Council on Aging Senior Guide 2013 - 110

COUNCIL ON AGING ORANGE COUNTY

2013 MEDICARE ADVANTAGE SPECIAL NEEDS (SNP) CHRONIC OR DISABLING CONDITION AND INSTITUTIONAL PLAN - COMPARISON CHART
Monthly Premium Max Out-of Primary -Pocket Care Visit Limit Amount Specialist Visit Inpatient Hospital Care Part B Chemo/ Other Drugs
Ambulance

Services

Home Health Care

DME Item

Annual Part D Deductible

Part D Drugs

Gap Coverage?

Health Net of California (H0562) / Medicare Advantage (HMO SNP) Plan Continued
Health Net Jade (092)
$0 $3,400 In-Network

New Enrollments: 800-977-6738
$0 $0 $0 Per Stay

Current Members: 800-431-9007
20% of the Cost $90 $0

Website: www.healthnet.com
10% of the Cost $0 $0 - $95 and/or 33% None

SCAN Health Plan (H5425) / Medicare Advantage (HMO SNP) Plan
Heart First (028)
$0 $3,400 In-Network

New Enrollments: 800-915-7226
$0 $0 $0 Per Stay

Current Members: 800-559-3500
20% of the Cost $50 $0

Website: www.scanhealthplan.com
20% of the Cost $0 $0 - $70 and/or 33% None

SCAN Balance (034)
$0 $3,400 In-Network

New Enrollments: 800-915-7226
$0 $5 $0 Per Stay

Current Members: 800-559-3500
20% of the Cost $50 $0

Website: www.scanhealthplan.com
20% of the Cost $0 $0 - $70 and/or 33% None

SCAN Health Plan (H9104) / Medicare Advantage (HMO SNP) Plan
SCAN Healthy at home (Institutional) (007) New Enrollments: 800-915-7226 Current Members: 800-559-3500 Website: www.scanhealthplan.com
$0 $6,700 In-Network $0 $5 Days 1 - 8: $50 Days 9 - 90: $0 20% of the Cost $100 $0 20% of the Cost $0 $3 - $80 and/or 33% None

2013 MEDICARE ADVANTAGE SPECIAL NEEDS (SNP) PLANS FOR INDIVIDUALS WITH BOTH MEDICARE AND MEDI-CAL - COMPARISON CHART**
Monthly Premium Max Out-of Primary Specialist -Pocket Care Visit Visit Limit Amount Inpatient Hospital Care Part B Chemo/ Other Drugs
Ambulance

Services

Home Health Care

DME Item

Annual Part D Deductible

Part D Drugs

Gap Coverage?

Brand New Day (H0838) / Medicare Advantage (HMO SNP) Plan
Brand New Day D SNP (024)
$0 $6,700 In-Network $0

New Enrollments: 866-255-4795
$0 $0 Per Visit

Current Members: 866-255-4795
$0 $0 $0

Website: www.brandnewdayhmo.com
$0 $0 $1.15 $3.50 None

Care1st Medicare Advantage Plan (H5928) / Medicare Advantage (HMO SNP) Plan
Care1st TotalDual Plan (005)
$0 $1 In-Network $0

New Enrollments: 800-847-1222
$0 $0 Per Visit

Current Members: 800-544-0088
$0 $0 $0

Website: www.care1st.com/ca/medicare
$0 $0 $1.15 $3.50 None

Health Net of California (H0562) / Medicare Advantage (HMO SNP) Plan
Health Net Seniority Plus Amber I (055)
$0 $6,700 In-Network $0

New Enrollments: 800-977-6738
$0 $0 Per Stay $0

Current Members: 800-431-9007
$0 $0 $0

Website: www.healthnet.com
$0 $1.15 $3.50 None

** Must have Medicare and Zero Share of Cost Medi-Cal in order to enroll in any of Dual SNP plans listed. Cost sharing listed applies to those that have Zero Share of Cost Medi-Cal. Please contact HICAP at 714-560-0424 or 800-434-0222 for more information.

110

Senior Guide OC 2013

COUNCIL ON AGING-ORANGE COUNTY (COAOC)SUBJECT TO CHANGE. ThisAging and Disability FREE OF COST, WE MUST SELL ADVERTISING|SPACE. WHILE WE APPRECIATE THE PAIDConsumers needGUIDE, THEIR THE INFORMATION ON THESE CHARTS IS IS A 501 (C) 3 NONPROFIT CORPORATION. TOthe most current available from the CenterConnection 800-510-2020 | www.adrcoc.org this information is DISTRIBUTE THE GUIDE Resource for Medicare and Medicaid Services on the date of publication. LISTINGS IN THE to verify INCLUSION DOES NOT IMPLY A RECOMMENDATIONare frequently made.OF PRODUCTS OR SERVICE BY COAOC. ALWAYScanA VIGILANT CONSUMER. VERIFY INFORMATION ANDvia our HICAP program 1-800-434-0222. information at www.medicare.gov as updates OR ENDORSEMENT COAOC is not responsible for these changes but BE help with accessing the most current information SEEK REFERENCES WHERE APPROPRIATE.
http://www.healthnet.com http://www.scanhealthplan.com http://www.scanhealthplan.com http://www.scanhealthplan.com http://www.brandnewdayhmo.com http://www.care1st.com/ca/medicare http://www.healthnet.com http://www.medicare.gov
Council on Aging Senior Guide 2013

Table of Contents for the Digital Edition of Council on Aging Senior Guide 2013
