Council on Aging Answers 2016 - 102

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
KAISER PERMANENTE

SCAN HEALTH PLAN

SCAN HEALTH PLAN

UNITEDHEALTHCARE

Kaiser Permanente Senior
Advantage L.A., Orange Co.
H0524-003

SCAN Classic
H5425-007

SCAN Plus
H5425-037

AARP MedicareComplete
SecureHorizons Premier
H0543-004

New enrollment: 800-777-1238
Current Members: 800-443-0815
kp.org/medicare

New enrollment: 800-915-7226
Current Members: 800-559-3500
scanhealthplan.com

New enrollment: 800-915-7226
Current Members: 800-559-3500
scanhealthplan.com

New enrollment: 800-555-5757
Current Members: 800-950-9355
aarpmedicareplans.com

MA-PD (HMO)

MA-PD (HMO)

MA-PD (HMO)
Medi-Medi option

MA-PD (HMO)

$0 monthly premium

$0 monthly premium

$31.10 monthly premium health plan
deduct.: unavail.
$360 drug plan deductible

$0 monthly premium

SIZE OF NETWORK

5501-6000 providers

3501-4000 providers

3501-4000 providers

4001-4500 providers

OUT OF POCKET MAXIMUM

$4,400 In-Network

$2,900 In-Network

$6,000 In-Network

$4,900 In-Network

DOCTOR/SPECIALIST VISIT

$5/$5 each visit

$0/$0 each visit

20%/20% of cost each visit

$5/$10 each visit

INPATIENT HOSPITALIZATION

Days 1-7: $240/day, Days 8-90:
$0/day. $0/day after 90 days. Unlimited
days each benefit period.

$0 copay. Unlimited days each benefit
period.

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

Days 1-5: $150/day, Days 6-90:
$0. $0/day after 90 days. Unlimited days
each benefit period.

SKILLED NURSING FACILITY

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

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

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

Days 1-20: $0/day, Days 21-51:
$160/day, Days 52-100:
$0/day. 100 days each benefit period.

AMBULANCE

$200 each service

$200 each service

20% of cost each service

$250 each service

CHEMOTHERAPY DRUGS

$0-$45 copay 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

$5 for subluxation manipulation

$0 for subluxation manipulation

20% for subluxation manipulation. $5 for $10 for subluxation manipulation
routine visit.

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

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

20% for monitoring supplies.
20% of cost 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.

$100 for diagnostic radiology services.
$0 for diagnostic tests and procedures.
$0 for lab services. $0 each x-ray. $50 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 for each x-ray. 20% of cost
for therapeutic radiology services.

20% of cost for diagnostic radiology
services. $9 for diagnostic tests and
procedures.
$9 for lab services. $0 each x- ray. 20% of
cost for therapeutic radiology services.

TELEPHONE NUMBERS AND
WEBSITE
PLAN TYPE
TOTAL MONTHLY PREMIUM &
ANNUAL DEDUCTIBLES

CHIROPRACTIC

DIABETES

$45-$165 for diagnostic radiology
services. $25 for diagnostic tests and
procedures.
DIAGNOSTIC TESTS, LAB &
RADIOLOGY SERVICES, AND X-RAYS $25 for lab services. $45 each x- ray. $0
for therapeutic radiology services.
EMERGENCY ROOM VISIT

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

$75 each visit

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

OUTPATIENT HOSPITAL SERVICES

$75-$210 each visit

$0-$100 each visit

20% of cost each visit

$125 each visit

OUTPATIENT REHAB SERVICES

$5 each occupational or cardiac visit.
$0-$5 each all other visits.

$10 each visit

20% of cost each visit

$10 each visit

TRANSPORTATION

Not covered

$0 copay

$0 copay

Not covered

DENTAL SERVICES

$5 for limited dental

$0 for limited dental

20% for limited dental

$10 for limited dental

$5 for diagnostic exam. $5 for routine
hearing exam.

$0 for diagnostic exam. $0 for routine
hearing exam. $0 for hearing aid fitting
or evaluation.
$0 for hearing aid. Plan pays up to $500
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 $1,400 for hearing aids.

$5 for diagnostic exam. $5 for routine
hearing exam. $390$450 for hearing aid.

$5 for diagnostic exam. $0-$5 for routine
eye exam. $0 for contact lenses. $0 for
eyeglasses. $0 for eyeglass lenses. $0 for
eyewear after cataract surgery. Plan pays
up to $40 for eyewear.

$0 for diagnostic exam. $0 for routine
eye exam. $35 for contact lenses. $35 for
eyeglasses. $0 for eyeglass frames. $35
for eyeglass lenses.
$0 for eyewear after cataract surgery.
Plan pays up to $105 for contacts or
frames.

0-20% 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 $175 for contacts
or frames.

$0-$10 for diagnostic exam. $10 for
routine eye exam. $0 for contact lenses.
$0 for eyeglass frames. $0 for eyeglass
lenses.
$0 for eyewear after cataract surgery.
Plan pays up to $105 for contacts & up to
$70 for frames.

HEARING SERVICES

VISION SERVICES

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
102

Answers Guide 2016	

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

COUNCIL
- ORANGE
IS Aor
501incorrect
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butTOcan
help with
accessing
the
most
current
information
via| our
HICAP
program
Aging
and
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Connection
800-510-2020
| 1-800-434-0222.
www.adrcoc.org
INCLUSION DOES NOT IMPLY A RECOMMENDATION OR ENDORSEMENT OF PRODUCTS OR SERVICES BY COAOC. ALWAYS BE A VIGILANT CONSUMER. VERIFY INFORMATION AND SEEK REFERENCES WHERE APPROPRIATE.


http://www.kp.org/medicare http://www.scanhealthplan.com http://www.scanhealthplan.com http://www.aarpmedicareplans.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
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Council on Aging Answers 2016 - Cover3
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