On this page we help consumers: Compare IEHP DualChoice with all 2020 Medicare Advantage Plans available in San Bernardino County, California. This is a MMP plan with a $0.00/mo premium and N/A max out-of-pocket limit.
IEHP DualChoice 2020 Medicare Advantage MMP Plan for San Bernardino County, CA
IEHP DualChoice is a MMP Medicare Advantage plan, from Inland Empire Health Plan (IEHP), that's available to Medicare beneficiaries living in San Bernardino County, California. This is a Medicare-Medicaid plan, with prescription drug coverage, for people with both Medicare and Medicaid benefits (dual-eligible). It gives you all of the same health insurance benefits as Original Medicare. However, the Medicare out-of-pocket costs are covered by Medicaid.
A Medicare Advantage Medicare-Medicaid Plan (MMP), aka, Medi-Medi plan, is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual-eligible Medicare beneficiaries. Nearly all MMPs are Health Maintenance Organization (HMO) plans. However, these plans can also be setup as an HMO-POS (point of sale) plan with costs assigned to supplemental benefits.
Unlike a Special Needs Plan (D-SNP), MMPs only serve full benefit dual-eligible beneficiaries. Plus, some additional limitations may apply, such as state-specific requirements.
Contact the California Medicaid office for more details or to see if you qualify.
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 9 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Medications are expensive, so you'll want to know how this plan covers your prescriptions.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
How Much Does IEHP DualChoice Cost?
With the IEHP DualChoice Medicare-Medicaid Plan there are no additional premiums (beyond your Medicare Part B premium paid through Social Security) and there are no deductibles. That includes your prescription drugs, as well. Plus, Medicare co-payments and/or co-insurances are paid for you through Medicaid.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Because MMPs must provide all Medicare Parts A and B services at $0 cost sharing to enrollees, Medicare's maximum out-of-pocket figure does not apply to these plans.
IEHP DualChoice is a new plan for 2020. As such it has not been rated by CMS.
NOTE: Many new plans enter the market with low premiums and low co-pays. Remember, it's important to evaluate plans every year. This is particularly true with new plans.
Does IEHP DualChoice include Medicare Part D?
This plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
|1 (Generic Drugs)||$0.00 - 3.40 copay|
|2 (Brand Drugs)||$0.00 - 8.50 copay|
|3 (Non-Medicare Rx/OTC Drugs)||$0.00 copay|
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services. For complete details or assistance call: 1-855-266-4865.
IEHP DualChoice vs. Medigap
To compare IEHP DualChoice with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide. It will help you understand how to compare IEHP DualChoice with Medicare Supplement plans in California. Medicare Plan F in California is the most popular.
Contact Inland Empire Health Plan (IEHP)
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov or the Wikipedia page. To learn more about this plan, visit the Inland Empire Health Plan (IEHP) Medicare website.
Additional Plan Options in San Bernardino County
Are you eligible for a San Bernardino County, CA Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- Senior Advantage Medicare Medi-Cal Plan South (Local HMO), for Dual-Eligible beneficiaries
- Anthem MediBlue Care On Site (Local HMO), for Institutional beneficiaries
- Anthem MediBlue Diabetes (Local HMO), for Chronic or Disabling Condition beneficiaries
- Anthem MediBlue Breathe (Local HMO), for Chronic or Disabling Condition beneficiaries
- Anthem MediBlue ESRD (Local HMO), for Chronic or Disabling Condition beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- Blue Shield 65 Plus (HMO)
- Blue Shield 65 Plus Choice Plan (HMO)
- Blue Shield Vital (HMO)
- Aetna Medicare Select Plan (HMO)
- Aetna Medicare Prime Plan (HMO)
Medicare Part C Plan Availability
IEHP DualChoice is available to beneficiaries living in Rancho Cucamonga, Chino, Chino Hills, Guasti, Ontario, Mt Baldy, Montclair, Upland, Earp, Joshua Tree, Morongo Valley, Parker Dam, Pioneertown, Twentynine Palms, Vidal, Yucca Valley, Landers, Adelanto, Amboy, Angelus Oaks, Apple Valley, Baker, Fort Irwin, Barstow, Grand Terrace, Big Bear City, Big Bear Lake, Bloomington, Blue Jay, Bryn Mawr, Cedar Glen, Cedarpines Park, Cima, Colton, Crestline, Crest Park, Daggett, Phelan, Fontana, Essex, Fawnskin, Ludlow, Forest Falls, Hesperia, Green Valley Lake, Helendale, Highland, Hinkley, Loma Linda, Lake Arrowhead, Lucerne Valley, Lytle Creek, Mentone, Needles, Nipton, Newberry Springs, Mountain Pass, Oro Grande, Patton, Pinon Hills, Redlands, Rialto, Rimforest, Running Springs, Skyforest, Sugarloaf, Twin Peaks, Victorville, Wrightwood, Yermo, Yucaipa, San Bernardino, Trona, and all other areas of San Bernardino County, California; Medicare plans are the same throughout the County.