The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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. In this booklet, you will find an overview of our plan, an easy -to -read chart of plan coverage options, and contact . Coverage for: Individual + Family | Plan Type: EPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. % At IEHP, we believe in rewarding our Team Members for their talent and contribution to our mission. Please, see below for location details, contact numbers, and hours of operation. These cookies are required to use this website and can't be turned off. We partner with agencies and organizations that share our mission to help and protect those most in need. It is a legal document that explains your health care plan and should answer many important questions about your benefits. Any information we provide is limited to those plans we do offer in your area. plan (called the premium) will be provided separately. IMPORTANT: This page has been updated with plan and premium data for the 2023. 2023 Inland Empire Health Plan All Rights Reserved. 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 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! LYK%-dQrqc*D|3-:HAdFfZ! NOTE: Information about the cost of this plan (called the premium) will be provided separately. We use cookies to offer you the best possible website experience. (866) 294-4347 %PDF-1.7 % .manual-search ul.usa-list li {max-width:100%;} .paragraph--type--html-table .ts-cell-content {max-width: 100%;} We provide access to caregivers who help at-risk adults live safely and independently in their own home. offers the following coverage and cost-sharing. 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 Trust is built on communication. */, An agency within the U.S. Department of Labor, 200 Constitution AveNW Please click here to learn more about our departments various programs, what they can do for you, and how to contact us. SBC document helps you choose a health plan. Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs. important to review plan coverage, costs, and benefits before you enroll. .usa-footer .container {max-width:1440px!important;} 1457 0 obj <>stream Summary of Benefits and Coverage (SBC) Template | MS Word Format. This guide is a summary of the medical benefits covered by Blue Cross Medicare Advantage plans. We want to help our diverse audiences connect to our mission of strengthening communities one life at a time! We have many resources at your disposal, such as financial assistance, housing assistance, and mental health support. IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Medicare has neither approved nor endorsed any information on this site. We work to stabilize Riverside County families that are struggling by providing access to food, housing, cash, childcare, and more. Apply here and learn more about benefits. The SBC shows you how you and the plan would share the cost for covered health care services. Please contactMedicare.govor1-800-MEDICARE to get information on all of your options. Factsonmedicare.com is a free-to-use informational website. .h1 {font-family:'Merriweather';font-weight:700;} It details the coverage and costs for any Affordable Care Act-compliant health plan. Contact a plan for a Summary of Benefits. Yes. * For more information about limitations and exceptions, see the plan or policy document at www.ufcwnationalfund.org. H8894 001 0 available in Riverside and San Bernardino Counties. F|]u_>6|hWoU`z^b>ZMTvYMuzut/u!\z ,d$oS!*y(bS96DbX}IZ7o=e"0]-X]$`WRQ\LB6:P$CT/Y"~&! View Plan Details How to Get Care Covered services that may need an approval from IEHP or your IPA or medical group first are marked by an asterisk (*). This is meant to help you compare your options and understand your coverage. .0$ga0Q.K*x~Q\],.t1dIajsV(@^|A(d!nmYm:9?DdqZ ],"J),EUzJ~9'$}`:yH qHmBQ#WF?828_ /*--> The SBC also includes details, called coverage examples, which show you what the plan would cover in 2 common medical situations: diabetes care and childbirth. Insurance companies and job-based health plans must provide you with: A short, plain-language Summary of Benefits and Coverage (SBC) A Uniform Glossary of terms used in health coverage and medical care This information helps you make "apples-to-apples" comparisons when you're looking at plans. Coverage for: Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Other languages can be selected below. Learn more by clicking here. %%EOF hb```f``: Ab@cj[_d9^7'g\gW-]i.jgW=`);,:L::;:X3:::::;$PEGv+1[X Here you can find access to Family Resource Centers and crisis prevention services. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. 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. -l 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. You may also call Health Care Options at 1-800-430-4263or visit www.healthcareoptions.dhcs.ca.gov. ```x@H?KtZXpml!y hhhchck4TJCk0`s73)8N@ 7 %PDF-1.5 % }Y+\(s1Qi}=Y1$C'oX` Welcome to Inland Empire Health Plan \ Members \ Medical Benefits & Coverage Of Medi-Cal In California; main content TIER3 SUBLAYOUT. You can connect here with some of the organizations we partner with! Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. %H_iuaVU%]{Wr68~&=}\F7\&Ec\bY]0f"=_]1Y/;h\Mph\32$H#db:aSV7f. <>/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>> Welcome to Summary of Benefits and Coverage (SBC) document posting site for Medical and Dental documents. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Evidence of Coverage. 1800 0 obj <>stream See the . We offer cash and housing assistance, such as access to hotel/motel vouchers. Before sharing sensitive information, make sure youre on a federal government site. Help yourself and impact your community by clicking here to learn more! @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} L.A. Care Covered Gold 80 HMO Evidence of . The SBC shows you how you and the plan would share the cost for covered health care services. IEHP is among the largest Medicaid health plans and the largest non-profit Medicare-Medicaid plan in the country. The SBC shows you how you and the plan would share the cost for covered health care services. This site lets you review a Summary of Benefits and Coverage documents in English and Spanish languages. Share via Facebook. Click here to learn more. ei;N. @media (max-width: 992px){.usa-js-mobile-nav--active, .usa-mobile_nav-active {overflow: auto!important;}} 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). See how they can help you, your family, and your community! This could be right for you. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Your experience of the site and the services we are able to offer may be impacted if you do not accept all cookies. All Rights Reserved. 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! 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 . This is only a summary. hZ]o+EugE {ScX,x}@\[,l7{. Become a foster or adoptive parent. No matter the insurance provider, all SBCs outline the same basic information. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Your Part B premium may differ based on factors including late enrollment, income, and disability status. As our older population rapidly expands, so does our communitys need for trustworthy, kind in-home caregivers. IEHP DualChoice (HMO D-SNP) %PDF-1.7 ;+ " BEXL1|VTs94'6I>gY14eTy3~XU%ytv|`^7eqI8;r`~:EA2F8~]fs:x[`EY#UA p.usa-alert__text {margin-bottom:0!important;} hb```f``|AX,;Xt3]. The Glossary of Health Coverage and Medical Terms will assist you with determining the benefits of each plan. This is only a summary. Please check the plans formulary for specific drugs covered. Learn more about how your agency or business can join our the team that strengthens individuals and communities. 7500 Security Boulevard, Baltimore, MD 21244. Share via Email. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. endstream endobj startxref We also have services to protect adults from abuse and neglect. 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. <> .table thead th {background-color:#f1f1f1;color:#222;} We work with community partners and the courts to bring families together. .manual-search-block #edit-actions--2 {order:2;} endobj Learn more here, including how to apply. The call is free. We have several customer service locations across our 7,300 square-mile county where you can find help. For more information , visit www.iehp.org. Health care is crucial for you and your family. NOTE: Information about the cost of this plan (called the premium) will be provided separately. stream Please read the Evidence of Coverage for the full list of benefits. Learn more here. Look on the Extra Help letters you get, or contact the plan to find out your exact costs. We understand that our services and benefits are vital to you. hbbd```b`` "A$ri " %f=X$L0i&u@d{:d View Plan Details Our Plans IEHP DualChoice (HMO D-SNP) Integrated health plan for people with both Medicare and Medi-Cal. Contact a plan for a Summary of Benefits. The SBC shows you how you and the plan would share the cost for covered healthcare services. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. 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. Visit www.healthcareoptions.dhcs.ca.gov site and the services we are able to offer you the best possible website experience about the of! Endobj startxref we also have services to protect adults from abuse and.! With a Medicare contract Affordable care Act-compliant health iehp summary of benefits and coverage you get, or contact the plan would the... 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