Health Net Healthy Heart: Medicare Advantage Local HMO Plan for San Francisco, CA Beneficiaries
| Summary Rating: |  |
|---|---|
| Part C Premium: | $89.00 |
| Part D Deductible: | $0.00 |
| ICL: | $0.00 |
| Mail Order: | No |
| Gap Coverage: | No Gap Coverage |
| LIS: | No |
| Formulary Drugs: | 4894 |
| Plan ID: | H0562-009 |
| Plan Year: | 2013 |
| Residents of: | CA Residents |
| Plan Type: | Local HMO |
| Regional Members: | 0 |
Plan Summary & Benefits
Health Net Healthy Heart (H0562-009), Medicare Advantage Health Maintenance Organization Plan, San Francisco County, CA
Health Net Healthy Heart is a Health Maintenance Organization (HMO) healthcare plan for seniors with Medicare benefits residing in San Francisco County, CA. It includes all of the benefits of Original Medicare and may include prescription coverage and other extras. The primary benefit of an HMO is that the out-of-pocket costs are lower and more predictable than with other types of plans.
Please note: You must use plan providers to avoid incurring additional costs. You will be responsible for the costs of out of network care. Referrals may be required for all but primary care physician visits.
The health care benefit information provided here is an overview only and not a comprehensive description of available benefits. Additional information about the plan benefits is available from your agent.
Health Net Healthy Heart Monthly Premium, San Francisco County
The monthly premium for this healthcare plan is $89.00 plus your monthly Medicare Part B premium. Most Medicare Beneficiaries pay the standard monthly Part B premium in addition to their MA or MAPD plan premium. However, some beneficiaries are required to pay slightly higher Part B and Part D premiums because of their income (over $85,000 per year for singles or $170,000 for married couples), or due to late enrollment penalties.
Health Net Healthy Heart, San Francisco County Summary of Benefits
NOTE: As of this publication date the Summary of Benefits information for this 2013 plan was not available from CMS. Please ask your agent for the Summary of Benefits documentation.
The Part D deductible for this plan is $0.00. That means you have first dollar coverage.
Health Net Healthy Heart Maximum Out of Pocket (MOOP) Benefit
The new ObamaCare (Patient Protection and Affordable Care Act) law placed a mandatory maximum limit of $6,700 on all out of pocket medical costs for Medicare Advantage plans, which is referred to as the Maximum Out of Pocket or MOOP. The MOOP does not include prescriptions and monthly premiums. The Mandatory MOOP is $6,700 but the Affordable Care Act allows for a “Voluntary MOOP” of up to $3,400. This plan's MOOP is $6,700
More Information
About The Insurer Health Net of California
Health Net is among the USA's largest publicly traded health insurers. The company's HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.6 million individuals in all 50 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE and Veterans Affairs programs. Health Net's behavioral health services subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states, including the company's own health plan members. The company's subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.
The summary (overall) rating for this Health Net of California plan is 3.5 out of 5 based on reviews from 0 user ratings from the previous year. For more information about the review process, visit http://cms.gov.