2018 CommuniCare Advantage Cal MediConnect Plan (Medicare-Medicaid Plan) H5172-2-0 in CA from Community Health Group | HealthPocket

CommuniCare Advantage Cal MediConnect Plan (Medicare-Medicaid Plan)

$0/mo

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Zip Code90011
Applicant12/10/1983 Male
Coverage Start12/11/2018
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderCommunity Health Group
Plan IDH5172-2-0
Plan Year2018
CMS RatingNot Rated
Plan TypeMedicare-Medicaid Plan
Annual Deductible$0.00

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2019. 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

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsNo
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Not Applicable
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$0.00
Monthly Health Plan Premium$0.00

Benefits

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

Coverage Area for CommuniCare Advantage Cal MediConnect (Medicare-Medicaid )

StateCalifornia
CountyLos Angeles

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 offereds0% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered0% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 5: Specialty Tier

90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered0% coinsuranceNot offered
Tier 2: Non-Preferred GenericNot offered0% coinsuranceNot offered
Tier 3: Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offered0% coinsuranceNot offered
Tier 5: Specialty Tier

Physicians that accept CommuniCare Advantage Cal MediConnect (Medicare-Medicaid ) for California

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COST:from $0CMS Rating:Not Rated
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COST:from $0CMS Rating:
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COST:from $0CMS Rating:
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COST:from $0CMS Rating:Not Rated
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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.

Medicare Plans Found

 

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.