Council on Aging Answers 2017 - 91

COUNCIL ON AGING - SOUTHERN CALIFORNIA

Medicare Advantage Plans Comparison Chart
SCAN HEALTH PLAN
SCAN Plus
H5425-037
New enrollment:
800-915-7226
Current Members:
800-559-3500
scanhealthplan.com
MA-PD (HMO)
Medi-Medi option offered
$36.30 monthly premium
$75 health plan deductible
$400 drug plan deductible
4001-4500 providers
$4,500 In-Network
$0/$0 each visit
90 days each benefit period. 60 lifetime
reserve days. Contact plan for more
details.
100 days each benefit period. Contact
plan for more details.
20% of cost each service
20% of cost for Part B chemotherapy
drugs
20% of cost for subluxation
manipulation. $5 for routine visit.
$0 for monitoring supplies. $0 for selfmanagement training. 20% 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.
20% of cost of Medicare- covered items

UNITEDHEALTHCARE
AARP MedicareComplete
SecureHorizons Plan 1
H0543-004

UNITEDHEALTHCARE
AARP MedicareComplete
SecureHorizons Essential
H0543-121

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

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

MA-PD (HMO)

MA ONLY (HMO)

$0 monthly premium

$0 monthly premium

4001-4500 providers
$4,900 In-Network
$5/$10 each visit
Days 1-5: $150/day, Days 6-90: $0. $0/
day after 90 days. Unlimited days each
benefit period.

4501-5000 providers
$4,900 In-Network
$5/$10 each visit
$50 each stay. Unlimited 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.
$220 each service
20% of cost for Part B chemotherapy
drugs

Days 1-20: $0/day, Days 21-51: $160/
day, Days 52-100: $0/day. 100 days each
benefit period.
$250 each service
20% of cost for Part B chemotherapy
drugs

$10 for subluxation manipulation

$10 for subluxation manipulation

$0 for monitoring supplies. $0 for selfmanagement training. 20% of cost for
therapeutic shoes or inserts.
20% of cost for diagnostic radiology
services. $0 for diagnostic tests and
procedures. $0 each lab service. $0
each x-ray. 20% of cost for therapeutic
radiology services.
20% of cost of Medicare- covered items

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

Notes
Plans may limit the frequency of coverage of a benefit during one or more plan
years. Please contact the plan for further details and to verify all information in
the chart with the respective plan. Plans may limit coverage to select Orange
County zip codes.
Dental Coverage: Medicare does not cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental
plates or other dental devices.
Medicare Part A (Hospital Insurance) will pay for certain dental services that you
get when you're in a hospital. Part A can pay for inpatient hospital care if you
need to have emergency or complicated dental procedures, even though the
dental care is not covered.
Comprehensive dental benefits may require that you pay an applicable copayment for each service you receive from a network dentist. Benefit limits, authorizations and referrals may apply to certain dental services.
The dental coverage benefit section of this chart details the standard dental
coverage from each plan. Standard coverage does not require an additional
premium.
*Optional supplemental dental benefits are available for an extra monthly
premium.
Hearing Coverage: Medicare covers diagnostic hearing and balance evaluations to determine if medical treatment is needed when provided by a physician, audiologist or other qualified provider.
**Optional supplemental hearing benefits are available for an extra monthly
premium.
Medi-Medi Option: Specified plans have an option for beneficiaries who have
Medicare and Medi-Cal benefits. Benefits may include zero or reduced costs.
Medicare Advantage Plans: These plans are also called Medicare Health
Plans and are offered by private companies that contract with Medicare to
provide Part A and Part B benefits to people with Medicare.
There are several different types of Medicare Advantage Plans including HMO's
and PPO's. In this chart you will find the type of plan, offered by each company,
in the "Plan Type" row. Enrollees must utilize plan physicians, providers and
hospitals.

20% of cost each visit

$75 each visit, waived if admitted within $75 each visit, waived if admitted within
24 hours.
24 hours.
$125 each visit
$0 each visit

20% of cost each visit

$10 each visit

$10 each visit

$0 copay

Not covered

Not covered

20% of cost for limited dental

Not covered*

Dental Services copay not available

Out-of-Pocket Maximum: All local MA plans must establish a mandatory
maximum out-of-pocket (MOOP) amount for all Medicare Parts A and B services
to mirror the same out-of-pocket costs an average beneficiary would have
under Original Medicare's fee-for-service program.

$5 for diagnostic exam. $5 for routine
hearing exam. $330-$380 for hearing
aid.

$5 for diagnostic exam. $5 for routine
hearing exam. $330-$380 for hearing
aid.

After meeting the MOOP, a beneficiary's MA plan will cover his/her remaining
Medicare-covered costs for the rest of the calendar year. The mandatory MOOP
is $6,700, but plans can voluntarily set a lower MOOP in exchange for more
flexibility in setting their cost-sharing amounts.

$0 for diagnostic exam. $0 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.

$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 $125 for contacts & up to
$130 for lenses and frames.

20% of cost each visit

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 $699-$999 for
hearing aids.
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 $225 for contacts or frames.

Outpatient Rehab Services: "Outpatient Rehab Services" as used in this
chart includes occupational, physical, and speech therapy services. It does not
include pulmonary therapy services.
Vision Coverage: "Eyewear" as used in this chart includes contact lenses and
eyeglasses. "Eyeglasses" as used in this chart includes frames and lenses.
***Optional supplemental vision benefits are available for an extra monthly
premium.

Confused by Medicare? Call the Council on Aging - Southern California HICAP experts at (800) 434-0222
THE INFORMATION ON THESE CHARTS IS SUBJECT TO CHANGE. Contact the plan to verify information.

Council On
| 714-479-0107
Answers Guide 2017
HICAPAging-Southern
is not liable for missingCalifornia
or incorrect information,
but can help| www.coasc.org	
with accessing the most current information via our HICAP program at 1-800-434-0222.

91


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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
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Council on Aging Answers 2017 - Cover3
Council on Aging Answers 2017 - Cover4
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