Council on Aging Answers 2016 - 101

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
HEALTH NET COMMUNITY
SOLUTIONS

HEALTH NET
OF CALIFORNIA

HEALTH NET
OF CALIFORNIA

Seniority Plus Sapphire
Premier H3561-002

Healthy Heart H0562-100

Gold Select H0562-101

HEALTH NET OF
CALIFORNIA
Health Net Seniority Plus
Sapphire
H0562-111

INTER VALLEY HEALTH
PLAN
Inter Valley Health Plan
OC Preferred H0545-013

New enrollment: 800-977-6738
Current Members: 800-431-9007
healthnet.com/medicare

New enrollment: 800-977-6738
Current Members: 800-275-4737
healthnet.com/medicare

New enrollment: 800-977-6738
Current Members: 800-275-4737
healthnet.com/medicare

New enrollment: 800-977-6738
Current Members: 800-431-9007
healthnet.com/medicare

New enrollment: 800-500-7018
Current Members: 800-251-8191
ivhp.com

MA-PD (HMO)
Medi-Medi option

MA-PD (HMO)

MA-PD (HMO)

MA-PD (HMO)
Medi-Medi option

MA-PD (HMO)

$31.00 monthly premium
$310 drug plan deductible

$20 monthly premium

$0 monthly premium

$31.00 monthly premium
$290 drug plan deductible

$0 monthly premium

13001-14000 providers

1001-1500 providers

1001-1500 providers

13001-14000 providers

6501-7000 providers

$6,700 In-Network

$3,000 In-Network

$2,200 In-Network

$6,700 In-Network

$2,000 In-Network

20%/20% of cost each visit

$0/$0 each visit

$0/$0 each visit

20%/20% of cost each visit

$0/$0 each visit

90 days each benefit period. 60 lifetime Days 1-5: $200/day, Days 6-90:
reserve days. Contact plan for more
$0/day. $0/day after 90 days. Unlimited
details.
days each benefit period.

$0 copay. Unlimited days each benefit
period.

90 days each benefit period. 60 lifetime $0 copay. Unlimited days each benefit
reserve days. Contact plan for more
period.
details.

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

Days 1-20: $0/day, Days 21100: $75/day. 100 days each benefit
period.

Days 1-20: $0/day, Days 21100: $75/day. 100 days each benefit
period.

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

Days 1-13: $0/day, Days 14100: $40/day. 100 days each benefit
period.

20% of cost each service

$250 each service

$250 each service

20% of cost each service

$200 each service

20% of cost for Part B chemotherapy
drugs

20% of cost for Part B chemotherapy
drugs

20% of cost for Part B chemotherapy
drugs

20% of cost for Part B chemotherapy
drugs

20% of cost for Part B chemotherapy
drugs

20% of cost for subluxation manipulation $0 for subluxation manipulation

$0 for subluxation manipulation

20% of cost for subluxation manipulation $0 for subluxation manipulation

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

$0 for monitoring supplies. $0 for selfmanagement training. 20% of cost for
therapeutic shoes or inserts.

$0 for monitoring supplies. $0 for selfmanagement training. 20% of cost for
therapeutic shoes or inserts.

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

$0 for monitoring supplies. $0 for selfmanagement training. 10% of cost for
therapeutic shoes or inserts.

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

$60 for diagnostic radiology services. $0
for diagnostic tests and procedures. $0
for lab services. $0 each x-ray. $60 for
therapeutic radiology services.

$60 for diagnostic radiology services. $0
for diagnostic tests and procedures. $0
for lab services. $0 each x-ray.
$60 for therapeutic radiology services.

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

$60 for diagnostic radiology services. $0
for diagnostic tests and procedures. $0
for lab services. $0 each x-ray.
$15 for therapeutic radiology services.

20% cost each visit, waived if admitted
immediately.

$75 each visit, waived if admitted
immediately.

$75 each visit, waived if admitted
immediately.

20% cost each visit, waived if admitted
immediately.

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

20% of cost each visit

$0-$200 each visit

$0 each visit

20% of cost each visit

$0 each visit

20% of cost each visit

$0 each visit

$0 each visit

20% of cost each visit

$0 each cardiac visit.
$10 each all other visits.

$0 copay

Not covered

$0 copay

$0 copay

Not covered

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

$0 for limited dental

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

$0 for limited dental. $10 for cleaning.
$0-$10 for x-rays. $10$12 for fluoride treatment. $4 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 $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.

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 $250
for hearing aids.

$0-$25 for diagnostic exam. $10 for
routine eye exam. $0 for eyewear after
cataract surgery.

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.
$0 for eyewear after cataract surgery.
Plan pays up to $200 for eyewear.

$0 for diagnostic exam. $15 for routine
eye exam. $25 for eyeglasses. $0 for
eyewear after cataract surgery. Plan pays
up to $100 for eyewear.

20% of cost for diagnostic exam.
$0-$30 for diagnostic exam. $30 for
$0 for routine eye exam. $0 for contact routine eye exam. $0 for eyewear after
lenses. $0 for eyeglasses. $0 for eyeglass cataract surgery.
frames. $0 for eyeglass lenses.
$0 for eyewear after cataract surgery.
Plan pays up to $500 for eyewear.

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.

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.
Council On
County
| 714-479-0107
| www.coaoc.org	
Answers Guide 2016

101


http://www.healthnet.com/medicare http://www.healthnet.com/medicare http://www.healthnet.com/medicare http://www.healthnet.com/medicare http://www.ivhp.com

Table of Contents for the Digital Edition of Council on Aging Answers 2016

Contents
Council on Aging Answers 2016 - Intro
Council on Aging Answers 2016 - Cover1
Council on Aging Answers 2016 - Cover2
Council on Aging Answers 2016 - 1
Council on Aging Answers 2016 - Contents
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Council on Aging Answers 2016 - Cover3
Council on Aging Answers 2016 - Cover4
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