Central Health Medicare Plan is a Coordinated Care plan with a Medicare Advantage contract but without a contract with the California Medicaid program. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1, 2013. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.
You must have both Medicare Part A and Part B, and reside in the service area of the plan to enroll. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Limitations, copayments, and restrictions may apply. Members may enroll in the plan only during specific times of the year. Contact Central Health Medicare Plan for more information.
You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply. You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor Central Health Medicare Plan will be responsible for the costs.
Premiums, co-pays, and co-insurance may vary based on the level of Extra Help you receive. For more information contact the plan.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or Your State Medicaid Office.
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.
Central Health Medi-Medi Plan HMO SNP has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2012. NCQA’s approval is based on a review of Central Health Medi-Medi Plan’s Model of Care and is an indicator of compliance with CMS requirements. NCQA’s approval is not an endorsement by CMS and/or NCQA of Central Health Medi-Medi Plan or the quality of service provided by Central Health Medi-Medi Plan. Central Health Medi-Medi Plan will still need to be approved each year by CMS in order to operate. If you have questions regarding our approval by the NCQA, please contact us at 1-866-314-2427.
This information is available for free in other languages. Please contact our customer service number at 1-866-314-2427 for additional information, TTY/TDD 1-888-205-7671, 7 days a week, 8:00 AM to 8:00 PM (PST).
Esta información es disponible gratuitamente en otros lenguajes. Para información adicional, favor de ponerse en contacto con nuestro número de servicio al cliente al 1-866-314-2427. TTY/TDD 1-888-205-7671, los 7 días de la semana, 8:00 AM a 8:00 PM (Tiempo Pacifico).