Blue Shield 65 Plus Choice (HMO)

Medicare Advantage Plan (Part C w/ RX)

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PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
Blue Shield of California
CMS Rating
Plan Type
HMO
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage
  • This plan is available for 2015. see plan

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copayNot offered
Tier 2: Non-Preferred Generic$35 copay$35 copayNot offered
Tier 3: Preferred Brand Name$70 copay$70 copayNot offered
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsuranceNot offered
Tier 5: Specialty Tier33% coinsurance33% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copay$0 copay
Tier 2: Non-Preferred Generic$70 copay$105 copay$70 copay
Tier 3: Preferred Brand Name$140 copay$210 copay$140 copay
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsurance25% coinsurance
Tier 5: Specialty Tier33% coinsurance33% coinsurance33% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Cholesterol screening for patients with heart disease
Glaucoma testing
Annual flu vaccine
Pneumonia vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Access to primary care doctor visits
Adult BMI assessment

Managing Chronic Conditions

Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Diabetes care – cholesterol controlled
Controlling blood pressure
Rheumatoid arthritis management
Improving bladder control
Reducing the risk of falling
Plan all-cause readmissions

Ratings of Plan Responsiveness and Care

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan

Member Complaints, Problems Getting Services, and Choosing to Leave the Plan

Complaints about the health plan
Beneficiary access and performance problems
Members choosing to leave the plan
Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability

Physician Finder

Physicians that accept Blue Shield 65 Plus Choice (HMO) for California

/
NICHOLS, PETER
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
MARTIN, SUE
1500 SAN PABLO STREET
LOS ANGELES, CA 90039
GOODWIN, THOMAS
1400 S GRAND AVE
LOS ANGELES, CA 90015
PACWEST ANESTHESIA MEDICAL GROUP, INC
1401 S GRAND AVE
LOS ANGELES, CA 90015
FRANCO, ROSINA
1430 SAN JULIAN ST
LOS ANGELES, CA 90015
CHAN, BRYAN
1225 WILSHIRE BLVD
LOS ANGELES, CA 90017
JACKSON, MELVIN
1225 WILSHIRE BOULEVARD
LOS ANGELES, CA 90017
BUTLER, FREDERICK
616 WITMER STREET
LOS ANGELES, CA 90017
PITTOKOPITIS, KYRIACOS
1127 WILSHIRE BLVD
LOS ANGELES, CA 90017
BAE, JUNG
1245 WILSHIRE BLVD
LOS ANGELES, CA 90017
PAULSON, RICHARD
1127 WILSHIRE BLVD
LOS ANGELES, CA 90017
SOKOL, REBECCA
1127 WILSHIRE BLVD
LOS ANGELES, CA 90017
STEINBERG, REBECCA
612 S FLOWER ST APT 407
LOS ANGELES, CA 90017
SHIN, JAY
2727 W OLYMPIC BLVD
LOS ANGELES, CA 90006
JAMES ALLEN GIBBS, M.D., INC.
3111 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
CESAR E ARANGURI, MD, INC
2955 E FLORENCE AVE
HUNTINGTON PARK, CA 90255
J L NAVARRETE M D INC
3231 E GAGE AVE
HUNTINGTON PARK, CA 90255
CASTANEDA, FORTINO
2131 W 3RD ST
LOS ANGELES, CA 90057
WALUCH, VICTOR
2131 W 3RD ST
LOS ANGELES, CA 90057
MCMONIGLE, E. MICHAEL
2131 W 3RD ST
LOS ANGELES, CA 90057
COX, LELAND
2131 W 3RD ST
LOS ANGELES, CA 90057
KATZ, JAMES
201 S ALVARADO ST
LOS ANGELES, CA 90057
DAE YONG LEE M.D. A MEDICAL CORPORATION
2131 W 3RD ST
LOS ANGELES, CA 90057
WARNECK, CHRISTINA
2131 W 3RD ST
LOS ANGELES, CA 90057
PARKS, STEPHEN
2131 W 3RD ST
LOS ANGELES, CA 90057
Details
PETER NICHOLS, MD
Phone Number
(323) 442-2582
Office Locations
1441 EASTLAKE AVE
LOS ANGELES, CA 90089
1441 EASTLAKE AVE LOS ANGELES CA, 90089

Community Q&A

Do you have questions about this plan?

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2 question
medication copay
Q:
Asked by Anonymous 
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DO YOU CARRY LONG TERM HEALTH CARE?
Q:
Asked by MARTIN COVE 
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