We offer cash and housing assistance, such as access to hotel/motel vouchers. 1 0 obj Medi-Cal Plan No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. A short, plain-language Summary of Benefits and Coverage (SBC), A Uniform Glossary of terms used in health coverage and medical care. NOTE: Information about the cost of this plan (called the premium) will be provided separately. 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. Help yourself and impact your community by clicking here to learn more! Learn more here. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Contact the plan for details. div#block-eoguidanceviewheader .dol-alerts p {padding: 0;margin: 0;} ? Outpatient (Ambulatory) Services Physician services Hospital outpatient & outpatient clinic services Outpatient surgery (Includes anesthesiologist services.) The SBC shows you how you and the plan would share the cost for covered health care services. We understand that our services and benefits are vital to you. Summary of Benefits and Coverage (SBC) Template | MS Word Format. Find out if you qualify for a Special Enrollment Period. 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. endobj Every child deserves a stable, safe, and supportive family. You may be able to get the SBC and Uniform Glossary in a language other than English upon request. %PDF-1.5 % The SBC shows you how you and the plan would share the cost for covered health care services. #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;} 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. IEHP - Medi-Cal California Medical Insurance Requirements : Welcome to Inland Empire Health Plan \. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. It details the coverage and costs for any Affordable Care Act-compliant health plan. Contact a plan for a Summary of Benefits. . Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. We care about the people we serve and last year we served one million people in Riverside County. ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials - for plan years beginning on or after 4/1/17. Here youll find the DPSS newsletter, press releases, compelling videos, regular podcasts and contact information for media inquiries. All Rights Reserved. The SBC shows you how you and the plan would share the cost for covered healthcare services. .cd-main-content p, blockquote {margin-bottom:1em;} 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! 1731 0 obj <> endobj That's why we offer an annual salary, eligibility for annual bonus, plus a benefits package estimated at 35% of the annual salary. .usa-footer .container {max-width:1440px!important;} stream Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. Learn more here, including how to apply. IEHP DualChoice (HMO D-SNP) Visit bluecrossmn.com or call toll free at 1-855-579 . KtV An official website of the United States government. NOTE: Information about the cost of this plan (called the premium) will be provided separately. TTY users should call 1-800-718-4347. <> L.A. Care Covered Gold 80 HMO Evidence of . We have several customer service locations across our 7,300 square-mile county where you can find help. 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. 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 This is only a summary. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R] /MediaBox[ 0 0 792 615] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 7500 Security Boulevard, Baltimore, MD 21244. Become a foster or adoptive parent. Any information we provide is limited to those plans we do offer in your area. This is only a summary. We work with community partners and the courts to bring families together. You need a roof over your head. At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. endstream endobj startxref It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions. A summary of benefits and coverage (SBC) is a document that all insurance companies are required to provide. 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. %%EOF Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. .agency-blurb-container .agency_blurb.background--light { padding: 0; } 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). We use cookies to offer you the best possible website experience. 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. We protect our communitys most vulnerable children and adults. Sample Completed SBC | MS Word Format. Were here to help! 4 0 obj When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. NOTE: Information about the cost of this . Youll also find access to services for those in crisis here. Restaurant Meals Program Vendor Information. See how they can help you, your family, and your community! NOTE: Information about the cost of this plan (called the premium) will be provided separately. SBCs also explain health plans' unique features You may also call Health Care Options at 1-800-430-4263. offers the following coverage and cost-sharing. %PDF-1.7 % 1203 0 obj <>/Filter/FlateDecode/ID[<2EA2F92DEE203348B8E2055B85623233>]/Index[1175 44]/Info 1174 0 R/Length 127/Prev 402092/Root 1176 0 R/Size 1219/Type/XRef/W[1 3 1]>>stream TAhh])f?u Vh7 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 . * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. Advantage Plus benefits and premiums . Coverage for: Individual + Family | Plan Type: EPO 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. 1800 0 obj <>stream We do not offer every plan available in your area. The SBC shows you how you and the plan would share the cost for covered health care services. IEHP DualChoice (HMO D-SNP) 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. All plan-related information on this site is from CMS.gov and Medicare.gov. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. hYioH+ 3"> >Ivg@K, #block-googletagmanagerfooter .field { padding-bottom:0 !important; } %PDF-1.6 % LYK%-dQrqc*D|3-:HAdFfZ! Contact the plan for details. If you or your family is at risk of experiencing homelessness or is homeless, click here to learn more. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. No matter the insurance provider, all SBCs outline the same basic information. The SBC shows you how you and the plan would share the cost for covered health care services. x}koH?5,H=Ht.cX(lmKIM7:XHxhGRyj'}wz/n6}~ya~Z=r~~}o~*,)7X0)K2x""-UerS/L[eo~=Kf|?~Vf\+yEr f|3),-$B:. For those struggling with low income, we offer assistance programs for food, cash, housing and health coverage. 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. If you need a paper copy, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical Program. stream Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. These cookies are required to use this website and can't be turned off. We have many resources at your disposal, such as financial assistance, housing assistance, and mental health support. Trust is built on communication. Contact a plan for a Summary of Benefits. 0 We provide access to caregivers who help at-risk adults live safely and independently in their own home. In fact, its our top priority. % View Plan Details How to Get Care also provides the following benefits. hbbd```b`` "A$ri " %f=X$L0i&u@d{:d "::B (fPP5HK:~f6|\LrZ* PQoE_}a`@`C'= .dol-alert-status-error .alert-status-container {display:inline;font-size:1.4em;color:#e31c3d;} wT].b`bd` FI? Apply here and learn more about benefits. Medi-Cal also known as Medicaid is a public health insurance program for low-income people offered by the state. Once you reach that amount, you will enter the next coverage phase. Enroll on the phone or online! Competitive Salary and Benefits Package IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. Learn more by clicking here. This is only a summary. We can give you job training opportunities, employment assistance, and access to rewarding careers that support individuals and families. (800) 720-4347 (TTY). 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. 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. 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. B%32/`N`da 1}v 500mZT` pau{@Z!o~Z@ bM Essential Health Benefits Summary A one-page Essential Health Benefits Summary is available for download. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} This is only a summary. d.Y&8&MUgQ p.usa-alert__text {margin-bottom:0!important;} #block-googletagmanagerheader .field { padding-bottom:0 !important; } If you or your has limited income, Medi-Cal provides health coverage for no or low-cost. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. We also have partners throughout Riverside County waiting to help you at any time. We believe in the power of partnerships. hb```f``|AX,;Xt3]. hZ]o+EugE {ScX,x}@\[,l7{. would share the cost for covered health care services. You may also qualify for Extra Help on drug costs. Please check the plans formulary for specific drugs covered. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. Want to speak to someone face-to-face? Look on the Extra Help letters you get, or contact the plan to find out your exact costs. Ready to sign up for IEHP DualChoice (HMO D-SNP) Copy Page Link. ei;N. Please, see below for location details, contact numbers, and hours of operation. Previous Next ===== TABBED SINGLE CONTENT GENERAL. You have the right to an easy-to-understand summary about a health plans benefits and coverage. You may request a printed copy of the Member Handbook by calling our Member Services department at 1-855-270-2327 (TTY 711 ). Consider or children in need. k)fXgj&*mg{~?>4CI[s10|=C>G>%/K yN&0xk^8Z^q. 324 0 obj <> endobj See the Part D Premium Reduction section below for more details. Your Part B premium may differ based on factors including late enrollment, income, and disability status. 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. Learn more by clicking here. 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. 4 711 (TTY), To Enroll with IEHP (800) 718-4347 (TTY), IEHP DualChoice Member Services IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Community is built on trust. TTY users should call 1-800-430-7077. Call the IEHP Enrollment Advisors at (866) 294-4347, Monday Friday, 8am 5pm. The site is secure. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. Health care is crucial for you and your family. Before sharing sensitive information, make sure youre on a federal government site. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Learn more about how your agency or business can join our the team that strengthens individuals and communities. You can compare options based on price, benefits, and other features that may be important to you. Our mission is to help our residents find a path to financial independence. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Your HBA, usually located in your agency's personnel office, can also print you a copy . )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# <> Children with Medi-Cal coverage under the Childrens Health Insurance Program (CHIP) will have a low monthly premium. %PDF-1.7 provides the following cost-sharing on drugs. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . Some of the services listed are covered only if IEHP or your IPA approves first. ah v$c`bd`Qb`_g "[y Federal government websites often end in .gov or .mil. Medicare has neither approved nor endorsed any information on this site. It covers families with children, seniors, persons with disabilities, foster care children, pregnant women, and low-income people with specific diseases. It is a legal document that explains your health care plan and should answer many important questions about your benefits. 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. H8894 001 0 available in Riverside and San Bernardino Counties. You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. 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. Live help. hb```f``Z pA2,Nh0b 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 $4,660.00. endstream endobj startxref You can become the loving parent a child needs and deserves. IEHP DualChoice (HMO D-SNP) This is only a . You can connect here with some of the organizations we partner with! Medi-Cal is a no-cost or low-cost health coverage program. This is only a summary. Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. /*--> endobj F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! IEHP DualChoice (HMO D-SNP) IMPORTANT: This page has been updated with plan and premium data for the 2023. Your family is your top priority. ]]>*/, An agency within the U.S. Department of Labor, 200 Constitution AveNW JQua/V7 25O,G RlJ E7j{ hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X Check if you qualify for a Special Enrollment Period. See the . for details. (=eVXPjZ=klnA0` 9bI1TE!~ZScs3$! is offered in the following locations. Inland . hbbd```b``A$~"fGHF-0;Dl>`O"`RLg@d0LRA vO6 -l Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. 1457 0 obj <>stream Other languages can be selected below. Click to Call 1-877-354-4611 TTY 711. View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. The .gov means its official. 0 This is only a summary. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. (866) 294-4347 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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! This is only a summary. ozI?TNt2J\2 k/=Ak <>/Metadata 2580 0 R/ViewerPreferences 2581 0 R>> SBC document helps you choose a health plan. This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. 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. We only use data released publicly each year. Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. (877) 273-4347 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 The SBC shows you how you and the plan would share the cost for covered health care services. 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. We believe in helping YOU take care of yourself and your family. [CDATA[/* >