Share via LinkedIn. 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). Share via Email. %PDF-1.5 % Every child deserves a stable, safe, and supportive family. Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). endobj See the Part D Premium Reduction section below for more details. 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. 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). offers the following coverage and cost-sharing. ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA 711 (TTY), To Enroll with IEHP Our mission is to help our residents find a path to financial independence. This is only a summary. A summary of benefits and coverage (SBC) is a document that all insurance companies are required to provide. ei;N. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. 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 partner with agencies and organizations that share our mission to help and protect those most in need. 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. ol{list-style-type: decimal;} Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. We use cookies to offer you the best possible website experience. Evidence of Coverage. Once you reach that amount, you will enter the next coverage phase. TTY users should call (800) 720-4347. 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. LYK%-dQrqc*D|3-:HAdFfZ! 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. It details the coverage and costs for any Affordable Care Act-compliant health plan. Apply here and learn more about benefits. Become a foster or adoptive parent. This is only a summary. This is only a summary. The SBC shows you how you and the plan would share the cost for covered health care services. Please read the Evidence of Coverage for the full list of benefits. <> The call is free. You need a roof over your head. The SBC shows you how you and the plan. Essential Health Benefits Summary A one-page Essential Health Benefits Summary is available for download. d.Y&8&MUgQ The SBC shows you how you and the plan would share the cost for covered health care services. We want to help. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. %%EOF The SBC shows you how you and the plan would share the cost for covered health care services. These cookies are required to use this website and can't be turned off. %%EOF Get help from a licensed Medicare agent. -l 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 This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. We provide access to caregivers who help at-risk adults live safely and independently in their own home. View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. Learn more about resources in languages other than English. %%EOF Help yourself and impact your community by clicking here to learn more! A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. You have the right to an easy-to-understand summary about a health plans benefits and coverage. Plan Overview. Trust is built on communication. Contact the plan for details. ozI?TNt2J\2 k/=Ak Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. %PDF-1.7 % NOTE: Information about the cost of this plan (called the premium) will be provided separately. All plan-related information on this site is from CMS.gov and Medicare.gov. A short, plain-language Summary of Benefits and Coverage (SBC), A Uniform Glossary of terms used in health coverage and medical care. SBCs also explain health plans' unique features We protect our communitys most vulnerable children and adults. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. You can become the loving parent a child needs and deserves. 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. If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. }Y+\(s1Qi}=Y1$C'oX` Learn more here. %PDF-1.7 It is a legal document that explains your health care plan and should answer many important questions about your benefits. hb```f``Z pA2,Nh0b 3 0 obj You may request a printed copy of the Member Handbook by calling our Member Services department at 1-855-270-2327 (TTY 711 ). 1731 0 obj <> endobj endobj The SBC shows you how you and the plan would share the cost for covered health care services. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 324 0 obj <> endobj This is only a summary. Press Tab to Move to Skip to Content Link. 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. Your Part B premium may differ based on factors including late enrollment, income, and disability status. 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. Were here to help! This could be right for you. Learn more about how your agency or business can join our the team that strengthens individuals and communities. 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. IEHP DualChoice (HMO D-SNP) Here you can find access to Family Resource Centers and crisis prevention services. endobj (800) 718-4347 (TTY), IEHP DualChoice Member Services 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 Your family is your top priority. 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), $0 copay (limits may apply) (authorization not required) (referral not required). 0 .table thead th {background-color:#f1f1f1;color:#222;} For those struggling with low income, we offer assistance programs for food, cash, housing and health coverage. is offered in the following locations. Your HBA, usually located in your agency's personnel office, can also print you a copy . Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. The SBC shows you how you and the plan would share the cost for covered healthcare services. Other languages can be selected below. As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. This is only a summary. .agency-blurb-container .agency_blurb.background--light { padding: 0; } stream Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Community is built on trust. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. IEHP DualChoice (HMO D-SNP) offers the following coverage and cost-sharing. 2 0 obj IEHP DualChoice (HMO D-SNP) Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. IEHP DualChoice (HMO D-SNP) IEHP DualChoice (HMO D-SNP) <> The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Youll also find access to services for those in crisis here. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. % IEHP DualChoice (HMO D-SNP) hYioH+ 3"> >Ivg@K, Click to Call 1-877-354-4611 TTY 711. 1457 0 obj <>stream 1800 0 obj <>stream NOTE: Information about the cost of this plan (called the premium) will be provided separately. hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 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 ? This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . In fact, its our top priority. You may also call Health Care Options at 1-800-430-4263. would share the cost for covered health care services. for details. 2023 Inland Empire Health Plan All Rights Reserved. This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. Please check the plans formulary for specific drugs covered. This is only a . IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. 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. This is only a summary. 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 $7,400.00. Because we respect your right to privacy, you can choose not to allow some types of cookies. This is only a summary. Advantage Plus benefits and premiums . NOTE: Information about the cost of this plan (called the premium) will be provided separately. See the . In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. p.usa-alert__text {margin-bottom:0!important;} .manual-search ul.usa-list li {max-width:100%;} IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. #block-googletagmanagerheader .field { padding-bottom:0 !important; } endstream endobj 1732 0 obj <>/Metadata 55 0 R/Pages 1729 0 R/StructTreeRoot 179 0 R/Type/Catalog>> endobj 1733 0 obj <>/MediaBox[0 0 792 612]/Parent 1729 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1734 0 obj <>stream View Plan Details How to Get Care IEHP DualChoice Cal MedConnect Plan (Medicare-Medicaid Plan): Summary of Benefits 2022 If you have questions , please call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$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. 4 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. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X For more information , visit www.iehp.org. 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. 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 [CDATA[/* >