Council on Aging Answers 2015 - 106

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
central health
premier plan

telephone numbers Website

plan type
monthly health and
drug plan premium
size of netWork
out of pocket maximum
doctor visit
specialist visit
in-patient hospitalization
skilled nursing facility
in-patient mental health
outpatient mental health
outpatient hospital services
ambulance
emergency room visit
outpatient rehab services
durable medical equipment
diagnostic tests
x-rays
lab services
part b chemotherapy drugs

dental services

hearing services

vision services

New enrollment:
866-314-2427
Current members:
866-314-2427
centralhealthplan.com
ma-pd (hmo) medicare Advantage
plan with prescription Drug benefit.
must utilize plan physicians, providers
and hospitals.
$28.80 monthly premium
Contact plan for health plan deductible
4501-5000 physicians and providers
$6,700 In-Network
20% of the cost each visit
20% of the cost each visit
Unlimited days each benefit period.
Contact plan for more details.
100 days each benefit period. Contact
plan for more details.
190-day psychiatric hospital lifetime
limit. Contact plan for more details.
$0 each individual or group therapy
visit.
20% of the cost each visit
20% of the cost each service

citizens choice
health plan

citizens choice
calplus plan

New enrollment:
866-646-2247
Current members:
866-634-2247
citizenschoicehealth.com
ma-pd (hmo) medicare Advantage
plan with prescription Drug benefit.
must utilize plan physicians, providers
and hospitals.
$0 monthly premium

7001-7500 physicians and providers
$3,400 In-Network
$0 each visit
$0 each visit
Days 1-10: $0/day, Days 11-45: $100/
day, Days 46-90: $75/day. $0/day after
90 days. Unlimited days each benefit
period.
Days 1-20: $40/day, Days 21-100: $50/
day. 100 days each benefit period.
Days 1-10: $120/day, Days 11-90, $0/
day, Days 91-130: $0/day. 130 days each
benefit period. $250 per stay.
$40 each individual or group therapy
visit.
$0 - $100 each visit

3501-4000 physicians and providers
$3,400 In-Network
$0 each visit
$0 each visit
$0 copay. Unlimited days each benefit
period.

9001-10000 physicians and providers
$3,400 In-Network
20% of the cost each visit
20% of the cost each visit
90 days each benefit period. 60
lifetime reserve days. Contact plan for
more details.

Days 1-20: $40/day, Days 21-100: $50/
day. 100 days each benefit period.
Days 1-10: $120/day, Days 11-90, $0/
day, Days 91-130: $0/day. 130 days each
benefit period. $250 per stay.
$40 each individual or group therapy
visit.
$0 - $100 each visit

100 days each benefit period. Contact
plan for more details.
190-day psychiatric hospital lifetime
limit. Contact plan for more details.

$0-$125 each service, waived if
admitted.
$0-$65 each visit, waived if admitted
within 24 hrs.
$0 each visit

20% of the cost of each service

20% each visit, waived if admitted
within 24 hrs.
20% for occup./cardiac
$0 each visit for all others
20% of cost for medicare-covered items. 0%-20% of cost for medicare-covered
items.
20% of the cost for diagnostic
$0 for diagnostic procedures and tests.
procedures and tests. 20% of the cost
$0 for diagnostic radiology services.
for diagnostic radiology services.
20% of cost each x-ray
$0 each X-ray
20% of cost for lab services. 20% of cost $0 copay for lab services.
for therapeutic radiology services.
$50 copay for therapeutic radiology
services.
20% of the cost for part b chemotherapy 20% of the cost for part b chemotherapy
drugs
drugs
$0 for medicare-covered benefits. $0 for $0 for medicare-covered benefits.
oral exam, up to 2 fluoride treatments/
yr. and up to 2 cleanings/yr. $0 for up to
1 x-ray/6 mo.
20% of the cost for diagnostic exams.
$0 copay for up to 1 routine exam and
up to 1 hearing aid fitting-eval./yr. $0
copay for hearing aid ($2,000 limit/yr.
for hearing aids)
20% of cost to diagnose & treat eye
conditions. 20% of cost for eyewear
after cataract surgery. $0 for up to 1
routine exam/yr. $0 copay for contact
lenses. $0 for up to 1 pair of glasses,
lenses, and frames/yr. ($300 limit/yr.
for eyewear).

citizens choice
platinum plan

20% of cost each individual or group
therapy visit.
20% of the cost each visit

20% each visit, waived if admitted
within 3 days.
20% of cost each visit

20% of cost for medicare-covered items. 20% of cost for medicare-covered items.
$0 for diagnostic procedures and tests.
$0 for diagnostic radiology services.

20% of cost for diagnostic procedures
and tests. 20% of the cost for diagnostic
radiology services.
20% of cost each x-ray
20% of cost for lab services. 20% of cost
for therapeutic radiology services.

$0 each x-ray
$0 copay for lab services.
$50 copay for therapeutic radiology
services.
20% of the cost for part b chemotherapy
drugs
$0-$425 for medicare-covered benefits.
$0 for up to 1 cleaning and 1 oral
exam/6 mo. $0-$20 for up to 1 fluoride
treatment/6 mo. $0-$30 for up to 1
x-ray/3 yrs.

20% of the cost for part b chemotherapy
drugs
$0-$425 for medicare-covered benefits.
$0 for up to 1 cleaning and up to 1 oral
exam/6 mo.
$0-$20 for up to 1 fluoride treatment/6
mo. $0-$30 for up to 1 x-ray/3 yrs.

$0 copay for diagnostic exams. $0 copay $0 copay for diagnostic exams. $0 copay
for up to 1 routine exam and hearing aid for up to 1 routine exam and hearing aid
fitting-eval./ yr.
fitting-eval./yr. $0 copay for hearing
aid. ($1,000 limit/2 yrs. for hearing aids)

$0 copay for diagnostic exams. $0 copay
for up to 1 routine exam and hearing aid
fitting-eval./ yr. $0 copay for hearing
aid. ($1,000 limit/2 yrs. for hearing aids)

$0 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $0 copay for up to
1 routine exam/yr. $0 copay for up
to 1 pair of glasses, contacts, lenses
and frames/2 yrs. ($75 limit/2 yrs. for
eyewear).

20% of cost to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. 20% of cost for up to
1 routine exam/yr. $0 copay for up to
1 pair contact lenses, glasses, lenses,
and frames/2 yrs. ($200 limit/2 yrs. for
eyewear).

$0 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $0 copay for up to 1
routine exam/yr. $0 copay for up to
1 pair contact lenses, glasses, lenses,
and frames/2 yrs. ($200 limit/2 yrs. for
eyewear).

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
106

Answers Guide 2015

COUNCIl ON on these charts is subJect to NONpROFIT CORpORATION. TO DISTRIbUTe ANSweRS FRee OF COST, we for medicare and medicaid Services on the date of publication. lISTINGS IN ANSweRS, THeIR
the informationAGING - ORANGe COUNTY IS A 501 (C)3change. This information is the most current available from the CentermUST Sell ADveRTISING SpACe. wHIle we AppReCIATe THe pAIDConsumers need to verify this
Aging and Disability Resource Connection | 800-510-2020 | www.adrcoc.org
INClUSION does notwww.medicare.gov as updatesor endorsement ofCOAOC is not or services by coaoc. AlwAYScanA vIGIlANT CONSUmeR. veRIFY INFORmATION ANDvia our HICAp program 1-800-434-0222.
information at imply a recommendation are frequently made. products responsible for these changes but be help with accessing the most current information SeeK ReFeReNCeS wHeRe AppROpRIATe.

http://www.centralhealthplan.com http://www.citizenschoicehealth.com http://www.citizenschoicehealth.com http://www.citizenschoicehealth.com http://www.medicare.gov

Council on Aging Answers 2015

Table of Contents for the Digital Edition of Council on Aging Answers 2015