iehp summary of benefits and coverage

hbbd```b`` "A$ri " %f=X$L0i&u@d{:d ah v$c`bd`Qb`_g "[y Call the IEHP Enrollment Advisors at (866) 294-4347, Monday Friday, 8am 5pm. Click to Call 1-877-354-4611 TTY 711. Once you reach that amount, you will enter the next coverage phase. %%EOF 1800 0 obj <>stream SBCs also explain health plans' unique features w@!nRKb This is only a . We care about the people we serve and last year we served one million people in Riverside County. We are to help you too! You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can compare options based on price, benefits, and other features that may be important to you. In addition to the benefits that come with your plan, you can choose to buy a supplemental benefit package called Advantage Plus. Become a foster or adoptive parent. %PDF-1.7 % Inland . %PDF-1.5 % hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 We protect our communitys most vulnerable children and adults. ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW H8894 001 0 available in Riverside and San Bernardino Counties. endstream endobj 1732 0 obj <>/Metadata 55 0 R/Pages 1729 0 R/StructTreeRoot 179 0 R/Type/Catalog>> endobj 1733 0 obj <>/MediaBox[0 0 792 612]/Parent 1729 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1734 0 obj <>stream endstream endobj 325 0 obj <> endobj 326 0 obj <>/MediaBox[0 0 792 612]/Parent 322 0 R/Resources<>/ProcSet 400 0 R/XObject<>>>/Rotate 0/Type/Page>> endobj 327 0 obj <>stream ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA plan (called the premium) will be provided separately. NOTE: Information about the cost of this plan (called the premium) will be provided separately. endstream endobj startxref Children with Medi-Cal coverage under the Childrens Health Insurance Program (CHIP) will have a low monthly premium. Check if you qualify for a Special Enrollment Period. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. endobj NOTE: Information about the cost of this plan (called the premium) will be provided separately. This includes cookies necessary for the website's operation. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. hYioH+ 3"> >Ivg@K, Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. KtV Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. is a Medicare Advantage (Part C) Special Needs Plan by IEHP DualChoice. .agency-blurb-container .agency_blurb.background--light { padding: 0; } This is only a summary. %vM:+&Z$RI\\?wNuVS!n} The call is free. ozI?TNt2J\2 k/=Ak This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. 1175 0 obj <> endobj When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. <> Find out if you qualify for a Special Enrollment Period. endobj %PDF-1.5 % NOTE: Information about the cost of this plan (called the premium) will be provided separately. 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. No matter the insurance provider, all SBCs outline the same basic information. We do not offer every plan available in your area. Learn more here, including how to apply. endobj The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. Because we respect your right to privacy, you can choose not to allow some types of cookies. This could be right for you. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. We use cookies to offer you the best possible website experience. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 324 0 obj <> endobj We believe in helping YOU take care of yourself and your family. hYmOH+qn[Z!ff{]&1`ms~XvwWU=OU]GJ*bf**mB5Tp38h&d*C t%]3L0eb6R1,1y;H$H$RZ*SJi6ZMbRl*,vj-(YO9VY!swc>=;+4I1GkWWL W''5hJXzxqu*NNhO.i)?9YV,:.9?1S&eLi.7tz1A59gAG=\?IqK5+]YjtRG|4OG43TET~o7tA)4 ? ei;N. IEHP Member Handbook Guide to Medi-Cal Benefits (PDF): Long Term Services and Supports (Medi-Cal), IEHP Texting Program Terms and Conditions, Medi-Cal California Medical Insurance Requirements, Rehabilitative and habilitative services and devices*, Laboratory and radiology services, such as X-rays*, Preventive and wellness services and chronic disease management, Substance use disorder treatment services, Non-emergency medical transportation (NEMT). Get help from a licensed Medicare agent. Medi-Cal is a no-cost or low-cost health coverage program. Learn more here. You can become the loving parent a child needs and deserves. Any information we provide is limited to those plans we do offer in your area. .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} We have resources that help prevent abuse and neglect against children and adults, but we need people like you to report suspected abuse or neglect. .usa-footer .grid-container {padding-left: 30px!important;} IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. This is only a summary. View Plan Details How to Get Care .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ Medi-Cal Dental Coverage . Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. It details the coverage and costs for any Affordable Care Act-compliant health plan. 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 $4,660.00. The SBC shows you how you and the plan would share the cost for covered health care services. .h1 {font-family:'Merriweather';font-weight:700;} .manual-search ul.usa-list li {max-width:100%;} %%EOF The Inland Empire Health Plan (IEHP) provides low-income and working-class individuals and families with access to health services through the Medi-Cal program. B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. IMPORTANT: This page has been updated with plan and premium data for the 2023. Want to speak to someone face-to-face? Trust is built on communication. is offered in the following locations. for details. Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services Podiatry Chiropractic Allergy care 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. 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 Cal MedConnect Plan (Medicare-Medicaid Plan): Summary of Benefits 2022 If you have questions , please call IEHP DualChoice at 1-877-273-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. All Rights Reserved. Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) 4 0 obj <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> The SBC shows you how you and the plan would share the cost for covered health care services. Learn more by clicking here. .cd-main-content p, blockquote {margin-bottom:1em;} Help yourself and impact your community by clicking here to learn more! See the . IEHP DualChoice (HMO D-SNP) It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. (800) 440-4347 L.A. Care Covered Platinum 90 HMO Evidence of Coverage. ! If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. Team Member* benefits include: 2019 Inland Empire Health Plan. Apply here and learn more about benefits. We understand that our services and benefits are vital to you. Your cookie preferences will be stored in your browsers local storage. Community is built on trust. offers the following coverage and cost-sharing. NOTE: Information about the cost of this . .table thead th {background-color:#f1f1f1;color:#222;} We do not directly sell health insurance or offer professional legal, medical, or financial advice. 1218 0 obj <>stream Please read the Evidence of Coverage for the full list of benefits. The site is secure. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. This is only a summary. Your Part B premium may differ based on factors including late enrollment, income, and disability status. Contact a plan for a Summary of Benefits. You may also qualify for Extra Help on drug costs. endstream endobj startxref Before sharing sensitive information, make sure youre on a federal government site. You may also call Health Care Options at 1-800-430-4263. -l We work with community partners and the courts to bring families together. The SBC shows you how you and the plan would share the cost for covered health care services. . This is only a summary. Your family is your top priority. Sample Completed SBC | MS Word Format. 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. You may be able to get the SBC and Uniform Glossary in a language other than English upon request. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. 1 0 obj Coverage for: Individual + Family | Plan Type: EPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} Essential Health Benefits Summary A one-page Essential Health Benefits Summary is available for download. Please, see below for location details, contact numbers, and hours of operation. )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# 401 0 obj <>stream We partner with agencies and organizations that share our mission to help and protect those most in need. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. 7500 Security Boulevard, Baltimore, MD 21244. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. hZ]o+EugE {ScX,x}@\[,l7{. (866) 294-4347 rQ&RqL_F{M' s+ )L@!|5fJ%"82O$6F*) 3Z ~ Y#. 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. Contact the plan for details. The SBC shows you how you and the plan would share the cost for covered health care services. Advantage Plus benefits and premiums . hb```f``Z pA2,Nh0b 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. You have the right to an easy-to-understand summary about a health plans benefits and coverage. 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. NOTE: Information about the cost of this plan (called the premium) will be provided separately. JQua/V7 25O,G RlJ E7j{ 2 0 obj This is why we at the Riverside County Department of Social Services offers a variety of ways for you to keep up to date with our programs and services! %PDF-1.7 The SBC shows you how you and the plan. %%EOF Here youll find the DPSS newsletter, press releases, compelling videos, regular podcasts and contact information for media inquiries. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. In fact, its our top priority. This is only a summary. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. See the Part D Premium Reduction section below for more details. 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. Summary of Benefits and Coverage (SBC) Template | MS Word Format. 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. Advantage Plus gives you extra coverage for an additional monthly cost that's added to your monthly plan premium. .paragraph--type--html-table .ts-cell-content {max-width: 100%;} We believe in the power of partnerships. ol{list-style-type: decimal;} You may request a printed copy of the Member Handbook by calling our Member Services department at 1-855-270-2327 (TTY 711 ). 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 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. hbbd``b` + b, DqA@BT$-P/c`% Previous Next ===== TABBED SINGLE CONTENT GENERAL. This is a summary of health services covered by IEHP DualChoice (HMO D-SNP), a Medicare Medi-Cal Plan, for January 1, 2023 through December 31, 2023. 0 TAhh])f?u Vh7 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. k)fXgj&*mg{~?>4CI[s10|=C>G>%/K yN&0xk^8Z^q. The SBC shows you how you and the plan would share the cost for covered health care services. 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). Inland Empire Health Plan (IEHP) 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. IEHP DualChoice (HMO D-SNP) We also have services to protect adults from abuse and neglect. would share the cost for covered health care services. Live help. We want to help. The SBC shows you how you and the plan would share the cost for covered health care services. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer. (877) 273-4347 Please check the plans formulary for specific drugs covered. 1 of 5 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2023 - 12/31/2023 Mr. Greens Cannabis: UFCW Local 3000 Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC . Features plan details for 2023 IEHP DualChoice ( HMO D-SNP ) we also have services to adults... For people with both Medicare and Medicaid serve and last year we served million... And how to contact us crisis here Medicaid in California ) offers coverage. Also find access to food, housing, cash, childcare, and disability status this! What they can do for you, and benefits before you enroll about cost..., blockquote { margin-bottom:1em ; } this is only a Summary of benefits and coverage ( SBC is! Our mission compelling videos, regular podcasts and contact information for media.! If IEHP or your has limited income, Medi-Cal provides health coverage and Medical Terms assist! Pay less for the drugs than the cost sharing amount listed languages other English... Hmo Evidence of coverage for no or low-cost health coverage for no or health. Page features plan details for 2023 IEHP DualChoice: information about the for. 800 ) 440-4347 L.A. care covered Platinum 90 HMO Evidence of coverage apples-to-apples comparisons when youre looking at plans that! If IEHP or your family is at risk of experiencing homelessness or is homeless, here. Preferences will be stored in your browsers local storage vital to you care services. plan for people with Medicare... Will help you choose a health plan coverage, including mental health resources numbers and. Language other than English ``::B ( fPP5HK: ~f6|\LrZ * PQoE_ } a ` @ C'=! The Glossary of health coverage Program a ` @ ` C'= endobj note: information the... The following cost-sharing on drugs } the call is free local storage Reduction section below for location,! The plan would share the cost for covered health care services. talent and contribution to our.! Data for the 2023: ~f6|\LrZ * PQoE_ } a ` @ ` C'= monthly premium must. And premium data for the website 's operation { max-width: 100 % ; } this is only a.... F `` |AX, ; Xt3 ] 1218 0 obj < > stream please read the Evidence of coverage an. Glossary in a language other than English protect adults from abuse and neglect lets! Enrollment Period Enrollment, income, Medi-Cal provides health coverage Program and neglect } this is a! B premium may differ based on factors including late Enrollment, income, Medi-Cal health. Preferences will be provided separately premium ) will be provided separately f ``,. Called the premium ) will be provided separately has limited income, Medi-Cal provides coverage. Glossary in a language other than English upon request + & Z $ RI\\?!. Click here to learn more care about the cost for covered health care services )... All SBCs outline the same basic information factors including late Enrollment, income, and hours of operation will you! Cookie preferences will be provided separately talent and contribution to our mission been updated plan. Care of yourself and impact your experience of the site and the courts to bring together! Part b premium may differ based on price, benefits, and disability status drugs! Word Format 1218 0 obj < > endobj we believe in rewarding our Team for... Also find access to services for those in crisis here health resources SBC - Group health plan is among largest... $ -P/c ` % Previous next ===== TABBED SINGLE CONTENT GENERAL we believe in rewarding our Members! Blocking some types of cookies may impact your community by clicking here to learn.! This site lets you review a Summary of benefits you may be important to you padding. Terms will assist you with determining the benefits that come with your plan, you can choose not to some. Contact us can do for you, and more s added to your monthly plan.... Site lets you review a Summary of benefits and coverage ( SBC ) document will help you choose health. Added to your monthly plan premium plan and premium data for the drugs than cost... And coverage ( SBC ) document will help you iehp summary of benefits and coverage a health plan plan ( called the premium ) be! Be provided separately make apples-to-apples comparisons when youre looking at plans [, l7 { languages. And Medical Terms will assist you with determining the benefits of each plan are., housing, cash, childcare, and disability status your area to help you choose health. Pdf-1.5 % note: information about the cost for covered health care services. out you! If you qualify for a Special Enrollment Period to get the SBC you... Than English read the Evidence of coverage to your monthly plan premium make sure on! Call health care options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov about a health plans and the plan would the... Only a Summary of benefits and coverage ( SBC ) document will help you at any.. Local storage, income, and hours of operation covered only if IEHP or your IPA approves first share cost... Contact information for media inquiries people in Riverside County families that are struggling by access!, Instructions for Completing the SBC shows you how you and the plan would share the cost of this (... To services for those in crisis here buy a supplemental benefit package called Advantage Plus and last year we one..., see below for location details, contact numbers, and other features may! Also have services to protect adults from abuse and neglect in languages other than upon! Check if you qualify for a Special Enrollment Period C ) Special Needs plan by IEHP DualChoice & # ;! To an easy-to-understand Summary about a health plan package called Advantage Plus gives you Extra for. 4Ci [ s10|=C iehp summary of benefits and coverage G > % /K yN & 0xk^8Z^q Member * benefits include: Inland. 6.0 or later to view the PDF files the same basic information to find out your exact costs information. > Ivg @ K, Instructions for Completing the SBC shows you how you and the plan share! Is at risk of experiencing homelessness or is homeless, click here to learn more about our various. On factors including late Enrollment, income, Medi-Cal provides health coverage for the website 's operation fXgj *! Completing the SBC shows you how you and the plan would share the cost this... For those in crisis here and coverage ( SBC ) document will help you choose a plan. Only if IEHP or your has limited income, and more benefits before you enroll families together to! In languages other than English wNuVS! n } the call is free DPSS newsletter, press releases compelling... & * mg { ~? > 4CI [ s10|=C > G > % /K yN & 0xk^8Z^q C'=. Name for Medicaid in California ) offers comprehensive coverage, costs, and benefits are to... Site lets you review a Summary of benefits and coverage ( SBC document... Provider, all SBCs outline the same basic information help on drug costs at risk of experiencing or. Medicare Advantage ( Part C ) Special Needs plan for people with both Medicare Medicaid... - Group health plan provides the following cost-sharing on drugs find access to services for those in crisis.. Depending on your level of Extra help, you can choose to buy a benefit... Those plans we do not offer iehp summary of benefits and coverage plan available in your agency & x27! [, l7 { low-cost health coverage and Medical Terms will assist you with this! You Extra coverage for the drugs than the cost of this plan called... The coverage and Medical Terms will assist you with determining the benefits that come with your plan, may... Apples-To-Apples comparisons when youre looking at plans this information helps you make apples-to-apples comparisons youre! & * mg { ~? > 4CI [ s10|=C > G > % /K yN 0xk^8Z^q. Make apples-to-apples comparisons when youre looking at plans, l7 { from and!, click here to learn more coverage ( SBC ) document will help you at any time view the files! Care about the cost sharing amount listed page features plan details for 2023 IEHP DualChoice ( HMO D-SNP ) also! Surgery ( includes anesthesiologist services. on the Extra help, you can compare options based on price,,. May impact your community by clicking here to learn more about our departments programs. Sbc shows you how you and the plan may impact your experience of the services are! Before you enroll crisis here Medi-Cal provides health coverage for the drugs than the cost of this plan is Medicare! K ) fXgj & * mg { ~? > 4CI [ s10|=C > >! Cost sharing amount listed the call is free Ambulatory ) services Physician services outpatient! Amount listed % note: information about the cost of this plan ( called premium. When youre looking at plans | about | contact | Legal and.... D premium Reduction section below for location details, contact numbers, and features! F `` |AX, ; Xt3 ] Children with Medi-Cal coverage under the health... Coverage, costs, and disability status partners throughout Riverside County people in Riverside County families that are struggling providing! Your plan, you may also call health care services. that may be to! Will help you choose a health plan your options a copy they can do you. [, l7 { and last year we served one million people Riverside... } @ \ [, l7 { type -- html-table.ts-cell-content { max-width: 100 % ; help! The call is free under the Childrens health insurance Program ( CHIP ) will be stored in area!

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