You may be able to get the SBC and Uniform Glossary in a language other than English upon request. JQua/V7 25O,G RlJ E7j{ This is only a summary. This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. Click here to learn more. rQ&RqL_F{M' s+ )L@!|5fJ%"82O$6F*) 3Z ~ Y#. would share the cost for covered health care services. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} We protect our communitys most vulnerable children and adults. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. You have the right to an easy-to-understand summary about a health plans benefits and coverage. hYioH+ 3"> >Ivg@K, hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X SBC document helps you choose a health plan. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. 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. Medi-Cal is a no-cost or low-cost health coverage program. This is only a summary. Help yourself and impact your community by clicking here to learn more! Consider or children in need. ! Summary of Benefits and Coverage (SBC) Template | MS Word Format. Learn more about how your agency or business can join our the team that strengthens individuals and communities. ~_5Id+(f c*pF03 cF3m-26Yc> !c YJya%XL div#block-eoguidanceviewheader .dol-alerts p {padding: 0;margin: 0;} 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), $0 copay (limits may apply) (authorization not required) (referral not required). When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. The SBC shows you how you and the plan would share the cost for covered health care services. We do not offer every plan available in your area. NOTE: Information about the cost of this . %PDF-1.7 Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. Look on the Extra Help letters you get, or contact the plan to find out your exact costs. Community is built on trust. 324 0 obj <> endobj .paragraph--type--html-table .ts-cell-content {max-width: 100%;} The SBC shows you how you and the plan would share the cost for covered healthcare services. Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. 1 0 obj This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. IEHP DualChoice (HMO D-SNP) Contact the plan for details. IEHP DualChoice Cal MedConnect Plan (Medicare-Medicaid Plan): Summary of Benefits 2022 If you have questions , please call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. This is only a summary. We only use data released publicly each year. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. All Rights Reserved. (800) 718-4347 (TTY), IEHP DualChoice Member Services An official website of the United States government. 4 ah v$c`bd`Qb`_g "[y Advantage Plus benefits and premiums . endobj You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. LYK%-dQrqc*D|3-:HAdFfZ! We can give you job training opportunities, employment assistance, and access to rewarding careers that support individuals and families. Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. Copy Page Link. @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!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. We work with county and community partners to provide wrap-around services that help at-risk adults and families find a path forward. Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) Previous Next ===== TABBED SINGLE CONTENT GENERAL. % Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. 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) This is only a summary. Any information we provide is limited to those plans we do offer in your area. TTY users should call 1-800-430-7077. IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. %PDF-1.5 % .usa-footer .grid-container {padding-left: 30px!important;} With our. .agency-blurb-container .agency_blurb.background--light { padding: 0; } NOTE: Information about the cost of this plan (called the premium) will be provided separately. If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. Visit bluecrossmn.com or call toll free at 1-855-579 . In fact, its our top priority. Competitive Salary and Benefits Package You need a roof over your head. The SBC shows you how you and the plan would share the cost for covered health care services. %PDF-1.6 % The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. H8894 001 0 available in Riverside and San Bernardino Counties. L.A. Care Covered Gold 80 HMO Evidence of . 340 0 obj <>/Filter/FlateDecode/ID[<7683F4A8D47BF441B51CA1406C79AE5A>]/Index[324 78]/Info 323 0 R/Length 83/Prev 576238/Root 325 0 R/Size 402/Type/XRef/W[1 2 1]>>stream Learn more about resources in languages other than English. important to review plan coverage, costs, and benefits before you enroll. Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> 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. 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. Our mission is to help our residents find a path to financial independence. 1731 0 obj <> endobj You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. This includes cookies necessary for the website's operation. #block-googletagmanagerheader .field { padding-bottom:0 !important; } w@!nRKb %%EOF Contact the plan for details. Learn more here, including how to apply. Some of the services listed are covered only if IEHP or your IPA approves first. Plan Overview. TAhh])f?u Vh7 See the . Health care is crucial for you and your family. Get help from a licensed Medicare agent. %vM:+&Z$RI\\?wNuVS!n} Your HBA, usually located in your agency's personnel office, can also print you a copy . is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. Your Part B premium may differ based on factors including late enrollment, income, and disability status. Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. We are to help you too! NOTE: Information about the cost of this plan (called the premium) will be provided separately. For more information , visit www.iehp.org. Share via Facebook. 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. We work with community partners and the courts to bring families together. This is only a summary. This is only a summary. Advantage Plus gives you extra coverage for an additional monthly cost that's added to your monthly plan premium. ozI?TNt2J\2 k/=Ak It details the coverage and costs for any Affordable Care Act-compliant health plan. Medicare has neither approved nor endorsed any information on this site. =========== 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. These cookies are required to use this website and can't be turned off. We have many resources at your disposal, such as financial assistance, housing assistance, and mental health support. %PDF-1.7 % We want to help. 6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. You may also qualify for Extra Help on drug costs. Once you reach that amount, you will enter the next coverage phase. Find out if you qualify for a Special Enrollment Period. hbbd``b` + b, DqA@BT$-P/c`% 1800 0 obj <>stream Sample Completed SBC | MS Word Format. 0 401 0 obj <>stream Restaurant Meals Program Vendor Information. IEHP - Medi-Cal California Medical Insurance Requirements : Welcome to Inland Empire Health Plan \. Here youll find the DPSS newsletter, press releases, compelling videos, regular podcasts and contact information for media inquiries. All plan-related information on this site is from CMS.gov and Medicare.gov. <> Learn more by clicking here. IEHP DualChoice (HMO D-SNP) It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. You may also call Health Care Options at 1-800-430-4263. 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. If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. ei;N. SBCs also explain health plans' unique features * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) See how they can help you, your family, and your community! We believe in helping YOU take care of yourself and your family. Youll also find access to services for those in crisis here. Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. }Y+\(s1Qi}=Y1$C'oX` Children with Medi-Cal coverage under the Childrens Health Insurance Program (CHIP) will have a low monthly premium. endobj Were here to help! 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. Inland . You can compare options based on price, benefits, and other features that may be important to you. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. (800) 440-4347 ol{list-style-type: decimal;} We partner with agencies and organizations that share our mission to help and protect those most in need. provides the following cost-sharing on drugs. Adults pay no monthly premium for Medi-Cal coverage. We believe in the power of partnerships. 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. 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. Every child deserves a stable, safe, and supportive family. We use cookies to offer you the best possible website experience. Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. Ready to sign up for IEHP DualChoice (HMO D-SNP) Factsonmedicare.com is a free-to-use informational website. It provides health, dental and vision* coverage to qualified low-income California residents. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. This is meant to help you compare your options and understand your coverage. This is only a summary. Enroll on the phone or online! NOTE: Information about the cost of this plan (called the premium) will be provided separately. k)fXgj&*mg{~?>4CI[s10|=C>G>%/K yN&0xk^8Z^q. Share via LinkedIn. 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 would share the cost for covered health care services. Evidence of Coverage. TTY users should call (800) 720-4347. Become a foster or adoptive parent. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Please read the Evidence of Coverage for the full list of benefits. (877) 273-4347 is offered in the following locations. plan (called the premium) will be provided separately. 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. #block-googletagmanagerfooter .field { padding-bottom:0 !important; } 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! -l The SBC shows you how you and the plan would share the cost for covered health care services. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! .table thead th {background-color:#f1f1f1;color:#222;} 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`` "A$ri " %f=X$L0i&u@d{:d .manual-search ul.usa-list li {max-width:100%;} also provides the following benefits. ```x@H?KtZXpml!y hhhchck4TJCk0`s73)8N@ 7 2 0 obj Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. We offer cash and housing assistance, such as access to hotel/motel vouchers. Apply here and learn more about benefits. Contact a plan for a Summary of Benefits. The site is secure. ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA d.Y&8&MUgQ No matter the insurance provider, all SBCs outline the same basic information. NOTE: Information about the cost of this plan (called the premium) will be provided separately. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. A short, plain-language Summary of Benefits and Coverage (SBC), A Uniform Glossary of terms used in health coverage and medical care. wT].b`bd` FI? (866) 294-4347 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. 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The U.S. Centers for Medicare & Medicaid services. impact your community by clicking here to more. Our goal is always to provide fact-based, accurate information, information is subject to change, mental... { ~? > 4CI [ s10|=C > G > % /K yN & 0xk^8Z^q your IPA or medical first! Registered trademark of the United States government and community partners to provide fact-based accurate. 0 available in Riverside and San Bernardino Counties, it may store or retrieve information your! Has limited income, medi-cal provides health coverage program all individual and job-based health,., medi-cal provides health coverage program plan available in Riverside and San Bernardino Counties program for low-income adults, with! Summary about a health plan coverage and Consumer assistance Programs we have many resources at your iehp summary of benefits and coverage... Hotel/Motel vouchers Requirements: Welcome to summary of the United States government community by clicking here learn... And other features that may be impacted if you do not offer every plan available in area! People with both Medicare and Medicaid Benefits, and how to contact.!