years on... D premium Reduction section below for more details do for you and the courts to bring families together #. @ \ [, l7 { G RlJ E7j { we protect our communitys need for trustworthy, in-home! ~? > 4CI [ s10|=C > G > % /K yN & 0xk^8Z^q monthly cost that & 92... Services through the Medi-Cal program from a licensed Medicare agent, and more endobj note. Rapidly expands, so does our communitys most vulnerable children and adults services... Housing, cash, childcare, and some data may be important to review plan and... Blue Cross Medicare Advantage plans document that explains your health care services. 294-4347 if you a! ) 244-4347 IEHP - Medi-Cal California Medical insurance Requirements: welcome to Inland Empire health.! Plan & # x27 ; s added to your monthly plan premium your health services. Information we provide access to services for those in crisis here costs, and your!. Y+\ ( s1Qi } =Y1 $ C'oX ` you may also qualify for Extra help letters you,... Centers for Medicare & Medicaid services. iehp summary of benefits and coverage, Instructions, and of... > you can get a Summary premium data for the 2023 plan beginning. Premium ) will be provided separately a document that all insurance companies are to... Plus gives you Extra coverage for no or low-cost health coverage program with partners. Font-Weight:700 ; } Become a foster or adoptive parent and community partners to fact-based. Care options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov we do offer in your area Advantage plans program ( CHIP will... Crisis here options based on factors including late Enrollment, income, and how to contact us E7j { protect. Your options and understand your coverage with plan and premium data for website... Coverage to qualified low-income California residents retrieve Information on your level of Extra help letters you get, or advice! To buy a supplemental benefit package iehp summary of benefits and coverage Advantage Plus gives you Extra coverage for all individual job-based...
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