Council on Aging Answers 2016 - 97

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
ANTHEM BLUE CROSS

ARCADIAN
HEALTH PLAN, INC.

BLUE SHIELD OF CALIFORNIA

Anthem MediBlue
Coordination Plus
H0564-080

Humana Gold Plus H
5619-021

Humana Gold Plus
H5619-022

Humana Gold Plus
H5619-037

Blue Shield 65 Plus
H0504-015

New enrollment: 800-797-6438
Current members: 888-230-7338
anthem.com/ca/shop

New enrollment: 800-833-2364
Current Members: 800-457-4708
humana.com/medicare

New enrollment: 800-488-8000
Current Members: 800-776-4466
blueshieldcamedicare.com

MA-PD (HMO)

$31.00 monthly premium
$360 drug plan deductible

$0 monthly premium

$39.00 monthly premium

$23.40 monthly premium health plan
deduct.: unavail.
$360 drug plan deductible

$0 monthly premium

9001-10000 providers

12001-13000 providers

13001-14000 providers

$6,700 In-Network

$3,400 In-Network

$6,700 In-Network

$2,800 In-Network

20%/20% of cost each visit

$0/$0 each visit

90 days each benefit period. 60 lifetime
reserve days. Contact plan for more
details.

$0 copay. Unlimited days each benefit
period.

Days 1-90: costs unavailable, Days
$0 copay. Unlimited days each benefit
91-150: $630/day. $0/day after 150 days. period.
Unlimited days each benefit period.

100 days each benefit period. Contact
plan for more details.

Days 1-20: $0/day, Days 21100: $50/day. 100 days each benefit
period.

Days 1-100: $0/day. 100 days each
benefit period.

Days 1-20: $0/day, Days 21100: $160/day. 100 days each benefit
period.

Days 1-20: $25/day, Days 21100: $100/day. 100 days each benefit
period.

20% of cost each service

$125 each service

$50 each service

20% of cost each service

$200 each service

20% of cost for Part B chemotherapy
drugs

20% of cost for subluxation
manipulation

$0 for subluxation manipulation

$0 for subluxation manipulation. $0 for
routine visit.

$0 for subluxation manipulation

$0 for monitoring supplies. $0 for selfmanagement training.
$0 for therapeutic shoes or inserts.

0-20% of cost for monitoring supplies. 0-20% of cost for monitoring supplies. 0-20% of cost for monitoring supplies. $0 for monitoring supplies.
$0 for self- management training. $0 for $0 for self- management training. $0 for $0 for self- management training. $0 for $0 for self-management training. $0 for
therapeutic shoes or inserts.
therapeutic shoes or inserts.
therapeutic shoes or inserts.
therapeutic shoes or inserts.

20% of cost for diagnostic radiology
services. 20% of cost for diagnostic tests
and procedures. 20% of cost for lab
services. 20% of cost each x-ray.
20% of cost for therapeutic radiology
services.

$0-$40 for diagnostic radiology services.
$0 for diagnostic tests and procedures.
$0 for lab services. $0 each x-ray. 20% of
cost for therapeutic radiology services.

20% of cost each visit

$75 each visit, waived if admitted within $75 each visit, waived if admitted within $75 each visit, waived if admitted within $75 each visit
24 hours.
24 hours.
24 hours.

20% of cost each visit

$0 each visit

20% of cost each visit

$100 each visit

20% of cost each visit

$0 each visit

0-20% of cost each visit

$20 each cardiac visit.
$15 each all other visits.

$0 copay

Not covered

20% of cost for limited dental.
$0 for cleaning. $0 for x-rays. $0 for
oral exam.

$0 for limited dental. $0 for cleaning. $0 $0 for limited dental. $0 for cleaning. $0 $0 for for limited dental. $0 for cleaning. $0 for limited dental
for x-rays. $0 for oral exam.
for x-rays. $0 for fluoride treatment. $0 $0 for x-rays. $0 for oral exam.
for oral exam.

20% of cost for diagnostic exam.
$0 for routine hearing exam. $0 for
hearing aid fitting or evaluation. $0 for
hearing aid.
Plan pays up to $2,000 for hearing aids.

$0 for diagnostic exam. $0 for routine
hearing exam. $0 for hearing aid fitting
or evaluation.
$0 for hearing aid. Plan pays up to
$1,000 for hearing aids.

$0 for diagnostic exam. $0 for routine
hearing exam.

20% of cost for diagnostic exam.
$0 for routine eye exam. $0 for contact
lenses. $0 for eyeglasses. $0 for eyeglass
frames. $0 for eyeglass lenses.
20% of cost for eyewear after cataract
surgery. Plan pays up to $100 for
eyewear.

$0 for diagnostic exam. $0 for routine
eye exam. $0 for contact lenses. $0
for eyeglasses. $0 for eyewear after
cataract surgery.
Plan pays up to $100 for eyewear.

$0 for diagnostic exam. $0 for routine
eye exam. $0 for contact lenses. $0 for
eyeglasses. 20% of cost for eyewear
after cataract surgery. Plan pays up to
$200 for eyewear.

$0 for diagnostic exam. $10 for routine
eye exam. $20 for eyeglass frames. $20
for eyeglass lenses. $0 for eyewear after
cataract surgery. Plan pays up to $75.00
for eyeglass frames

$0-$40 for diagnostic radiology services.
$0 for diagnostic tests and procedures.
$0 for lab services. $0 each x-ray.
20% of cost for therapeutic radiology
services.

0-20% of cost for diagnostic radiology
services. 0-20% of cost for diagnostic
tests and procedures. 0-20% of cost for
lab services. 0- 20% of cost each x-ray.
20% of cost for therapeutic radiology
services.

$40 for diagnostic radiology services. $0
for diagnostic tests and procedures. $0
each lab service. $0 each x-ray. 20% of
cost for therapeutic radiology services.

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
THE INFORMATION ON THESE CHARTS IS SUBJECT TO CHANGE. Contact the plan to verify information.

Council On
County
| 714-479-0107
| www.coaoc.org
Answers Guide 2016
HICAPAging-Orange
is not liable for missing
or incorrect
information, but can
help with accessing the most current information via our HICAP program at 1-800-434-0222.

http://www.anthem.com/ca/shop http://www.humana.com/medicare http://www.humana.com/medicare http://www.humana.com/medicare http://www.blueshieldcamedicare.com

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