2019 Summary of Benefits
|
|
|
- Vincent Blair
- 5 years ago
- Views:
Transcription
1 Effective January 1 December 31, Summary of Benefits Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP) blueshieldca.com/medicare S2468_18_336A_M Accepted
2 2019 Summary of Benefits Blue Shield Rx Plus Blue Shield Rx Enhanced January 1, 2019 December 31, 2019 The information provided does not list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, please refer to the Evidence of Coverage (EOC) at blueshieldca.com/medpdp or by calling Member Services at (888) [TTY: 711], 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m., Saturday and Sunday), from April 1 through September 30. To join Blue Shield Rx Plus or Blue Shield Rx Enhanced, you must be entitled to Medicare Part A and/or Part B and permanently live in the plan service area. Our service area includes the following: California. If you want to know more about the coverage and costs of Original Medicare, look in your current Medicare & You handbook. View it online at or get a copy by calling MEDICARE ( ), 24 hours a day, 7 days a week. TTY users should call Our plan Pharmacy Directory is located on our website at blueshieldca.com/med_pharmacy. To get the most complete and current information about which drugs are covered, you can visit our website at blueshieldca.com/med_formulary.
3 Prescription Drug Coverage Summary of Benefits Effective January 1 through December 31, 2019 Monthly premium, deductible and limits on how much you pay for covered services. You pay the following: Blue Shield Rx Plus Retail Blue Shield Rx Enhanced Retail Monthly plan premium: $81.10 Monthly plan premium: $ Stage 1: Annual Prescription Deductible $415 (except for drugs listed on Tier 1 which are excluded from the deductible) Stage 1: Annual Prescription Deductible This stage does not apply because there is no deductible. $2 copay $4 copay $4 copay $8 copay $6 copay $12 copay $10 copay $20 copay $31 copay $62 copay $40 copay $80 copay Non- 31% 31% Non- 27% 27% Injectable Injectable Tier Tier
4 Blue Shield Rx Plus Standard retail Blue Shield Rx Enhanced Standard retail $8 copay $24 copay $13 copay $39 copay $15 copay $45 copay $17 copay $51 copay $38 copay $114 copay $47 copay $141 copay Non- Non- 29% 29% Injectable Injectable Tier Tier
5 Blue Shield Rx Plus Mail service Blue Shield Rx Enhanced Mail service $4 copay $8 copay $12 copay $20 copay $62 copay $80 copay Non- 31% NDS Non- 27% NDS Injectable NDS Injectable NDS Tier Tier If you reside in a long-term care facility, you pay the same as at a standard retail costsharing pharmacy. There are limited situations where you may get drugs from an out-of-network pharmacy at the same cost as an in network standard retail cost sharing pharmacy. NDS A long-term (up to a ) is not available for select drugs. We limit the amount select drugs can be filled at one time for your protection. The drugs that are not available for a long-term are marked with the symbol NDS in our Drug List.
6 Stage 3: Coverage Gap Coverage for outpatient prescription drugs after the total yearly drug costs paid by both you and Blue Shield reach $3,820, until your yearly out-of-pocket drug costs reach $5,100 You pay of the price for brand-name drugs (plus a portion of the dispensing fee) and 37% of the price for generic drugs until your costs total $5,100, which is the end of the coverage gap. Whether a drug is considered generic or brand can be determined using the plan formulary. Stage 4: Catastrophic Coverage After your yearly out-of-pocket drug costs (including drugs you bought through your retail pharmacy and through mail service) reach $5,100, you pay the greater of: 5% of the cost, or $3.40 copay for a generic drug (including brand drugs treated as generic) and an $8.50 copay for all other drugs (This stage protects you from any additional costs once you have paid your yearly out-of-pocket drug costs.) Network pharmacies that offer preferred cost-sharing You may pay less when you visit one of our network pharmacies that offer preferred costsharing. Here s just a few: CVS/pharmacy (including CVS pharmacy at Target) (888) [TTY: 711] Safeway and Vons pharmacies (877) [TTY: 711] Albertsons/Sav-on/Osco pharmacies (877) [TTY: 711] Costco (800) [TTY: 711] Ralphs, Walmart and many more. You do not have to be a Costco member to use Costco Pharmacies. Accepts e-prescribing.
7 We re here to help Contact Blue Shield at (800) [TTY: 711] 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays, from April 1 through September 30. Blue Shield of California is a PDP plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. This information is not a complete description of benefits. Call (888) [TTY: 711] for more information. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call (888) (TTY: 711). ATENCIÓN: Si no habla inglés, tiene a su disposición gratis el servicio de asistencia en idiomas. Llame al (888) (TTY: 711). Blue Shield of California complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. Blue Shield of California cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad ni discapacidad. Blue Shield of California 遵循適用的州法律和聯邦公民權利法律, 並且不以種族 膚色 原國籍 血統 宗教 性別 婚姻狀況 性別認同 性取向 年齡或殘障為由而進行歧視 Blue Shield of California is an independent member of the Blue Shield Association PDP00049 (10/18)
2019 Summary of Benefits
Effective January 1 December 31, 2019 2019 Summary of Benefits Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan blueshieldca.com/medicare H0504_18_334C_M Accepted 09012018 2019 Summary
2019 Summary of Benefits
Effective January 1 December 31, 2019 2019 Summary of Benefits Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan San Luis Obispo County (partial)/ Santa Barbara County (partial) blueshieldca.com/medicare
2019 Summary of Benefits
Effective January 1 December 31, 2019 2019 Summary of Benefits Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan blueshieldca.com/medicare H0504_18_334H_M Accepted 09012018 2019 Summary
2019 Summary of Benefits
Effective January 1 December 31, 2019 2019 Summary of Benefits Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan Los Angeles County (partial)/orange County blueshieldca.com/medicare H0504_18_334E_M
Effective January 1 December 31, Summary of Benefits. Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP) blueshieldca.com/findamedicareplan
Effective January 1 December 31, 2018 Summary of Benefits Blue Shield Rx Plus (PDP) Blue Shield Rx Enhanced (PDP) blueshieldca.com/findamedicareplan S2468_17_217A_003_004 Accepted 08252017 We all have
Medicare Supplement plans at a glance. access the care you ve earned. Effective as of May 1, 2018
Medicare Supplement plans at a glance access the care you ve earned. Effective as of May 1, 2018 MULTI-PLAN_18_145A Accepted 04202018 Medicare Supplement plans at a glance Why choose a Medicare Supplement
To Enroll in Liberty Advantage, Please Provide the Following Information:
Please contact Liberty Advantage if you need information in another language or format (Braille). To Enroll in Liberty Advantage, Please Provide the Following Information: LAST name: FIRST Name: Middle
Why choose Blue Shield?
Why choose Blue Shield? Solutions for Medicare-eligible retirees Y0118_16_446A 10142016 You ve got Medicare-eligible retirees. We ve got solutions. Affordable and flexible product designs. The quality
SUMMARY OF BENEFITS HEALTHTEAM ADVANTAGE PLAN I (PPO) HEALTHTEAM ADVANTAGE PLAN II (PPO)
2018 SUMMARY OF BENEFITS HEALTHTEAM ADVANTAGE PLAN I (PPO) HEALTHTEAM ADVANTAGE PLAN II (PPO) HealthTeam Advantage, a product of Care N Care Insurance Company of North Carolina, Inc., is a Medicare Advantage
2019 Individual Enrollment Request Form
2019 Individual Enrollment Request Form Please contact IU Health Plans if you need information in another language or format. Return completed form to: Enrollment Department Indiana University Health Plans
Medicare Advantage plans from people who care. New for 2018!
Medicare Advantage plans from people who care. New for 2018! Elderplan is an HMO plan with Medicare and Medicaid contracts. Enrollment in Elderplan depends on contract renewal. This information is not
custom fused glass tile Important Copy: custom glass tile and fused glass tile Custom Glass Tile
custom fused glass tile Custom Glass Tile Important Copy: custom glass tile and fused glass tile Drug Lists: The prescription drugs your plan covers. No copayment per prescription for up to a 30-day supply
Medicare Advantage plans from people who care. New for 2017!
Medicare Advantage plans from people who care. New for 2017! Elderplan is an HMO plan with Medicare and Medicaid contracts. Enrollment in Elderplan depends on contract renewal. This information is not
Blue Shield 65 Plus (HMO)
Effective January 1 December 31, 2018 Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan San Luis Obispo County (partial)/santa Barbara County (partial) Summary of Benefits blueshieldca.com/medicare
Retiree Healthcare Benefits. Guide
Retiree Healthcare Benefits Guide 2017 This Benefits Guide presents an overview of the LACERA-administered health plans, details about administrative rules and procedures, and insurance carrier contact
Annual Notice of Changes for 2018
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
Annual Notice of Changes for 2018
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
(PDP) 2015 Summary of benefits for our Medicare prescription drug plans (Enhanced and Standard)
(PDP) 2015 Summary of benefits for our Medicare prescription drug plans (Enhanced and Standard) Contract S5540, Plans 004 and 002 January 1, 2015 December 31, 2015 Y0079_6779 CMS Accepted 08312014 U5073b,
Clover Georgia Summary of Benefits. Clover Health Choice (PPO-026) Available in Chatham County
Clover Georgia 2019 Summary of Benefits (PPO-026) Available in Chatham County Plus (PPO-043) Available in Chatham County 2019 Summary of Benefits Georgia (H5141) (plan 026) and Clover Health Choice Plus
Summary of Benefits January 1, 2017 December 31, 2017
Pennsylvania Northeastern and West Virginia Pennsylvania BLUE RX PDP Summary of Benefits January 1, 2017 December 31, 2017 This booklet gives you a summary of what we cover and what you pay. It doesn t
Summary Of Benefits. January 1, December 31, Blue Shield Promise TotalDual Plan (HMO SNP)
Summary Of Benefits Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Care1st is an independent licensee of the Blue Shield Association January 1,
2018 Summary of Benefits
2018 Summary of Benefits Liberty Advantage (HMO SNP) H6351, Pan 001 This is a summary of drug and heath services covered by Liberty Advantage (HMO SNP) January 1, 2018 - December 31, 2018 Liberty Advantage
(PDP) 2016 Summary of benefits for our Medicare prescription drug plans (Standard and Enhanced)
(PDP) 2016 Summary of benefits for our Medicare prescription drug plans (Standard and Enhanced) Contract S5540, Plans 002 and 004 January 1, 2016 December 31, 2016 Y0079_7238 CMS Accepted 08312015 U5073g,
Summary Of Benefits. January 1, December 31, Blue Shield Promise Coordinated Choice Plan (HMO)
Summary Of Benefits Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Care1st is an independent licensee of the Blue Shield Association January 1,
Summary Of Benefits January 1, December 31, 2019
Summary Of Benefits January 1, 2019 - December 31, 2019 Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Care1st is an independent licensee of the
Frequently Asked Questions (FAQs)
NJ FamilyCare Aged, Blind, Disabled Programs STATE OF NEW JERSEY Department of Human Services Division of Medical Assistance and Health Services Qualified Income Trust (QIT) Frequently Asked Questions
2019 SUMMARY OF BENEFITS
2019 SUMMARY OF BENEFITS Overview of your plan AARP MedicareRx Saver Plus (PDP) S5921-353 Look inside to learn more about the drug coverages the plan provides. Call Customer Servi or go online for more
Blue Shield Trio Medicare (HMO)
Effective January 1 December 31, 2018 Blue Shield Trio Medicare (HMO) Medicare Advantage Prescription Drug Plan Sacramento County (partial) Summary of Benefits blueshieldca.com/medicare H0504_17_215A_037
2019 SUMMARY OF BENEFITS
2019 SUMMARY OF BENEFITS Overview of your plan AARP MedicareRx Preferred (PDP) S5820-024 Look inside to learn more about the drug coverages the plan provides. Call Customer Servi or go online for more
2019 SUMMARY OF BENEFITS
2019 SUMMARY OF BENEFITS Overview of your plan AARP MedicareRx Walgreens (PDP) S5921-390 Look inside to learn more about the drug coverages the plan provides. Call Customer Servi or go online for more
Blue Shield 65 Plus (HMO)
Effective January 1 December 31, 2018 Blue Shield 65 Plus (HMO) Medicare Advantage Prescription Drug Plan Los Angeles County (partial)/orange County Summary of Benefits blueshieldca.com/medicare H0504_
Evidence of Coverage:
January 1 December 31, 2018 Evidence of Coverage: Your Medicare Prescription Drug Coverage as a Member of Blue Shield Rx Plus (PDP) This booklet gives you the details about your Medicare prescription drug
SUMMARY OF BENEFITS E0654_19SBSBP
2019 SUMMARY OF BENEFITS JANUARY 1, 2019 DECEMBER 31, 2019 E0654_19SBSBP FI755 TEAMStar MEDICARE PART D PRESCRIPTION DRUG PROGRAM (PDP) (a Medicare Prescription Drug plan (PDP) offered by the International
To Enroll in PPA, Please Provide the Following Information: Date of Birth (MM/DD/YYYY) Sex Home Phone Number q M q F
www.pphealthplan.com 901 Elkridge Landing Rd., Suite #100, Linthicum Heights, MD 21090 1-800-405-9681 TTY 711 Provider Partners Advantage HMO SNP Individual Enrollment Request Form Please contact PPA if
SYMPHONIX RITE AID VALUE RX (PDP)
SYMPHONIX RITE AID VALUE RX (PDP) and SYMPHONIX RITE AID PREMIER RX (PDP) (a Medicare Prescription Drug plan (PDP) offered by SYMPHONIX HEALTH INSURANCE, INC. with a Medicare contract) Summary of Benefits
Blue Shield Medicare Basic Plan (PDP) Blue Shield Medicare Enhanced Plan (PDP)
Summary of Benefits January 1, 2014 December 31, 2014 State of California S2468_13_228 CMS Accepted 09102013 SECTION I INTRODUCTION TO SUMMARY OF BENEFITS Thank you for your interest in and. Our plans
Prescription Drug Schedule Humana Medicare Employer Plan
PUB Name: GSB0012 2018 Prescription Drug Schedule Humana Medicare Employer Plan Rx 269 University of Richmond Y0040_GHHK48XEN18 (Pending CMS Approval) Rx 269 Let's talk about Humana Medicare Employer
2017 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2017 Summary of Benefits Employer PDP sponsored by The Coca-Cola Company () A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with a Medicare contract
2017 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2017 Summary of Benefits Employer PDP sponsored by Shell () A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with a Medicare contract January
SUMMARY OF BENEFITS CARE1ST HEALTH PLAN. Care1st TotalDual Plan (HMO SNP) California: Los Angeles County. January 1, December 31, 2018
SUMMARY OF BENEFITS January 1, 2018 - December 31, 2018 CARE1ST HEALTH PLAN This booklet gives you a summary of what we cover and what you pay. It doesn t list every service that we cover or list every
2018 Summary of Benefits
SilverScript Insurance Company P.O. Box 52424, Phoenix, AZ 85072-2424 2018 Summary of Benefits sponsored by the New York State Health Insurance Program (NYSHIP) A Medicare Prescription Drug Plan (PDP)
Qualified Income Trust (QIT)
NJ FamilyCare Aged, Blind, Disabled Programs STATE OF NEW JERSEY Department of Human Services Division of Medical Assistance and Health Services Qualified Income Trust (QIT) Frequently Asked Questions
2017 Summary of Benefits LifeWorks Advantage Health Plan HMO SNP H2185, Plan 002
2017 Summary of Benefits LifeWorks Advantage Health Plan HMO SNP H2185, Plan 002 This is a summary of drug and health services covered by LifeWorks Advantage Health Plan (HMO SNP) January 1, 2017 - December
Evidence of Coverage:
January 1 December 31, 2018 Evidence of Coverage: Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of Blue Shield 65 Plus (HMO) This booklet gives you the details about
www.pphealthplanpa.com 901 Elkridge Landing Rd., Ste. #100 Linthicum Heights, MD 21090 1-800-405-9681 TTY 711 Provider Partners Pennsylvania Advantage HMO SNP Enrollment Form Please contact Provider Partners
PPHP-PA HMO SNP Individual Enrollment Request Form Please contact PPHP- PA if you need information in another language or format (Large Print).
www.pphealthplanpa.com 901 Elkridge Landing Rd., Ste. #100 Linthicum Heights, MD 21090 1-800-405-9681 TTY 711 PPHP-PA HMO SNP Individual Enrollment Request Form Please contact PPHP- PA if you need information
2019 SUMMARY OF BENEFITS
2019 SUMMARY OF BENEFITS Vitality Health Plan of California (HMO) County and County H1426 001/002/003 H1426_19_078_MK_ENG_M H1426 001/002/003 Vitality Health Plan of California January 1, 2019 December
Enhanced Rx $10/30/50 - $20/60/100 with $0 Pharmacy Deductible. Blue Shield of California
An independent member of the Blue Shield Association Enhanced Rx $10/30/50 - $20/60/100 with $0 Pharmacy Deductible Outpatient Prescription Drug Coverage (For groups of 101 and above) THIS DRUG COVERAGE
WELCOME Y0107_18_07 Approved
WELCOME. 2018 Y0107_18_07 Approved TODAY S DISCUSSION LET S TALK MEDICARE Medicare Questions? Answered. Your Needs. Your Decision. Medicare Advantage Care N Care. Enrollment. You have questions and we
Participating Pharmacy 9 Non-Participating Pharmacy 7,8
Rx Spectrum $10/25/40 - $20/50/80 with $0 Pharmacy Deductible Outpatient Prescription Drug Coverage (For groups of 101 and above) Highlight: $0 Calendar Year Pharmacy Deductible $10 Tier 1 / $25 Tier 2
TOWN OF WINCHESTER Aetna Medicare Rx Plan Custom RX $10/$25/$50/$50. Benefits and Premiums are effective January 01, 2019 through December 31, 2019
Benefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY PHARMACY - PRESCRIPTION DRUG BENEFITS Calendar-year deductible
2019 Summary of Benefits
2019 Summary of Benefits H3291 This is a summary of drug and health services covered by PruittHealth Premier D-SNP (HMO SNP) January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands
Producer Information Booklet
2017 Blue Shield of California Producer Information Booklet Plans for Medicare beneficiaries Medicare Advantage HMOs Medicare Supplement plans Medicare Prescription Drug Plans Dental plans Y0118_16_576A
Annual Notice of Changes for 2018
VNSNY CHOICE Preferred (HMO SNP) offered by VNSNY CHOICE Medicare Annual Notice of Changes for 2018 You are currently enrolled as a member of VNSNY CHOICE Preferred. Next year, there will be some changes
Blue Cross MedicareRx (PDP) SM
(PDP) SM Summary of Benefits January 1, 2014 December 31, 2014 Y0096_BEN_IL_PDPSB14 Accepted 10012013 31980.0613 SECTION I Introduction to the Summary of Benefits for SM January 1, 2014 December 31, 2014
Summary of Benefits. Aetna Medicare Rx Costco Plus Plan (PDP) S5810. California. January 1, 2010 to December 31, 2010
January 1, 2010 to December 31, 2010 Summary of Benefits Aetna Medicare Rx S5810 California S5810_D_PE_SB_90712 (08/2009) Visit us www.aetnamedicare.com 1 Summary of Benefits: Aetna Medicare Rx Section
You have from October 15 until December 7 to make changes to your Medicare coverage for next year.
Blue Cross MedicareRx Basic (PDP) SM offered by HCSC Insurance Services Company Annual Notice of Changes for 2018 You are currently enrolled as a member of Blue Cross MedicareRx Basic (PDP) SM. Next year,
Summary of Benefits for Blue Shield Medicare Basic Plan (PDP) Blue Shield Medicare Enhanced Plan (PDP) Blue Shield Medicare Premium Plan (PDP)
Summary of s for Blue Shield Blue Shield Blue Shield January 1, 2012 December 31, 2012 State of California S2468 S2468_11_134 CMS Approved 09012011 blueshieldca.com Section I Introduction to Summary of
2015 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2015 Summary of Benefits sponsored by Shell (a Medicare Prescription Drug Plan (PDP) offered by SilverScript Insurance Company with a Medicare contract) January 1,
2018 Summary of Benefits
2018 Traditional HMO PBP 006 Los Angeles Traditional Plus HMO PBP 008 Los Angeles Senior Value HMO-SNP PBP 010 Los Angeles Section 1 Imperial Health Plan of California (HMO) (HMO SNP) Who can join? To
Medicare Part D Prescription Drug Plan
Medicare Part D Prescription Drug Plan The value you expect with exclusive Costco savings... in a plan that s easy to use and understand That s the Aetna Medicare Rx Costco Plus Plan (PDP) Enroll at www.aetnamedicare.com/costco
(PDP) 2014 Summary of benefits for our Medicare prescription drug plans (Enhanced and Standard)
(PDP) 2014 Summary of benefits for our prescription drug plans (Enhanced and Standard) Contract S5540, Plans 004 and 002 January 1, 2014 December 31, 2014 U5073c, 8/13 Y0079_6249 CMS Accepted 09112013
2019 Summary of Benefits
2019 Summary of Benefits Jan. 1, 2019 Dec. 31, 2019 888-645-6025 TTY 711 Seven Days a Week, 8 A.M. to 8 P.M.(Oct. 1, 2018, to Mar. 31, 2019) Monday-Friday, 8 A.M. to 8 P.M. (All Other Times) (PDP) (PDP)
Errata Sheet to the Imperial Health Plan of California (HMO) Traditional LA (006) & Traditional SFO (007) 2018 Evidence of Coverage
Errata Sheet to the Imperial Health Plan of California (HMO) Traditional LA (006) & Traditional SFO (007) 2018 Evidence of Coverage [Insert date] This is important information on changes in your Imperial
2019 Summary of Benefits
Connecticut Massachusetts Rhode Island Vermont Blue MedicareRx (PDP) 2019 Summary of Benefits Independent Licensees of the Blue Cross and Blue Shield Association. S2893_1846_M (a Medicare Prescription
2019 Summary of Benefits
Plus Plan Value Plan S7126 2019 Summary of Benefits January 1, 2019 December 31, 2019 This booklet gives you a summary of what Mutual of Omaha Rx SM (PDP) Plus and Value plans cover and what you pay. It
Annual Notice of Changes for 2018
Stanford Health Care Advantage Gold (HMO) offered by Stanford Health Care Advantage Annual Notice of Changes for 2018 You are currently enrolled as a member of Stanford Health Care Advantage Gold Next
Blue Shield 65 Plus (HMO) Summary of Benefits
Ventura County (partial) Blue Shield 65 Plus (HMO) Summary of Benefits Medicare Advantage Prescription Drug Plan Effective January 1 through December 31, 2017 H0504_16_230A_029 Accepted 08302016 Keep living
IU HEALTH PLANS MEDICARE SELECT PLUS (HMO)
IU HEALTH PLANS MEDICARE SELECT PLUS (HMO) (a Medicare Advantage Health Maintenance Organization (HMO) offered by INDIANA UNIVERSITY HEALTH PLANS, INC. with a Medicare contract) Summary of Benefits January
2014 Summary of Benefits. Empire Plan Medicare Rx sponsored by New York State Health Insurance Program (NYSHIP)
SilverScript Insurance Company Empire Plan Medicare Rx P.O. Box 52424, Phoenix, AZ 85072-2424 Empire Plan Medicare Rx sponsored by New York State Health Insurance Program (NYSHIP) 2014 Summary of Benefits
summary of benefits Blue Shield of California Medicare Rx Plan (PDP)
summary of benefits Blue Shield of California Medicare Rx Plan (PDP) An employer-sponsored Medicare Prescription Drug Plan for City and County of San Francisco retirees, spouses and eligible dependents
2016 Summary of Benefits
P.O. Box 52424, Phoenix, AZ 85072-2424 2016 Summary of Benefits Employer PDP sponsored by REHP () A Medicare Prescription Drug Plan (PDP) offered by Insurance Company with a Medicare contract January 1,
IU HEALTH PLANS MEDICARE SELECT (HMO)
IU HEALTH PLANS MEDICARE SELECT (HMO) (a Medicare Advantage Health Maintenance Organization (HMO) offered by INDIANA UNIVERSITY HEALTH PLANS, INC. with a Medicare contract) Summary of Benefits January
Blue Shield 65 Plus (HMO) Summary of Benefits
San Bernardino County (partial) Blue Shield 65 Plus (HMO) Summary of Benefits Medicare Advantage Prescription Drug Plan Effective January 1 through December 31, 2017 H0504_16_230B_017 Accepted 08302016
2019 Summary of Benefits
2019 Summary of Benefits Los Angeles & San Francisco Imperial Traditional (HMO) PBP 007 Imperial Traditional Plus (HMO) PBP 009 Senior Value (HMO SNP) PBP 005 Section 1 Imperial Health Plan of California
Medical, Prescription Drug and Dental Insurance. What s Inside. Retiree Newsletter
2018 Retiree Newsletter Medical, Prescription Drug and Dental Insurance The University of Nebraska annual benefits enrollment period is currently underway. We would like to take this opportunity to share
Summary of Benefits. Tufts Medicare Preferred PDP PLANS Employer Group Tufts Medicare Preferred PDP3
Tufts Medicare Preferred PDP PLANS 2018 Summary of Benefits Employer Group Tufts Medicare Preferred PDP3 The benefit information provided is a summary of what we cover and that you pay. It does not list
Summary of Benefits 2018
Summary of Benefits 2018 Indiana University Health Plans Medicare Advantage Select Plus HMO 009-001 Indiana University Health Plans Medicare Advantage Select Plus HMO 009-002 Indiana University Health
Summary of Benefits. Regence Medicare Script TM. Enhanced (PDP) Basic (PDP) Medicare Prescription Drug Plan for Utah
2013 Summary of Benefits Medicare Prescription Drug Plan for Utah Regence Medicare Script TM Enhanced (PDP) Regence Medicare Script TM Basic (PDP) Regence BlueCross BlueShield of Utah is an Independent
Annual Notice of Changes for 2014
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2014 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
Medicare Questions? Answered.
Medicare Questions? Answered. A Resource to help you navigate Medicare Advantage Medicare Questions Answered is a FREE enrollment guide providing answers to your Medicare questions, and how a Medicare
Summary of Benefits. January 1, 2015 December 31, First Health Part D Premier Plus (PDP) S
January 1, 2015 December 31, 2015 Summary of Benefits S5768-167 S5768-131 80.06.370.1-NC Y0022_2015_S5768_167_131_NC Accepted 9/2014 Summary of Benefits January 1, 2015 December 31, 2015 This booklet gives
2019 Summary of Benefits
2019 Summary of Benefits Bexar, Dallas, El Paso, Harris, Tarrant, Travis Traditional (HMO) PBP 003 Dual (HMO SNP) PBP 004 Value (HMO SNP) PBP 005 Section 1 (HMO) (HMO SNP) Who can join? To join any of
2019 Benefit Highlights
Los Angeles and Orange Counties 2019 Benefit Highlights VillageHealth (HMO-POS SNP) Medicare Advantage Plan Plan Details Monthly Plan Premium $0 $34.80 $34.80 Annual Plan Deductible $0 deductible deductible
2011 Summary of Benefits
2011 Summary of Benefits (PDP) and January 1, 2011 December 31, 2011 BlueCross BlueShield of South Carolina contracts with the federal government. Contract # s5953 (PDP) s5953_pdp2011sb cms approved 08312010
2019 Benefit Highlights
Riverside County 2019 Benefit Highlights SCAN Prime (HMO) Medicare Advantage Plan NEW PLAN FEATURED BENEFITS Over-the-Counter Drugs VIAGRA (generic) Telehealth Dental Coverage Included Plan Details Monthly
Name: Date of Birth: Gender: Telephone: Address: Check if you do not have a Health Care Proxy. Name: Relationship to Participant: Address:
Enrollment Agreement Name: Date of Birth: Gender: Telephone: Address: Health Care Proxy Check if you do not have a Health Care Proxy Name: Relationship to Participant: Address: Telephone: Guardian or Other
MedicareBlue Rx a stand-alone prescription drug plan
MedicareBlue Rx a stand-alone prescription drug plan 2018 Step-by-step enrollment guide MedicareBlue SM Rx (PDP) S5743_090716_B04_RE CMS Approved 09/07/2017 Thank you for considering MedicareBlue Rx to
Medicare Made Simple
Medicare Made Simple TABLE OF CONTENTS 2 A Coverage Overview: What is Medicare? 3 Original Medicare Parts A and B 5 Medicare Part C Medicare Advantage Plans 6 Medicare Part D Prescription Drug Coverage
2019 Benefit Highlights
Riverside County 2019 Benefit Highlights SCAN Classic (HMO) and Heart First (HMO SNP) Medicare Advantage Plans Plan Details SCAN CLASSIC HEART FIRST Monthly Plan Premium $0 $0 Annual Plan Deductible $0
ANNUAL NOTICE OF CHANGES FOR 2017
Cigna-HealthSpring Rx Secure-Extra (PDP) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2017 You are currently enrolled as a member of Cigna-HealthSpring Rx Secure-Extra (PDP). Next year, there
2017 Summary of Benefits
2017 Summary of Benefits University of Maryland Health Advantage COMPLETE Plan (HMO) H8854 001 This is a summary of drug and health services covered by University of Maryland Health Advantage COMPLETE
How the Aetna Medicare Advantage plan option compares to your current plan Below are coverage and cost examples of key benefits that are important to
151 Farmington Avenue, Hartford, CT 06156 , Key things you should know about Dow 2017
2019 Benefit Highlights
San Diego County 2019 Benefit Highlights Scripps Classic (HMO), Scripps Heart First (HMO SNP) and Scripps Signature (HMO) Medicare Advantage Plans Plan Details Monthly Plan Premium $0 $26 $74 Annual Plan
Annual Notice of Changes for 2015
Prescription Plan Basic (PDP) offered by Health Alliance Medicare Annual Notice of Changes for 2015 You are currently enrolled as a member of Health Alliance Medicare Prescription Plan Basic. Next year,
welcome blueshieldca.com/med_formulary University of California Medicare PPO with Prescription Drug
welcome Welcome to the Blue Shield of California Medicare Rx Plan (PDP) an employer group/union-sponsored Medicare Part D plan for eligible retirees. This plan provides you access to enhanced Medicare
Annual Notice of Changes for 2015
P.O. Box 52424, Phoenix, AZ 85072-2424 SilverScript Plus (PDP) offered by SilverScript Insurance Company Annual Notice of Changes for 2015 You are currently enrolled as a member of BlueRx Enhanced (PDP).
Mail your completed claim form(s) and original, Medicare Part D Drug Claim Form detailed pharmacy receipts to:
Prime Therapeutics Questions about completing this form? Call 401-227-2958 or 1-800-267-0439 TTY: 711 8 a.m. 8 p.m.* Mail your completed claim form(s) and original, Medicare Part D Drug Claim Form detailed
Annual Notice of Changes for 2017
Blue Shield 65 Plus (HMO) offered by Blue Shield of California Annual Notice of Changes for 2017 You are currently enrolled as a member of Blue Shield 65 Plus. Next year, there will be some changes to
Annual Notice of Change
2019 Annual Notice of Change Essence Advantage Plus (HMO) Serving the Missouri counties of Jefferson, St. Charles, St. Louis and St. Louis City and the Illinois counties of Madison, Monroe and St. Clair