Council on Aging Answers 2015 - 108

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
health net
seniority plus complete
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

health net
gold select

humana
gold plus h0108-011

humana
gold plus h0108-047

New enrollment:
800-877-4814
Current members:
800-275-4737
healthnet.com/medicare
ma-pd (hmo) medicare Advantage plan
with prescription Drug benefit. must
utilize plan physicians, providers and
hospitals.
$176 monthly premium

New enrollment:
866-205-0000
Current members:
800-457-4708
humana.com/medicare
ma-pd (hmo) medicare Advantage plan
with prescription Drug benefit. must
utilize plan physicians, providers and
hospitals.
$0 monthly premium

1001-1500 physicians and providers
$2,500 In-Network
$0 each visit
$0 each visit
Days 1-5: $100/day. Days 6-90: $0/day.
$0/day after 90 days. Unlimited days
each benefit period.

1001-1500 physicians and providers
$2,200 In-Network
$0 each visit
$0 each visit
$0 copay. Unlimited days each benefit
period.

7501-8000 physicians and providers
$3,400 In-Network
$0 each visit
$0 each visit
$0 copay. Unlimited days each benefit
period.

Days 1-20: $0/day, Days 21-100: $75/day.
100 days each benefit period.
$900 each stay. 190-day psychiatric
hospital lifetime limit.

Days 1-20: $0/day, Days 21-100: $50/day.
100 days each benefit period.
$0 copay. 190-day psychiatric hospital
lifetime limit.

Days 1-100: $0/day. 100 days each
benefit period.
$0 copay. 190-day psychiatric hospital
lifetime limit.

$25 each individual or group therapy
visit.
$0-$100 each visit
$150 each service
$65 each visit, waived if admitted
immediately.
$0 each visit

$25 each individual or group therapy
visit.
$0 -$60 each visit
$250 each service
$65 each visit, waived if admitted
immediately.
$0 each visit

$10 each individual or group therapy
visit.
$0-$40 or 20% of cost each visit.
$50 each service
$65 each visit, waived if admitted within
24-hrs.
$0 each visit

20% of cost for medicare-covered items. 20% of cost for medicare-covered items. 0% - 20% of cost for medicare-covered
items.
$0 for diagnostic procedures and tests. $0 for diagnostic procedures and tests. $0 for diagnostic procedures and tests.
$60 for diagnostic radiology services.
$60 for diagnostic radiology services.
$0-$40 for diagnostic radiology services.

0% - 20% of cost for medicare-covered
items.
$0 for diagnostic procedures and tests.
$0-$40 for diagnostic radiology services.

$0 each x-ray
$0 copay for lab services.
$60 copay for therapeutic radiology
services.
20% of the cost for part b chemotherapy
drugs
$0 copay for medicare-covered benefits.
$0 for up to 2 cleanings, 2 x-rays, 2
fluoride treatments, and 2 oral exams/yr.
($1000 limit/yr. for most dental services)

$0 each x-ray
$0 copay for lab services.
$60 copay for therapeutic radiology
services.
20% of the cost for part b chemotherapy
drugs
$0 copay for medicare-covered benefits.
$0 for oral exam, $0 for up to 1 fluoride
treatment, for up to 1 x-ray, and up to 2
cleanings/yr.

$0 each x-ray
$0 each x-ray
$0 copay for lab services. 20% of cost for $0 copay for lab services.
therapeutic radiology services.
20% of cost for therapeutic radiology
services.
20% of the cost for part b chemotherapy 20% of the cost for part b chemotherapy
drugs
drugs
$0 copay for medicare-covered benefits. $0 copay for medicare-covered benefits.
$0 for up to 1 cleaning, x-ray, oral
$0 for up to 2 cleanings, up to 2 fluoride
exam/yr.
treatments, up to 2 oral exams/yr.,
$0 for up to 4 x-rays.

$25 copay for diagnostic exams. $25
copay for up to 1 routine exam/yr. $0
copay for up to 1 hearing aid fittingeval/3 yrs. $0 for hearing aid ($2000
limit/3 yrs. for hearing aids)
$0-$25 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $25 copay for up to 1
routine exam/yr. $0 copay for up to 1 pair
of glasses, contacts, lenses, frames/2 yrs.
($100 limit/2 yrs. for eyewear)

$0 copay for diagnostic exams. $0 copay
for up to 1 routine exam/yr. $0 for up
to 1 hearing aid fitting-eval./3 yrs., $0
for hearing aid ($1,000 limit/3 yrs. for
hearing aids)
$0-$25 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $10 copay for up to 1
routine exam/yr. $0 copay for up to 1 pair
of glasses, contacts, lenses, frames/2 yrs.
($100 limit/2 yrs. for eyewear)

$0 copay for diagnostic exams. $0 copay
for up to 1 routine exam and up to 1
hearing aid fitting-eval/yr. $0 for hearing
aid. ($2000 limit/yr. for hearing aids)

$0 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $0 copay for up to 1
routine eye exam/yr. $0 copay for up to 1
pair contacts or glasses/yr. ($100 limit/
yr. for contacts or glasses)

$0 copay to diagnose & treat eye
conditions. $0 copay for eyewear after
cataract surgery. $0 copay for up to 1
routine eye exam, up to 1 pair contacts,
up to 1 pair glasses/yr. ($200 limit/yr.
for contacts or glasses)

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
108

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.healthnet.com/medicare http://www.healthnet.com/medicare http://www.humana.com/medicare http://www.humana.com/medicare http://www.medicare.gov

Council on Aging Answers 2015

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