Council on Aging Senior Guide 2012 - 131

COUNCIL ON AGING ORANGE COUNTY

2012 MEDICARE ADVANTAGE (HMO, PPO) COMPARISON CHART
Monthly Premium Part C/ Part D Max Out-of Primary -Pocket Care Visit Limit Amount Specialist Visit Inpatient Hospital Care Copay Part B Chemo/ Other Drugs
Ambulance

Services

Home Health Care

DME Item

Annual Part D Deductible

Part D Drugs

Gap Coverage?

Blue Shield of California (H0504) / Medicare Advantage (HMO) Plan
Blue Shield 65 Plus (015) New Enrollments: 800-488-8000 Current Members: 800-776-4466 Website: www.blueshieldca.com/findmedicareplan
$0 / $0 $3,000 In-Network $0 $5 Days 1 - 5: $50 Days 6 - 90: $0 20% of Cost $200 $0 20% of Cost $0 $5 - $80 and/or 33% Many Generics

Blue Shield 65 Plus Choice (021) New Enrollments: 800-488-8000
$0 / $0 $2,000 In-Network $0 $0

Current Members: 800-776-4466
20% of Cost $60

Website: www.blueshieldca.com/findmedicareplan
$0 20% of Cost $0 $0 - $70 and/or 33% Many Generics

$0 Per Stay

Brand New Day (H0838) / Medicare Advantage (HMO)
Brand New Day (022)
$0 / $0 $3,400 In-Network

New Enrollments: 866-255-4795
$0 $7.50

Current Members: 866-255-4795
20% of Cost $50 $0

Website: www.brandnewdayhmo.com
20% of Cost $0 $2.50 $40 Many Generics

Days 1 - 3: $100 Days 4 - 90: $0

Brand New Day HMO Extra Care (023) New Enrollments: 866-255-4795 Current Members: 866-255-4795 Website: www.brandnewdayhmo.com
$0 / $0 $6,7000 In-Network $0 $0 Data Unavailable 20% / 0% of Cost 20% of Cost $0 20% of Cost $320 25% None

2012 MEDICARE ADVANTAGE (HMO, PPO) COMPARISON CHART
Monthly Premium Part C/ Part D Max Out-of Primary -Pocket Care Visit Limit Amount Specialist Visit Inpatient Hospital Care Copay Part B Chemo/ Other Drugs
Ambulance

Services

Home Health Care

DME Item

Annual Part D Deductible

Part D Drugs

Gap Coverage?

Care 1st Medicare Advantage Plan (H5928) / Medicare Advantage (HMO) Plan
Medicare AdvantageOptimum Plan (006) New Enrollments: 800-847-1222 Current Members: 800-544-0088 Website: www.care1st.com/ca/medicare
$0 / $0 $3,400 In-Network $0 $5 Days 1 - 3: $50 Days 4 - 90: $0 20% of Cost $75 $0 20% of Cost $0 $0-$50 and/or 30% Many Generics

CareMore Health Plan (H0544) / Medicare Advantage (HMO) Plan
CareMore Value Plus (002)*
$0 / $0 $3,400 In-Network $0

New Enrollments: 866-622-2820
$0 $0 Per Stay

Current Members: 800-822-6991
0% - 20% of Cost $50 $0

Website: www.caremore.com
20% of Cost $0 $0-$85 and/or 33% All Formulary Drugs

StartSmart with CareMore* (007) New Enrollments: 866-622-2820
$0 / $0 $3,400 In-Network $5 $20 Days 1 - 4: $100 Days 5 - 90: $0

Current Members: 800-822-8720
0% - 20% of Cost $100 $0 20% of Cost

Website: www.caremore.com
$0 $5 - $95 and/or 33% None

Central Health Medicare Plan (H5649) / Medicare Advantage (HMO) Plan
Central Health Medicare Plan (001)
$0 / $0 $3,400 In-Network $0

New Enrollments: 626-388-2390
$0 $0 Per Stay

Current Members: 626-388-2390
$50 $0

Website: www.centralhealthplan.com
$0 $0-$50 and/or 33% All Generics

20% of the Cost

20% of the cost

* Only available to Medicare beneficiaries that reside in certain Orange County zip codes . For more information about the zip codes please contact the plan directly.

Council On Aging-Orange County | 714-479-0107 | www.coaoc.org

Senior Guide OC 2012

131

http://www.blueshieldca.com/findmedicareplan http://www.blueshieldca.com/findmedicareplan http://www.brandnewdayhmo.com http://www.brandnewdayhmo.com http://www.care1st.com/ca/medicare http://www.caremore.com http://www.caremore.com http://www.centralhealthplan.com http://www.coaoc.org

Council on Aging Senior Guide 2012

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