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

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)

All cost-sharing assumes in-network healthcare providers.

Plan Details

Costs and Other Important Information

Plan Year:
2016
Monthly Drug Plan Premium
Information Not Available
Health Plan Deductible
Information Not Available
Choice of Doctors?
Information Not Available
Monthly Health Plan Premium
Information Not Available
Out-Of-Pocket Spending Limit
Information Not Available
Optional Supplemental Benefits?
Information Not Available
Prescription Drugs Covered?
Information Not Available
Other Health Plan Deductibles?
Information Not Available

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$7 copayNot offered
Tier 2: Non-Preferred Generic$3 copay$10 copayNot offered
Tier 3: Preferred Brand Name$30 copay$37 copayNot offered
Tier 4: Non-Preferred Brand Name$65 copay$72 copayNot offered
Tier 5: Specialty Tier25% coinsurance25% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$21 copay$0 copay
Tier 2: Non-Preferred Generic$6 copay$30 copay$6 copay
Tier 3: Preferred Brand Name$60 copay$111 copay$60 copay
Tier 4: Non-Preferred Brand Name$130 copay$216 copay$130 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
Not Rated
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
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

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

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

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

/
SELSTED, MICHAEL E
2011 ZONAL AVE
LOS ANGELES, CA 90089
PACWEST ANESTHESIA MEDICAL GROUP, INC
1401 S GRAND AVE
LOS ANGELES, CA 90015
STEINBERG, REBECCA
612 S FLOWER ST APT 407
LOS ANGELES, CA 90017
SOKOL, REBECCA
1127 WILSHIRE BLVD
LOS ANGELES, CA 90017
PAULSON, RICHARD
1127 WILSHIRE BLVD
LOS ANGELES, CA 90017
FITZGIBBONS, TERRENCE
1245 WILSHIRE BLVD
LOS ANGELES, CA 90017
BUTLER, FREDERICK
616 WITMER STREET
LOS ANGELES, CA 90017
JACKSON, MELVIN
1225 WILSHIRE BOULEVARD
LOS ANGELES, CA 90017
BAE, JUNG
1245 WILSHIRE BLVD
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
SANCHEZ, LUCIO
6330 RUGBY 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
RAHA AKHAVAN, M.D., APC
2131 W 3RD ST
LOS ANGELES, CA 90057
LEE, BOCK
2131 W 3RD ST
LOS ANGELES, CA 90057
SEDKY, SOURAYA
2131 W 3RD ST
LOS ANGELES, CA 90057
WARNECK, CHRISTINA
2131 W 3RD ST
LOS ANGELES, CA 90057
DAE YONG LEE M.D. A MEDICAL CORPORATION
2131 W 3RD ST
LOS ANGELES, CA 90057
COX, LELAND
2131 W 3RD ST
LOS ANGELES, CA 90057
WALUCH, VICTOR
2131 W 3RD ST
LOS ANGELES, CA 90057
LEE, DAE
2131 W 3RD ST
LOS ANGELES, CA 90057
LOIS, JUAN
2131 W 3RD ST
LOS ANGELES, CA 90057
LEE, JOUNG
2131 W 3RD ST
LOS ANGELES, CA 90057
PARKS, STEPHEN
2131 W 3RD ST
LOS ANGELES, CA 90057
Details
MICHAEL E SELSTED, MD
Phone Number
(323) 442-1180
Office Locations
2011 ZONAL AVE
LOS ANGELES, CA 90089
2011 ZONAL AVE LOS ANGELES CA, 90089

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