Council on Aging Answers 2016 - 105

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
AETNA MEDICARE

ANTHEM BLUE CROSS

ANTHEM BLUE CROSS

Aetna Medicare Choice Plan
Out-of-Network
H5521-056

Anthem MediBlue Access
In-Network
H8552-020

Anthem MediBlue
Access Out-of-Network
H8552-020

New enrollment: 855-338-7027
Current Members: 800-282-5366
aetnamedicare.com

New enrollment: 844-364-2129
Current members: 877-811-3107
anthem.com/ca/shop

New enrollment: 844-364-2129
Current members: 877-811-3107
anthem.com/ca/shop

MA-PD (PPO)

MA-PD (PPO)

MA-PD (PPO)

$107 monthly premium
$750 health plan deductible
$150 drug plan deductible

$141 monthly premium
$1,250 health plan deductible
$130 drug plan deductible

$141 monthly premium
$1,250 health plan deductible
$130 drug plan deductible

251-500 providers

20000 and above providers

20000 and above providers

$6,700 In-Network
$10,000 In & Out

$6,700 In-Network
$10,000 In & Out

$6,700 In-Network
$10,000 In & Out

40%/40% of cost each visit

$10/$35 each visit

$30/$50 each visit

40% of cost per stay. Unlimited days each benefit Days 1-7: $220/day, Days 8-90:
period.
$0/day. 90 days each benefit period. 60 lifetime
reserve days.

40% of cost per stay. 90 days each benefit period.
60 lifetime reserve days.

40% of cost/stay. 100 days each benefit period.

Days 1-20: $0/day, Days 21100: $80/day. 100 days each benefit period.

15% of cost per stay. 100 days each benefit
period.

$300 each service

$325 or 20% of cost each service

$325 or 20% of cost each service

40% of cost for Part B chemotherapy drugs

20% of cost for Part B chemotherapy drugs

20% of cost for Part B chemotherapy drugs

40% of cost for subluxation manipulation

$20 for subluxation manipulation

$50 for subluxation manipulation

40% of cost for monitoring supplies. 40% of cost $0 for monitoring supplies. $0 for selffor self- management training. 40% of cost for
management training.
therapeutic shoes or inserts.
$0 for therapeutic shoes or inserts.

40% of cost for monitoring supplies. 30% of cost
for self- management training. 30% of cost for
therapeutic shoes or inserts.

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

$100 for diagnostic radiology services. $0-$100
for diagnostic tests and procedures. $10 for lab
services. $25 each x-ray.
20% for therapeutic radiology services.

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

$75 each visit, waived if admitted immediately.

$75 each visit

$75 each visit

40% of cost each visit

$0-$100 each visit

40% of cost each visit

40% of cost for each visit

$50 each cardiac visit.
$25 each all other visits.

40% of cost each cardiac visit.
$50 each all other visits.

Not covered

Not covered

Not covered

40% of cost for limited dental

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

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

40% of cost for diagnostic exam. 40% of cost for $35 for diagnostic exam
routine hearing exam. 40% for hearing aid fitting
or evaluation.

40% of cost for diagnostic exam

40% of cost for diagnostic exam. 40% of cost for
routine eye exam. 40% of cost for eyewear after
cataract surgery.

$0 for diagnostic exam. $0 for routine eye exam.
$0 for eyewear after cataract surgery.
Plan pays up to $69 for routine eye exams from
any provider.

$0 for diagnostic exam. $0 for routine eye exam.
$0 for eyewear after cataract surgery.
Plan pays up to $69 for routine eye exams from
any provider.

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(714)479-0107

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
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this information at www.medicare.gov as updates are frequently made. COAOC is not responsible for these changes but can help with accessing the most current information via our HICAP program 1-800-434-0222.

105


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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
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