2018 Aspire Health Plus (HMO-POS) H8764-2-0 in CA from Aspire Health Plan | HealthPocket

Aspire Health Plus (HMO-POS)

Medicare Advantage Plan for California

select spinner
PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderAspire Health Plan
Plan IDH8764-2-0
CMS Rating1
Plan TypeHMO-POS
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

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$0 In and Out-of-network $0 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$59.00
Monthly Health Plan Premium
$188.00

Benefits

Service
Cost
Inpatient hospital coverage
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient hospital coverage
In-Network:
$0 copay
Out-of-Network:
$0 copay
Doctor visits
Primary:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Specialist:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Preventive care
In-Network:
$0 copay
Out-of-Network:
$0 copay
Emergency care/Urgent care
Emergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Lab services:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Diagnostic radiology services (e.g., MRI):
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient x-rays:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Mental health services
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient group therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient individual therapy visit with a psychiatrist:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient group therapy visit:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Outpatient individual therapy visit:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Skilled Nursing Facility
In-Network:
$0 copay
Out-of-Network:
$0 copay
Rehabilitation services
Occupational therapy visit:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Physical therapy and speech and language therapy visit:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Ambulance
In-Network:
$0 copay
Out-of-Network:
$0 copay
Transportation
In-Network:
$0 copay
Foot care (podiatry services)
Foot exams and treatment:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Routine foot care:
Not covered
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
In-Network:
$0 copay
Out-of-Network:
$0 copay
Prosthetics (e.g., braces, artificial limbs):
In-Network:
$0 copay
Out-of-Network:
$0 copay
Diabetes supplies:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
In-Network:
$0 copay
Out-of-Network:
$0 copay
Other Part B drugs:
In-Network:
$0 copay
Out-of-Network:
$0 copay

Coverage Area for Aspire Health Plus (HMO-POS)

StateCalifornia
CountyLos Angeles

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$8 copayNot offered
Tier 3: Preferred Brand NameNot offered$42 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$90 copayNot offered
Tier 5: Specialty TierNot offered33% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$0 copayNot offered
Tier 2: Non-Preferred GenericNot offered$16 copayNot offered
Tier 3: Preferred Brand NameNot offered$84 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered$180 copayNot offered
Tier 5: Specialty TierNot offered33% coinsuranceNot offered

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Not Rated
Improving or maintaining mental health
Not Rated
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
Not Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Not Rated
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
Not Rated
Call center – foreign language interpreter and TTY/TDD availability - Medical
Not Rated

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
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
Not Rated
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 Aspire Health Plus (HMO-POS) for California

/

No results found. Try changing the search distance or zip code.

Similar Plans

PremiumPlan NameCMS Rating
from $12
Kaiser Permanente Senior Advantage B Only South (HMO)
Details
from $0
Alignment Health Plan Platinum (HMO)
Details
from $0
Anthem Value Plus (HMO)
Details
from $28
SilverScript Choice (PDP)
Details
from $0
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
Details

Related Articles

Related Searches

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

{}