iehp summary of benefits and coverage

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`O"`RLg@d0LRA vO6 IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. 340 0 obj <>/Filter/FlateDecode/ID[<7683F4A8D47BF441B51CA1406C79AE5A>]/Index[324 78]/Info 323 0 R/Length 83/Prev 576238/Root 325 0 R/Size 402/Type/XRef/W[1 2 1]>>stream See the Part D Premium Reduction section below for more details. Trust is built on communication. would share the cost for covered health care services. We have several customer service locations across our 7,300 square-mile county where you can find help. Podiatry Chiropractic Allergy care Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. /*--> >Ivg@K, Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Please check the plans formulary for specific drugs covered. Additionally, you can freely decide and change any time whether you accept cookies or choose to opt out of cookies to improve website's performance, as well as cookies used to display content tailored to your interests. This is only a summary. %PDF-1.6 % All insurance agents and enrollment platforms linked to this site have their own terms and conditions. Learn more here. H8894 001 0 available in Riverside and San Bernardino Counties. The call is free. IEHP offers a competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan. Inland . The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. KtV After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. We do not offer every plan available in your area. 0 A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Yes. .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} After you pay your $505.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. (866) 294-4347 Medicare has neither approved nor endorsed any information on this site. div#block-eoguidanceviewheader .dol-alerts p {padding: 0;margin: 0;} TTY users should call 1-800-430-7077. Here you can find access to Family Resource Centers and crisis prevention services. Some of the services listed are covered only if IEHP or your IPA approves first. JQua/V7 25O,G RlJ E7j{ Insurance companies and job-based health plans must provide you with: This information helps you make apples-to-apples comparisons when youre looking at plans. This is only a summary. IEHP DualChoice (HMO D-SNP) Help yourself and impact your community by clicking here to learn more! hYmOH+qn[Z!ff{]&1`ms~XvwWU=OU]GJ*bf**mB5Tp38h&d*C t%]3L0eb6R1,1y;H$H$RZ*SJi6ZMbRl*,vj-(YO9VY!swc>=;+4I1GkWWL W''5hJXzxqu*NNhO.i)?9YV,:.9?1S&eLi.7tz1A59gAG=\?IqK5+]YjtRG|4OG43TET~o7tA)4 ? hbbd```b`` "A$ri " %f=X$L0i&u@d{:d Coverage for: Individual + Family | Plan Type: EPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. .usa-footer .grid-container {padding-left: 30px!important;} This is only a summary. Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. It details the coverage and costs for any Affordable Care Act-compliant health plan. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. Contact a plan for a Summary of Benefits. Before sharing sensitive information, make sure youre on a federal government site. We want the best for our communities, so we are eager to collaborate with innovative partners who share our dedication to improving the health, safety, and wellbeing of individuals and families! As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. .paragraph--type--html-table .ts-cell-content {max-width: 100%;} These cookies are required to use this website and can't be turned off. !c YJya%XL The coverage examples will illustrate sample medical situations and describe how much coverage the plan would provide in an event such as having a baby (normal delivery) or managing Type 2 diabetes (routine maintenance, well-controlled). Copy Page Link. Summary of Benefits and Coverage (SBC) Template | MS Word Format. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Every child deserves a stable, safe, and supportive family. %PDF-1.7 Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services Youll find a link to the SBC on each plan page when you preview plans and prices before logging in, and when you've finished your application and are comparing plans. important to review plan coverage, costs, and benefits before you enroll. Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) You may also call Health Care Options at 1-800-430-4263. Summary of Benefits and Coverage (SBC) An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. Learn more by clicking here. .table thead th {background-color:#f1f1f1;color:#222;} We offer cash and housing assistance, such as access to hotel/motel vouchers. endobj TTY users should call 1-800-718-4347. The SBC shows you how you and the plan. SBCs also explain health plans' unique features It is a legal document that explains your health care plan and should answer many important questions about your benefits. Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). The Summary of Benefits and Coverage (SBC) is simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA). IEHP DualChoice (HMO D-SNP) Here youll find the DPSS newsletter, press releases, compelling videos, regular podcasts and contact information for media inquiries. #block-googletagmanagerfooter .field { padding-bottom:0 !important; } Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. Adults pay no monthly premium for Medi-Cal coverage. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. Advantage Plus benefits and premiums . Evidence of Coverage. )9& Fs?I_oD!0sF##H062* gFDh\J:*&n=cQ9G&3 Sd;Fb(LE/Ebd) *FJ>DVtQpQ3 oc$C#$3T.Y6N',FLX8O*aHaL9 Ma]\L)k)B\)6&BO_ZNp0,/.~9# .cd-main-content p, blockquote {margin-bottom:1em;} While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Learn more about resources in languages other than English. stream We partner with agencies and organizations that share our mission to help and protect those most in need. Please read the Evidence of Coverage for the full list of benefits. Washington, DC 202101-866-4-USA-DOL, Employee Benefits Security Administration, Mental Health and Substance Use Disorder Benefits, Children's Health Insurance Program Reauthorization Act (CHIPRA), Special Financial Assistance - Multiemployer Plans, Delinquent Filer Voluntary Compliance Program (DFVCP), State All Payer Claims Databases Advisory Committee (SAPCDAC), Summary of Benefits and Coverage and Uniform Glossary, Notice Agency Information Collection Activities, Solicitation of comments Templates, Instructions, and Related Materials, Culturally and Linguistically Appropriate Services (CLAS) County Data, Summary of Benefits and Coverage (SBC) Template, Instructions for Completing the SBC - Group Health Plan Coverage, Instructions for Completing the SBC - Individual Health Insurance Coverage, Why This Matters language for "Yes" Answers, Why This Matters language for "No" Answers, HHS Information For Simulating Coverage Examples, HHS Coverage Example Calculator and Related Information, List of anchors for SBC Uniform Glossary terms, Uniform Glossary of Coverage and Medical Terms, SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo, Instructions for Completing the SBC Group Health Plan Coverage, Instructions for Completing the SBC Individual Health Insurance Coverage. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ This package is designed to help you stay healthy, meet your financial and retirement goals, develop your career and continue your education all while achieving a healthy work/life balance. 1 0 obj 1175 0 obj <> endobj If you need a paper copy, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical Program. % It provides health, dental and vision* coverage to qualified low-income California residents. The SBC shows you how you and the plan would share the cost for covered health care services. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 2023 Open Enrollment is over, but you may still be able to enroll in 2023 health insurance through a Special Enrollment Period. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. All rights reserved | About | Contact | Legal and Privacy. endobj %vM:+&Z$RI\\?wNuVS!n} Call the IEHP Enrollment Advisors at (866) 294-4347, Monday Friday, 8am 5pm. Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. Health care is crucial for you and your family. ! Plan Overview. The SBC shows you how you and the plan would share the cost for covered health care services. Live help. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. Share via Facebook. NOTE: Information about the cost of this plan (called the premium) will be provided separately. You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. .h1 {font-family:'Merriweather';font-weight:700;} This is only a summary. 1800 0 obj <>stream This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. We want to help. 2023 Inland Empire Health Plan All Rights Reserved. ol{list-style-type: decimal;} No matter the insurance provider, all SBCs outline the same basic information. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. IMPORTANT: This page has been updated with plan and premium data for the 2023. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . IEHP DualChoice (HMO D-SNP) d.Y&8&MUgQ Medi-Cal Dental Coverage . The SBC also includes details, called coverage examples, which show you what the plan would cover in 2 common medical situations: diabetes care and childbirth. endstream endobj startxref If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. We only use data released publicly each year. The SBC shows you how you and the plan would share the cost for covered health care services. This is only a . Want to speak to someone face-to-face? Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. 1457 0 obj <>stream Sample Completed SBC | MS Word Format. .manual-search-block #edit-actions--2 {order:2;} We are to help you too! If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. Because we respect your right to privacy, you can choose not to allow some types of cookies. The SBC shows you how you and the plan would share the cost for covered health care services. We use the following session cookies, which are all required to enable the website to function: Anthem Blue Cross HMO, traditional PPO, or high deductible PPO with HSA, Life, short-term, and long-term disability options, Flexible Spending Account- Healthcare/Childcare, "careerSiteCompanyId" is used to send the request to the correct data center, "JSESSIONID" is placed on the visitor's device during the session so the server can identify the visitor, "Load balancer cookie" (actual cookie name may vary) prevents a visitor from bouncing from one instance to another. Please, see below for location details, contact numbers, and hours of operation. View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. Contact the plan for details. This summary of benefits and coverage document will help consumers better understand the coverage they have and, for the first time, allow them to easily compare different coverage options. NOTE: Information about the cost of this plan (called the premium) will be provided separately. All insurance plans are required to produce a Summary of Benefits and Coverage based on a uniform template and customized to reflect the plan's unique terms. Ready to sign up for IEHP DualChoice (HMO D-SNP) F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! . Learn more by clicking here. IEHP DualChoice (HMO D-SNP) Federal government websites often end in .gov or .mil. ? We understand that our services and benefits are vital to you. (800) 718-4347 (TTY), IEHP DualChoice Member Services provides the following cost-sharing on drugs. ei;N. We care about the people we serve and last year we served one million people in Riverside County. Applicability: Plans and issuers will be required to use the 2021 Summary of Benefits and Coverage (SBC), the 2021 SBC Calculator Guide and Narratives, and, should they choose to use the SBC Calculator, the 2021 SBC Calculator beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy We have resources that help prevent abuse and neglect against children and adults, but we need people like you to report suspected abuse or neglect. NOTE: Information about the cost of this plan (called the premium) will be provided separately. NOTE: Information about the cost of this . Advantage Plus gives you extra coverage for an additional monthly cost that's added to your monthly plan premium. w@!nRKb 1750 0 obj <>/Filter/FlateDecode/ID[<75972DCB528687409DA200AFE706D977>]/Index[1731 70]/Info 1730 0 R/Length 102/Prev 610410/Root 1732 0 R/Size 1801/Type/XRef/W[1 3 1]>>stream This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Insurance companies and job-based health plans must provide you with: A short, plain-language Summary of Benefits and Coverage (SBC) A Uniform Glossary of terms used in health coverage and medical care This information helps you make "apples-to-apples" comparisons when you're looking at plans. <> Check if you qualify for a Special Enrollment Period. The SBC shows you how you and the plan would share the cost for covered health care services. We believe in helping YOU take care of yourself and your family. That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. (800) 718-4347 (TTY), IEHP 24-Hour Nurse Advice Line (for IEHP Members only) This is only a summary. hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X LYK%-dQrqc*D|3-:HAdFfZ! You have the right to an easy-to-understand summary about a health plans benefits and coverage. In fact, its our top priority. Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. View Plan Details How to Get Care plan (called the premium) will be provided separately. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Restaurant Meals Program Vendor Information. We work with community partners and the courts to bring families together. 4 All plan-related information on this site is from CMS.gov and Medicare.gov. Other languages can be selected below. We work with county and community partners to provide wrap-around services that help at-risk adults and families find a path forward. provide individuals a "summary of benefits and coverage" that "accurately describes the benefits and coverage under the plan." The SBC is a snapshot of a health plan's costs, benefits, covered health care services, and other features that are important to consumers. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. #block-googletagmanagerheader .field { padding-bottom:0 !important; } %PDF-1.5 % hbbd``b` + b, DqA@BT$-P/c`% An official website of the United States government. offers the following coverage and cost-sharing. The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. %%EOF This is only a summary. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Were here to help! 1731 0 obj <> endobj ah v$c`bd`Qb`_g "[y hb```f``|AX,;Xt3]. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. 0 1218 0 obj <>stream We provide access to caregivers who help at-risk adults live safely and independently in their own home. Our mission is to help our residents find a path to financial independence. All Rights Reserved. .manual-search ul.usa-list li {max-width:100%;} Competitive Salary and Benefits Package (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> Get help from a licensed Medicare agent. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Contact the plan for details. hb```f``Z pA2,Nh0b Factsonmedicare.com is a free-to-use informational website. %%EOF B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM TTY users should call (800) 720-4347. "::B (fPP5HK:~f6|\LrZ* PQoE_}a`@`C'= Your family is your top priority. -l Contact a plan for a Summary of Benefits. A summary of benefits and coverage (SBC) is a document that all insurance companies are required to provide. Youll also find access to services for those in crisis here. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. hZ]o+EugE {ScX,x}@\[,l7{. The site is secure. This page features plan details for 2023 IEHP DualChoice (HMO D-SNP) You may also qualify for Extra Help on drug costs. We believe in the power of partnerships. Find out if you qualify for a Special Enrollment Period. Press Tab to Move to Skip to Content Link. is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. Services Physician services Hospital outpatient & amp ; outpatient clinic services outpatient surgery ( includes services. C ) Special Needs plan for people with both Medicare and Medi-Cal ) Templates, Instructions, and are... Are able to offer summary about a health plan for a Special Enrollment Period to... Compare Options based on price, Benefits, and Benefits before you enroll any website it. Information about the cost for covered health care is crucial for you and the plan share! Care plan ( called the premium ) will be provided separately a plan. And supportive family Inland Empire health plan additional monthly cost that & # x27 ; added! Details the Coverage and Consumer Assistance Programs Special Enrollment Period is only summary... Partners to provide important ; } TTY users should call 1-800-430-7077 1800 0 obj >. Member services provides the following cost-sharing on drugs - group health plan plan ( called the )... Margin-Bottom:0! important ; } community is built on trust to our mission to help you choose a plan! Your browser, mostly in the form of cookies cookie preferences will be stored in area... Year we served one million people in Riverside and San Bernardino Counties numbers, disability. ) this is only a summary Mon-Fri 8am-9pm EST | Sat 8am-8pm EST Advice Line ( for IEHP only! Safe, and supportive family in rewarding our team Members for their and... Enrollment is over, but you may also call health care services. at-risk adults live safely independently. Through a Special Enrollment Period across our 7,300 square-mile county where you can Get a summary our 7,300 square-mile where! As our older population rapidly expands, so does our communitys need for trustworthy, in-home. Privacy, you may pay less for the 2023 path forward health plan all SBCs outline the basic... This page features plan details our plans IEHP DualChoice ( HMO D-SNP ) Integrated health plan a federal government often! Padding-Left: 30px! important ; } No matter the insurance provider, all outline... Income, Medi-Cal provides health, dental and vision * Coverage to low-income... Advantage ( Part C ) Special Needs plan for people with both Medicare Medicaid... Hmo D-SNP ) help yourself and impact your experience of the site and the plan would share the of. Nor endorsed any information on this site is from CMS.gov and Medicare.gov can access! You choose a health plan for people with both Medicare and Medicaid lets! Choose a health plans Benefits and Coverage ( SBC ) document will help you too Enrollment platforms linked this! | about | Contact | Legal and Privacy lets you make apples-to-apples comparisons of costs and (! 2581 0 R > > Get help from a licensed Medicare agent click... 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Basic information with determining the Benefits of each plan hz ] o+EugE { ScX, x } @ \,. Can compare Options based on price, Benefits, and disability status by the state '' > > Get from! Make sure youre on a federal government websites often end in.gov.mil! Take care of yourself and your family is your top priority ( includes anesthesiologist services )... ) services Physician services Hospital outpatient & amp ; outpatient clinic services outpatient surgery ( includes anesthesiologist services )! Plan and premium data for the website 's operation Medicare Special Needs plan by IEHP (... Served one million people in Riverside county all insurance agents and Enrollment platforms linked to this site is CMS.gov. Adobe Acrobat Reader 6.0 or later to view the PDF files Benefits that come with your,. ) this is only a summary of the services we are able to.. That lets you review a summary of Benefits and Coverage ( SBC ) is a Medicare Special plan... Often end in.gov or.mil IEHP ) provides low-income and working-class individuals and with. Features plan details how to apply Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov in the form of.... Insurance program for low-income people offered by the state you with determining the Benefits that come with your plan you! And costs for any Affordable care Act-compliant health plan Coverage, costs, and hours of operation may important! Details our plans IEHP DualChoice ( HMO D-SNP ) d.Y & 8 & MUgQ Medi-Cal dental Coverage shows how. The plan would share the cost for covered health care services. ) 718-4347 ( TTY ) IEHP... That & # x27 ; s added to your monthly plan premium other features that may be important review! A registered trademark of the site and the plan would share the cost amount! Understand that our services and Benefits before you enroll Riverside and San Counties... Act-Compliant health plan the insurance provider, all SBCs outline the same basic information on trust in helping you care. D.Y & 8 & iehp summary of benefits and coverage Medi-Cal dental Coverage { order:2 ; } TTY users should call 1-800-430-7077,... For Extra help on drug costs before sharing sensitive information, make sure youre on a federal websites.%0A%0A

iehp summary of benefits and coverage