Orange County California
For Assistance, call HICAP 714-560-0424 or 1-800-Medicare or www.medicare.gov
2008 Part D Prescription Drug Plans for Medicare/Medi-Cal and Low Income Subsidy Beneficiaries The following Medicare Prescription Drug Plans are for:
1. People with Medicare AND Full Medi-Cal benefits. 2. People who do NOT belong to HMO Plans such as OneCare, Secure Horizons etc. 3. People who have met their "share of cost" (SOC) at least once, since August 2007, for Medi-Cal benefits 4. People who are approved for Low Income Subsidy through the Social Security Application 5. People who are on Medicare Savings Programs — such as QMB, SLMB or QI-1 Programs (These programs pay for your Part A and/or Part B premiums) Prescription Drug Company Blue Cross Medicare Rx Bravo Health First Health Part D Health Net Health Spring Rx America Unicare Unicare WellCare Instructions to Enroll: 1. 2. 3. 4. 5. 6. Things to remember: 1. Toll Free Telephone number 1-866-892-5340 1-800-723-9209 1-800-588-3322 1-800-606-3604 1-800-331-6293 1-800-429-6686 1-866-892-5333 1-866-892-5334 1-888-423-5252
Plan Name Value Plan BravoRx Premier Option 1 HealthSpring-Reg 32 Advantage Star Rx Rewards Value Rx Rewards Standard Classic
Website bluecrossca.com bravohealth.com firsthealthpremier.net healthnet.com healthspring.com meds4medicare.com unicare.com unicare.com wellcarepdp.com
Call Toll Free Number or go to Website. Identify yourself as Medicaid (Medi-Cal) or Low Income Subsidy Ask about coverage of the medication you use. Ask if the pharmacy you prefer is approved by that plan. Ask for information and enrollment form be sent to your home (optional) Some plans allow you to enroll over the telephone. Recipients of Medi-Cal, SOC Medi-Cal, QMB, SLMB, QI-1 may change plans on a monthly basis 2. There will be a $1.05 to $5.60 copay for each prescription depending on the cost of the drug. You will pay this at the pharmacy. 3. If you do NOT have full Medi-Cal benefits, you may pay a percentage of a monthly premium and drug costs depending on the Low Income Subsidy category you qualify for. This also applies to QBM, SLBM, QI-1.
Rev. October 22, 2007 Information is subject to change.
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For Assistance, call HICAP 714-560-0424 or 1-800-Medicare or www.medicare.gov
Special Needs Medicare Advantage Plans (HMO Plans) for Dual Eligible Beneficiaries Memberships in these plans are NOT REQUIRED. THEY ARE OPTIONAL!!!
These plans include health AND prescription drug coverage.
You may continue with traditional Medicare and Medi-Cal. If you choose traditional Medicare and Medi-Cal, you MUST also choose a Prescription Drug Plan listed on page 1.
The following Medicare Advantage Plans (HMOs) are for:
1. People with Medicare AND Full Medi-Cal 3. People who are on Medicare Savings Programs — such as QMB, SLMB or QI-1 Programs (These programs pay for your Part A and/or Part B premiums) Medicare Advantage Company Arta Medical Health Plan CareMore Health Plan Care1st Orange County Health Net of California Health Net of California Kaiser Permanente OneCare by Cal-Optima Secure Horizons by United Healthcare Toll Free Telephone number 1-866-844-2170 1-866-622-2820 1-800-847-1222 1-800-935-6565 1-800-935-6565 1-800-777-1238 1-800-412-2734 1-888-834-3721
Plan Name Arta Select CareMore Connect Care1st Dual Plus Plan Seniority Plus Amber I Plan Seniority Plus Amber II Plan Senior Advantage Medicare/Medi-Cal Plan OneCare Evercare Plan DH
Website artamedicare.com californiamedicare.com care1st.com healthnet.com healthnet.com kaiserpermanente.org caloptima.org/onecare securehorizons.com
Call each plan for full explanation of benefits, including the plan's Prescription Drug benefits.
Rev. October 22, 2007 Information is subject to change.