Council on Aging Answers 2015 - 109

COUNCIL ON AGING - ORANGE COUNTY

Medicare Advantage Plans Comparison Chart
humana
gold plus h0108-050

inter valley
oc preferred

kaiser
senior advantage

scan
scan classic

scan
scan plus

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.
$22.90 monthly premium Contact plan
for health plan deductible
10001-11000 physicians and providers
$6,700 In-Network
20% of the cost each visit
20% of the cost each visit
Days 1-60: $0, Days 61-90: $304, Days
91-150: $608/day. $0 for days 151 and
beyond. Unlimited days each benefit
period.
Days 1-20: $0/day, Days 21-100: $150/
day. 100 days each benefit period.
190-day psychiatric hospital lifetime
limit. Contact plan for more details.

New enrollment:
800-500-7018
Current members:
800-251-8191
ivhp.com
ma-pd (hmo) medicare Advantage plan
with prescription Drug benefit. must
utilize plan physicians, providers and
hospitals.
$0 monthly premium

New enrollment:
866-973-4584
Current members:
800-443-0815
kp.org/medicare
ma-pd (hmo) medicare Advantage plan
with prescription Drug benefit. must
utilize plan physicians, providers and
hospitals.
$0 monthly premium

4501-5000 physicians and providers
$3,400 In-Network
$0 each visit
$0 each visit
$0 copay. Unlimited days each benefit
period.

3501-4000 physicians and providers
$4,400 In-Network
$5 each visit
$5 each visit
Days 1-7: $210/day, Days 8-90: $0/day,
$0/day after 90 days. Unlimited days
each benefit period.

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

New enrollment:
877-452-5898
Current members:
800-559-3500
scanhealthplan.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
3501-4000 physicians and providers
$6,000 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: $0/day, Days 21-100: $50/day.
100 days each benefit period.
Days 1-7: $210/day, Days 8-90: $0/day,
$0/day after 90 days. Unlimited days
each benefit period.
$5 each individual visit.
$2 each group therapy visit.
$0-$210 each visit
$200 each service
$65 each visit, waived if admitted within
24-hrs.
$5 each visit cardiac/occup.
$0-$5 each visit all others
20% of cost for medicare-covered items.

Days 1-20: $0/day, Days 21-100: $25/day.
100 days each benefit period.
$0 copay. 190-day psychiatric hospital
lifetime limit.

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

$30 each individual or group therapy
visit.
$0 - $100 each visit
$200 each service
$65 each visit, waived if admitted
immediately.
$10 each visit

20% of the cost each individual or group
therapy visit.
20% of cost for each visit
20% of the cost for each service
$65 each visit.

0%-20% of cost for medicare-covered
items.
$0 for diagnostic procedures and tests.
$100 copay for diagnostic radiology
services.
$0 for each x-ray
$0 copay for lab services. $50 copay for
therapeutic radiology services.

20% of cost for medicare-covered items.

Days 1-13: $0/day, Days 14-100: $40/day.
100 days each benefit period.
Days 1-6: $75/day. Days 7-90: $0/day.
190-day psychiatric hospital lifetime
limit.
20% of cost each individual or group
$10 each individual or group therapy
therapy visit.
visit.
20% of cost each visit
$0 each visit
20% each service
$200 each service
$65 each visit, waived if admitted within $65 each visit, waived if admitted within
24-hrs.
24-hrs.
20% of cost each visit
$0 each visit cardiac; $10 each visit all
others
20% of cost for medicare-covered items. 10% of cost for medicare-covered items.
0-20% of cost for diagnostic procedures
and tests. 20% of the cost for diagnostic
radiology services.
20% of cost each x-ray
0-20% of cost for lab services.
20% of cost for therapeutic radiology
services.
20% of the cost for part b chemotherapy
drugs
20% of cost for medicare-covered
benefits. $0 for up to 2 cleanings, up to
2 oral exams, up to 2 x-rays/yr. ($2000
limit/yr. for most dental services)

$0 for diagnostic procedures and tests. $0-$20 for diagnostic procedures and
$0-$60 for diagnostic radiology services. tests. $155 for diagnostic radiology
services.
$0-$60 each x-ray
$40 each x-ray
$0 copay for lab services.
$0-$20 copay for lab services. $0 copay
$15 copay for therapeutic radiology
for therapeutic radiology services.
services.
20% of the cost for part b chemotherapy $0-$45 copay for part b chemotherapy
drugs
drugs
$0 copay for medicare-covered benefits. $5 copay for medicare-covered benefits.
$4-$10 for up to 1 oral exam and $10 for
up to 1 cleaning/6 mo., $10-$20 for up to
1 fluoride treatment/6 mo., $0-$10 for
up to 1 x-ray/3 yrs.
20% of cost for diagnostic exams. $0
$0 copay for diagnostic exams. $0 copay $5 copay for diagnostic exams.
copay for up to 1 routine exam and up
for up to 1 routine exam, up to 1 hearing
to 1 hearing aid fitting-eval/yr. $0 for
aid fitting-eval./yr., $0 for hearing aid.
hearing aid. ($2000 limit/yr. for hearing ($250 limit/3 yrs. for hearing aids)
aids)
0-20% of cost to diagnose & treat eye
$0 copay to diagnose & treat eye
$5 copay to diagnose & treat eye
conditions. 20% of cost for eyewear after conditions. $0 copay for eyewear after conditions. $0 for eyewear after cataract
cataract surgery. $0 copay for up to 1
cataract surgery. $15 copay for up to 1
surgery. $5 copay for routine exams. $0
routine eye exam/yr. $0 copay for up to routine exam/yr. $25 copay for up to 1 copay for glasses, lenses, contacts ($50
1 pair contacts, up to 1 pair glasses/yr. pair of eyeglasses/2 yrs. ($100 limit/2 yrs. limit/2 yrs. for glasses, lenses, contacts).
($200 limit/yr. for contacts, glasses)
for glasses)

20% of cost each visit

20% of cost for diagnostic procedures
and tests. 20% of cost for diagnostic
radiology services.
20% of cost for each x-ray
$0 copay for lab 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. 20% of the cost for medicare-covered
benefits.

$0 copay for diagnostic exams. $0 copay
for up to 1 routine exam/yr. and up to 1
hearing aid fitting-eval./2 yrs. $0 copay
for hearing aid. ($500 limit/2 yrs. for
hearing aids)
$0 copay to diagnose & treat eye
conditions. $0 for up to 1 routine exam/
yr. $0 for eyewear after cataract surgery.
$35 for up to 1 pair of glasses, contacts,
lenses/2 yrs. $0 for up to 1 frame/2
yrs. ($105 limit each for contacts and
frames/2 yrs.)

20% of the cost for diagnostic exams. $0
copay for up to 1 routine exam/yr. and
up to 1 hearing aid fitting-eval./2 yrs. $0
copay for hearing aid. ($1,400 limit/2 yrs.
for hearing aids)
0%-20% of the cost to diagnose & treat
eye conditions. $0 for up to 1 routine
exam/yr. 20% of the cost for eyewear
after cataract surgery. $0 for up to 1 pair
of contacts, glasses, lenses, frames/2
yrs. ($175 limit each for contacts and
frames/2 yrs.

Confused by Medicare? Call the Council on Aging Orange County HICAP experts at (800) 434-0222
the information on these charts is subJect to change. 714-479-0107 | current available from the Center for medicare and medicaid Services on the date of publication. Consumers need to verify this
Council On Aging-Orange County | This information is the most www.coaoc.org
information at www.medicare.gov as updates are frequently made. COAOC is not responsible for these changes but can help with accessing the most current information via our HICAp program 1-800-434-0222.

Answers Guide 2015

109

http://www.humana.com/medicare http://www.ivhp.com http://www.kp.org/medicare http://www.scanhealthplan.com http://www.scanhealthplan.com http://www.medicare.gov

Council on Aging Answers 2015

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