Here you can find access to Family Resource Centers and crisis prevention services. Summary of Benefits and Coverage (SBC) Template | MS Word Format. We care about the people we serve and last year we served one million people in Riverside County. 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. Contact the plan for details. %PDF-1.7 It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. You can compare options based on price, benefits, and other features that may be important to you. In fact, its our top priority. L.A. Care Covered Platinum 90 HMO Evidence of Coverage. TAhh])f?u Vh7 Copy Page Link. You can get a Summary of Benefits and Coverage for all individual and job-based health plans, including. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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. 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). This is only a summary. (866) 294-4347 IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. 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. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Medicare has neither approved nor endorsed any information on this site. All rights reserved | About | Contact | Legal and Privacy. 0 SBC document helps you choose a health plan. Once you reach that amount, you will enter the next coverage phase. We work with community partners and the courts to bring families together. For more information , visit www.iehp.org. Ready to sign up for IEHP DualChoice (HMO D-SNP) This includes cookies necessary for the website's operation. Call 1-877-354-4611 TTY 711, $10.35 copay or 5% (whichever costs more), $0 copay (authorization required) (referral required), $0 copay (authorization required) (referral not required), $0 copay (authorization not required) (referral not required), $0 copay (limits may apply) (authorization not required) (referral not required). As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. We want to help our diverse audiences connect to our mission of strengthening communities one life at a time! 1731 0 obj <> endobj plan (called the premium) will be provided separately. A summary of benefits and coverage (SBC) is a document that all insurance companies are required to provide. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! We believe in the power of partnerships. We do not offer every plan available in your area. It is a legal document that explains your health care plan and should answer many important questions about your benefits. Learn more about resources in languages other than English. Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. Learn more here. Some of the services listed are covered only if IEHP or your IPA approves first. hb```f``Z pA2,Nh0b 3 0 obj Want to speak to someone face-to-face? Share via LinkedIn. The call is free. TTY users should call (800) 720-4347. (800) 718-4347 (TTY), IEHP DualChoice Member Services 711 (TTY), To Enroll with IEHP Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. We protect our communitys most vulnerable children and adults. 0 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. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. (877) 273-4347 We have several customer service locations across our 7,300 square-mile county where you can find help. 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. See the Part D Premium Reduction section below for more details. NOTE: Information about the cost of this plan (called the premium) will be provided separately. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. %PDF-1.7 % Factsonmedicare.com is a free-to-use informational website. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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. %PDF-1.5 % hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 Please read the Evidence of Coverage for the full list of benefits. The SBC also includes details, called coverage examples, which show you what the plan would cover in 2 common medical situations: diabetes care and childbirth. endstream endobj startxref d.Y&8&MUgQ IEHP DualChoice (HMO D-SNP) We also have partners throughout Riverside County waiting to help you at any time. This is only a summary. <> <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. It provides health, dental and vision* coverage to qualified low-income California residents. Team Member* benefits include: 2019 Inland Empire Health Plan. ? F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! Get help from a licensed Medicare agent. 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. 2023 Open Enrollment is over, but you may still be able to enroll in 2023 health insurance through a Special Enrollment Period. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Click here to learn more. Important Reading for IEHP Medi-Cal Members, IEHP Medi-Cal Member Services This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. 2023 Inland Empire Health Plan All Rights Reserved. View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. Restaurant Meals Program Vendor Information. 2 0 obj Youll also find access to services for those in crisis here. You may also call Health Care Options at 1-800-430-4263. After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. Medi-Cal (the name for Medicaid in California) offers comprehensive coverage, including mental health resources. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. .usa-footer .grid-container {padding-left: 30px!important;} We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ Press Tab to Move to Skip to Content Link. Plan Overview. .table thead th {background-color:#f1f1f1;color:#222;} The .gov means its official. [CDATA[/* >
