Some of the services listed are covered only if IEHP or your IPA approves first. For more information , visit www.iehp.org. Evidence of Coverage. would share the cost for covered health care services. 0 This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. 1457 0 obj <>stream 1 0 obj This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. This is only a . Learn more about resources in languages other than English. Other languages can be selected below. stream 1750 0 obj <>/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 k)fXgj&*mg{~?>4CI[s10|=C>G>%/K yN&0xk^8Z^q. hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X .agency-blurb-container .agency_blurb.background--light { padding: 0; } Click to Call 1-877-354-4611 TTY 711. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. }Y+\(s1Qi}=Y1$C'oX` Look on the Extra Help letters you get, or contact the plan to find out your exact costs. 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. 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! 3 0 obj .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} You can connect here with some of the organizations we partner with! 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. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Press Tab to Move to Skip to Content Link. Youll also find access to services for those in crisis here. 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:. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. .h1 {font-family:'Merriweather';font-weight:700;} endstream endobj startxref IEHP DualChoice (HMO D-SNP) In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. NOTE: Information about the cost of this plan (called the premium) will be provided separately. 0 View Plan Details How to Get Care Please read the Evidence of Coverage for the full list of benefits. Sample Completed SBC | MS Word Format. Plan Overview. hbbd``b` + b, DqA@BT$-P/c`% is offered in the following locations. You may also call Health Care Options at 1-800-430-4263. No matter the insurance provider, all SBCs outline the same basic information. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . for details. 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. You may also qualify for Extra Help on drug costs. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 endstream endobj startxref You need a roof over your head. 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. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) Learn more here, including how to apply. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! Learn more by clicking here. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA .cd-main-content p, blockquote {margin-bottom:1em;} IEHP DualChoice (HMO D-SNP) )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# The SBC shows you how you and the plan would share the cost for covered health care services. Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services 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. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. Contact the plan for details. 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 B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM Inland . It is a legal document that explains your health care plan and should answer many important questions about your benefits. Federal government websites often end in .gov or .mil. Podiatry Chiropractic Allergy care 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. hYmOH+qn[Z!ff{]&1`ms~XvwWU=OU]GJ*bf**mB5Tp38h&d*C t%]3L0eb6R1,1y;H$H$RZ*SJi6ZMbRl*,vj-(YO9VY!swc>=;+4I1GkWWL W''5hJXzxqu*NNhO.i)?9YV,:.9?1S&eLi.7tz1A59gAG=\?IqK5+]YjtRG|4OG43TET~o7tA)4 ? 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. . 1218 0 obj <>stream 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 . Medi-Cal is a no-cost or low-cost health coverage program. Summary of Benefits and Coverage (SBC) Template | MS Word Format. Copy Page Link. You can compare options based on price, benefits, and other features that may be important to you. TTY users should call (800) 720-4347. 2023 Inland Empire Health Plan All Rights Reserved. Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) Your Part B premium may differ based on factors including late enrollment, income, and disability status. endobj IMPORTANT: This page has been updated with plan and premium data for the 2023. .manual-search ul.usa-list li {max-width:100%;} 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. 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. If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. hYioH+ 3"> >Ivg@K, 2 0 obj Find out if you qualify for a Special Enrollment Period. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. All Rights Reserved. The SBC shows you how you and the plan would share the cost for covered health care services. also provides the following benefits. .usa-footer .grid-container {padding-left: 30px!important;} SBCs also explain health plans' unique features Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. 4 0 obj Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. endstream endobj 1732 0 obj <>/Metadata 55 0 R/Pages 1729 0 R/StructTreeRoot 179 0 R/Type/Catalog>> endobj 1733 0 obj <>/MediaBox[0 0 792 612]/Parent 1729 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1734 0 obj <>stream The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Please, see below for location details, contact numbers, and hours of operation. The .gov means its official. We only use data released publicly each year. plan (called the premium) will be provided separately. (888) 244-4347 p.usa-alert__text {margin-bottom:0!important;} H8894 001 0 available in Riverside and San Bernardino Counties. d.Y&8&MUgQ All plan-related information on this site is from CMS.gov and Medicare.gov. We use cookies to offer you the best possible website experience. These cookies are required to use this website and can't be turned off. This could be right for you. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. We have several customer service locations across our 7,300 square-mile county where you can find help. For those struggling with low income, we offer assistance programs for food, cash, housing and health coverage. "::B (fPP5HK:~f6|\LrZ* PQoE_}a`@`C'= You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. NOTE: Information about the cost of this plan (called the premium) will be provided separately. IEHP DualChoice (HMO D-SNP) TTY users should call 1-800-718-4347. We care about the people we serve and last year we served one million people in Riverside County. ! <>/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>> Click here to learn more. Want to speak to someone face-to-face? (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. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} See the Part D Premium Reduction section below for more details. We work with county and community partners to provide wrap-around services that help at-risk adults and families find a path forward. See how they can help you, your family, and your community! Any information we provide is limited to those plans we do offer in your area. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. <> The SBC shows you how you and the plan. We partner with agencies and organizations that share our mission to help and protect those most in need.