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Page 1 of 8 H0544_010-000_019-000_CA Enrollment form Anthem Blue Cross Individual Enrollment Request Form-2024 Section 1-All fields below are required (unless marked optional). Please check the plan you want to enroll in. To add an Optional Supplemental Benefits (OSB) Package, check only one box from the2022 Anthem MediBlue Dual Advantage (HMO D-SNP) - H0544-053-0 in CA Plan Benefits DetailsH0544 CareMore Health Plan, Chronic or Disabling Condition End-Stage Renal Disease Requiring Analysis Any Mode of Dialysis Special Needs Plan Model of Care Score: 100.00% 3-Year Approval January 1, 2015 - December 31, 2017 Target PopulationPlan Membership and Plan Ratings. The Anthem MediBlue Dual Advantage (HMO D-SNP) (H0544 - 054) currently has 4,336 members. There are 2,937 members enrolled in this plan in Sacramento, California. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings ...Get 2018 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCH0544_004-000_014-000_CA_HMO C-SNP Medicare Advantage and Part D Plan year: January 1 – December 31, 2024 California Los Angeles, Orange counties Anthem I Carelon Chronic Care (HMO C-SNP)* Anthem I Carelon Lung Care (HMO C-SNP)* * This plan uses a focused network of doctors and hospitals. of Benefits 0544M1 1Benefit. Cigna Preferred Savings Medicare (HMO) Monthly Premium. $0 per month. In addition, you must keep paying your Medicare Part B premium. Cigna will reduce your Medicare Part B premium by $100. Medical Deductible. This plan does not have a deductible. Pharmacy (Part D) Deductible.H0544 - 058 - 0 Click to see other plans: Member Services: 1-888-230-7338 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.Open peril. An HO-5 policy will reimburse your primary dwelling at replacement cost value, while your personal property is reimbursed at either actual cost value or replacement cost value — depending on the specifics of your policy. Actual cash value looks specifically at the depreciation of your property when considering your claim payout ...H0544 - 032 - 0 Click to see other plans: Member Services: 1-888-357-4187 TTY users 1-800-577-5586 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.Page 1 of 8 H0544_004-000_014-000_CA Enrollment form Anthem Blue Cross Individual Enrollment Request Form-2024 Section 1-All fields below are required (unless marked optional). Please check the plan you want to enroll in. To add an Optional Supplemental Benefits (OSB) Package, check only one box from the3 out of 5 stars* for plan year 2024. Anthem I Carelon Chronic Care (HMO C-SNP) is a HMO C-SNP Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross. Plan ID: H0544-004-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; 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. Medicare evaluates plans based on a 5-Star rating system.

Providing 2021 Medicare Plan Star Rating Details and detailed information on the Medicare Part D prescription drug and Medicare Advantage plans for every state, including Medicare Part D plan features and costs. Free Medicare Part D Newsletter, Use the Online Caculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLCUrgent Care: $25.00 copay. Emergency room visit. Emergency Care: $120.00 copay. Copay waived if admitted to hospital within 24 hours. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for …2021 Anthem MediBlue Dual Advantage (HMO D-SNP) - H0544-053-0 in CA Plan Benefits DetailsRoutine hearing services: This plan covers 1 routine hearing exam(s) and hearing aid fitting/evaluation(s) every year. $3,000.00 maximum plan benefit for hearing aids every year. Doctors in our plan: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids.Urgent Care: $25.00 copay. Emergency room visit. Emergency Care: $120.00 copay. Copay waived if admitted to hospital within 24 hours. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months.

Outpatient hospital coverage. • 0% or 20% coinsurance per visit (authorization and referral required) Skilled Nursing Facility. • In 2020 the amounts for each benefit period are $0 or: $0 copay for days 1 through 20. $176.00 copay per day for days 21 through 100 (authorization required) Preventive care. • $0 copay.EOC_67426MUSENMUB_016 H0544 066 000 CA Y0114_18_31676_U_016_EOC CMS Accepted . 2018 Evidence of Coverage Table of contents This list of chapters and page numbers is your starting point. For more help in finding information you need, go to the first page of a chapter. You will find a detailed list…

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. Anthem MediBlue Dual Advantage (HMO SNP) Individual Enrollmen. Possible cause: Los Angeles H0544-129-000 Anthem MediBlue Dual Advantage (HMO D-SNP) Fresno, Kings, Ma.