Council on Aging Answers 2017 - 84

COUNCIL ON AGING - SOUTHERN CALIFORNIA

Medicare Advantage Plans Comparison Chart
ALIGNMENT HEALTH PLAN

ALIGNMENT HEALTH PLAN

ALIGNMENT HEALTH PLAN

ANTHEM BLUE CROSS

Platinum Plan
H3815-008

CalPlus Plan
H3815-009

smartHMO Plan
H3815-013

Anthem MediBlue Select
H0564-063

TELEPHONE NUMBERS
AND WEBSITE

New enrollment:
888-979-2247
Current members:
866-634-2247
alignmenthealthplan.com

New enrollment:
888-979-2247
Current members:
866-634-2247
alignmenthealthplan.com

New enrollment:
888-979-2247
Current members:
866-634-2247
alignmenthealthplan.com

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

PLAN TYPE

MA-PD (HMO)

MA-PD (HMO)
Medi-Medi option offered

MA-PD (HMO)

MA-PD (HMO)

TOTAL MONTHLY PREMIUM
& ANNUAL DEDUCTIBLES

$0 monthly premium

$36.30 monthly premium
$400 drug plan deductible

$0 monthly premium

$0 monthly premium

SIZE OF NETWORK
OUT OF POCKET MAXIMUM
DOCTOR/SPECIALIST VISIT

7501-8000 providers
$2,200 In-Network
$0/$0 each visit

11001-12000 providers
$3,400 In-Network
$0/$0 each visit

7501-8000 providers
$3,400 In-Network
$0/$10 each visit

12001-13000 providers
$1,900 In-Network
$0/$0 each visit

IN-PATIENT HOSPITALIZATION

$0 copay. Unlimited days each benefit
period.

90 days each benefit period. 60 lifetime
reserve days. Contact plan for more
details.
Days 1-20: $0/day, Days 21-100: $50/day. Days 1-20: $0/day, Days 21-100: $161/day.
100 days each benefit period.
100 days each benefit period.
$125 each service, waived if admitted. 20% of cost each service

Days 1-5: $120/day, Days 6-90: $0/day.
$0/day after 90 days. Unlimited days
each benefit period.
Days 1-20: $20/day, Days 21-100: $100/
day. 100 days each benefit period.
$100 each service, waived if admitted.

20% of cost for Part B chemotherapy
drugs
$10 for subluxation manipulation
$0 for monitoring supplies.
$0 for self-management training. 20% of
cost for therapeutic shoes or inserts.

20% of cost for Part B chemotherapy
drugs
20% of cost for subluxation manipulation
$0 for monitoring supplies.
$0 for self-management training. 20% of
cost for therapeutic shoes or inserts.

20% of cost for Part B chemotherapy
drugs
$10 for subluxation manipulation
$0 for monitoring supplies.
$0 for self-management training. 20% of
cost for therapeutic shoes or inserts.

20% of cost for Part B chemotherapy
drugs
$0 for subluxation manipulation
$0 for monitoring supplies. $0 for selfmanagement training. $0 for therapeutic
shoes or inserts.

DIAGNOSTIC TESTS, LAB &
RADIOLOGY SERVICES,
AND X-RAYS

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

$0 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.

$85 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.

DURABLE MEDICAL EQUIPMENT

20% of cost of Medicare- covered items

20% of cost of Medicare- covered items

20% of cost of Medicare- covered items

0-20% of cost of Medicare-covered items

SKILLED NURSING FACILITY
AMBULANCE
CHEMOTHERAPY DRUGS
CHIROPRACTIC
DIABETES

$0 copay. Unlimited days each benefit
period.
Days 1-20: $0/day, Days 21-100: $145/
day. 100 days each benefit period.
$200 each service

OUTPATIENT HOSPITAL SERVICES

$75 each visit, waived if admitted within 20% of cost each visit, waived if admitted $75 each visit, waived if admitted within
$75 each visit
24 hours.
within 3 days.
24 hours.
$100 each visit
20% of cost each visit
$150 each visit
$0 each visit

OUTPATIENT REHAB SERVICES

$0 each visit

20% of cost each visit

$0 each visit

$0 each visit

TRANSPORTATION

$0 copay

$0 copay

Not covered.

$0 copay

DENTAL SERVICES
(SEE NOTES FOR *)

$0-$425 for limited dental. $0 for
cleaning. $0-$30 for x-rays. $0-$20 for
fluoride treatment. $0 for oral exam.

$0-$425 for limited dental. $0 for
cleaning. $0-$30 for x-rays. $0-$20 for
fluoride treatment. $0 for oral exam.

$0 for limited dental

$0 for limited dental. $0 for cleaning. $0
for oral exam.*

HEARING SERVICES
(SEE NOTES FOR **)

$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. $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 diagnostic exam. $0 for routine
hearing exam. $0 for hearing aid fitting
or evaluation. $0 copay for hearing aid.
Plan pays up to $3,000 for hearing aids.

VISION SERVICES
(See Notes for ***)

$0 for diagnostic exam. $0 for routine
eye exam. $0 for contact lenses. $0 for
eyeglasses. $0 for eyeglass frames. $0
for eyeglass lenses. $0 for eyewear after
cataract surgery. Plan pays up to $200
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 $300
for eyewear.

EMERGENCY ROOM VISIT

$0 for diagnostic exam. $0 for routine
$0 for diagnostic exam. $0 for routine
eye exam. $0 for contact lenses. $0 for eye exam. $0 for eyewear after cataract
eyeglass frames. $0 for eyeglass lenses. surgery.***
$0 for eyewear after cataract surgery.
Plan pays up to $100 for contacts & up to
$200 for glasses, frames and lenses.

Confused by Medicare? Call the Council on Aging - Southern California HICAP experts at (800) 434-0222
84

Answers Guide 2017	

THE INFORMATION ON THESE CHARTS IS SUBJECT TO CHANGE. Contact the plan to verify information.

COUNCILHICAP
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CORPORATION.
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INCLUSION DOES
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OR ENDORSEMENT
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PRODUCTS
OR SERVICES
BY COASC.the
ALWAYS
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CONSUMER. VERIFY
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AND SEEKat
REFERENCES
WHERE APPROPRIATE.


http://www.alignmenthealthplan.com http://www.alignmenthealthplan.com http://www.alignmenthealthplan.com http://www.anthem.com/ca/shop

Table of Contents for the Digital Edition of Council on Aging Answers 2017

Contents
Council on Aging Answers 2017 - Intro
Council on Aging Answers 2017 - Cover1
Council on Aging Answers 2017 - Cover2
Council on Aging Answers 2017 - 1
Council on Aging Answers 2017 - Contents
Council on Aging Answers 2017 - 3
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Council on Aging Answers 2017 - 1a
Council on Aging Answers 2017 - 1b
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Council on Aging Answers 2017 - 2a
Council on Aging Answers 2017 - 2b
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Council on Aging Answers 2017 - 3a
Council on Aging Answers 2017 - 3b
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Council on Aging Answers 2017 - Cover3
Council on Aging Answers 2017 - Cover4
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