| The Medicare Project a consumer's guide to California Medicare programs, Medicare Part D Prescription Drug Reimbursement and Coverage topics: Medicare Prescription Drug Help, Medicare coverage, Medicare Advantage prescription drug programs, supplement insurance, what is Medicare? help |
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| Who Offers California Medicare Prescription Drug Plans? | Medicare California help & articles | The Medicare Project (Home) | California MEDICAID help |
California Medicare, California Medicare Prescription Drug Coverage
Answers and information about Medicare, prescription drug coverage and health insurance
involves searching through hundreds of pages at government and private websites. To help seniors and caregivers get
started in their search, our editors have compiled this digest of California Medicare help and information
resources. |
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Medicare Web Page: CONSUMERS: SENIOR INSURANCE BILL OF RIGHTS (SIBOR) source: California Department of Insurance , languages: English Look down the page --about half way-- for information about Medicare Supplement Insurance. Medicare Drug Pricing Inquiry source: Medi-Cal (California Department of Health Services) languages: English "The drugs listed below are 200 brand-name drugs that are frequently inquired upon by Medi-Cal Pharmacy providers in California's Medicare Drug Discount Program..." more from Medi-Cal (California Department of Health Services): Medicare Web Page: Prescription Drug Discount Program For Medicare Recipients - Frequently Asked Questions languages: English "...many questions have arisen regarding when and how the program will work. The following Frequently Asked Questions have been written to answer some of these questions..." Medicare Web Page: Medicare Part D (Federal Prescription Drug Benefit) Update languages: English Updated August 18, 2006 What Physicians Need to Know About Medicare’s New Prescription Drug Coverage source:Orange County Medical Association file size: 4 pg. languages: English Basic Facts About Medicare’s New Prescription Drug Coverage What is Medi-Gap? source: Congress of California Seniors languages: English "A Medicare supplemental policy - Medi-Gap - is a type of insurance that is designed specifically to cover part or all of Medicare's co-payments and deductibles.... " A Consumer's Guide to Getting and Keeping Health Insurance in California source:healthinsuranceinfo.net file size: 43pg. languages: English from GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE. As a resident of California, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a resident of California. Medicare Prescription Drug Coverage source: CalMedicare.org languages: English "Medicare offers voluntary prescription drug coverage, known as "Medicare Part D" and sometimes as "Medicare Rx." This insurance is available through private companies and benefits began being offered in January 2006. If you already have Medicare, and did not sign up in the Initial Enrollment Period (IEP) (between November 15, 2005 and May 15, 2006), you can sign up for a plan during the Annual Enrollment Period (AEP)... " more from CalMedicare.org: Medicare Web Page: Guide to Making a Decision about Drug Coverage Based on Your Situation languages: English "This page lists the important questions to think about before you decide if you want Medicare prescription drug coverage..." web page: Medigap: Supplementing Medicare languages: English "Medicare is not a comprehensive health care program. A private Medigap policy is one option for supplementing Medicare coverage..." The Medicare Drug Benefit: Implications for California source:California HealthCare Foundation languages: English "...an overview of the Medicare drug benefit, this issue brief highlights the special characteristics of California that will affect introduction of the benefit and identifies numerous policy issues ..." Medicare Advantage Plans: An Overview source:California Health Advocates file size: 2 pg. languages: English, Spanish Fact sheet provides basic information about the four types of Medicare Advantage plans: Medicare Health Maintenance Organizations (HMOs), Medicare Preferred Provider Organizations (PPOs), Medicare Private Fee-for-Service Plans (PFFS) and Medicare Special Needs Plans. more from California Health Advocates: Medicare brochure or publication: Supplementing Medicare: Medigap Plans file size: 3 pg. languages: English Describes the choices for Medigap insurance plans, along with requirements, coverage, and deductibles. Medicare Web Page: Centers for Medicare & Medicaid Services - Region 9 - San Francisco source:Centers for Medicare & Medicaid Services languages: English "Regional Offices generally serve as the agency's main link to beneficiaries, health care providers, state and local governments as well as the general public..." web page: Medicare Fact Sheets languages: English A list of fact sheets, in English and Spanish, that cover a variety of Medicare-related topics. Sample topics: Medicare, Supplementing Medicare, Low-Income Assistance, Managed Care, Medicare and Other Health Insurance Coverage, Billing and Claims, Long-Term Care, Medicare and Disabilities and Appeals California Medicare Drug Plan Ratings source:AARP file size:5 pg. languages: English "...This AARP rating tool contains information about “stand-alone” Medicare plans in your state that cover only prescription drugs...." Medicare - Quick Facts for Consumers source:California Department of Aging languages: English "...Medicare now offers insurance coverage to help Medicare beneficiaries pay for prescription medications, Medicare Part D. Medicare beneficiaries can sign up for this new prescription drug benefit during the open enrollment period. In most cases, if you have not joined a plan by May 15, 2006, ..." Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. Lanscape: 2007 California Stand-Alone Prescription Drug Plans source:CENTERS FOR MEDICARE & MEDICAID SERVICES, U.S. Department of Health and Human Services file size:3 pg. languages: English date:2007 California 2007 Medicare Part D Stand-Alone Prescription Drug Plans. Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded." Medicare brochure or publication: Landscape: California Medicare Advantage, Cost Plans, and Demonstrations source:CENTERS FOR MEDICARE & MEDICAID SERVICES file size:25 pg. languages: English "California 2007 Medicare Advantage, Cost, and Demonstration Plans. Data as of September 12, 2006. Data as of September 29, 2006. Includes all contracts/plans regardless of 2007 approval status. PACE, Special Needs Plans, and Employer sponsored plans (800 series) are excluded." |
| 47 Prescription Drug Plans in California This list is to familiarize you with Medicare Prescription Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
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| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Coverage in the Gap About the gap |
Contact Service Phones |
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| Humana PDP Standard S5884-090 (S5884-090) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Enhanced S5884-030 (S5884-030) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Health Net Orange (S5678-002) |
Health Net | No gap coverage | Non-Members 1-800-806-8811 TTY Users should call: 1-800-929-9955 Members 1-800-806-8811 TTY Users should call: 1-800-806-8811 |
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| WellCare Signature (S5967-066) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| SierraRx (S5917-008) |
SierraRx | No gap coverage | Non-Members 1-866-789-0565 TTY Users should call: 1-866-789-0572 Members 1-866-789-1522 TTY Users should call: 1-866-789-1522 |
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| AdvantraRx Value (S5674-056) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5178 TTY Users should call: 1-866-823-5178 |
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| Blue Cross MedicareRx Value (S5596-033) |
Blue Cross of California | No gap coverage | Non-Members 1-866-892-5340 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards (S5960-032) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| PacifiCare Saver Plan (S5921-002) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| UnitedHealthRx (S5820-140) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-556-7052 TTY Users should call: 1-888-556-7053 Members 1-888-556-7060 TTY Users should call: 1-888-556-7060 |
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| Health Net Orange (S5678-008) |
Health Net | No gap coverage | Non-Members 1-800-806-8811 TTY Users should call: 1-800-929-9955 Members 1-800-806-8811 TTY Users should call: 1-800-806-8811 |
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| AARP MedicareRx Plan (S5820-031) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-867-5564 TTY Users should call: 1-877-730-4192 Members 1-888-867-5575 TTY Users should call: 1-888-867-5575 |
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| Community Care Rx BASIC (S5803-101) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Advantage Star Plan (S5644-084) |
RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| SilverScript (S5601-064) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-552-6106 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Aetna Medicare Rx Essentials (S5810-066) |
Aetna Medicare | No gap coverage | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| United Medicare MedAdvance (S5820-135) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-556-6657 TTY Users should call: 1-888-556-7065 Members 1-888-556-7047 TTY Users should call: 1-888-556-7047 |
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| Prescription Pathway Bronze Plan Reg 32 (S5597-097) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Blue Cross MedicareRx Plus (S5596-034) |
Blue Cross of California | No gap coverage | Non-Members 1-866-892-5340 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards Plus (S5960-068) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| YOURx PLAN (S5660-032) |
Medco YOURx PLAN | No gap coverage | Non-Members 1-800-758-3605 TTY Users should call: 1-800-716-3231 Members 1-800-758-4574 TTY Users should call: 1-800-758-4574 |
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| Advantage Freedom Plan (S5644-064) |
RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| CIGNATURE Rx Value Plan (S5617-158) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| AdvantraRx Premier (S5674-057) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5178 TTY Users should call: 1-866-823-5178 |
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| Blue Shield of California Medicare Rx Plan (S2468-002) |
Blue Shield of California | No gap coverage | Non-Members 1-800-488-8000 TTY Users should call: 1-888-595-0000 Members 1-888-239-6469 TTY Users should call: 1-888-239-6469 |
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| UA Medicare Part D Prescription Drug Cov (S5755-035) |
United American Insurance Company | No gap coverage | Non-Members 1-866-524-4169 TTY Users should call: 1-866-524-4170 Members 1-866-524-4169 TTY Users should call: 1-866-524-4169 |
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| Blue Shield of California Medicare Rx Plan (S2468-001) |
Blue Shield of California | No gap coverage | Non-Members 1-800-488-8000 TTY Users should call: 1-888-595-0000 Members 1-888-239-6469 TTY Users should call: 1-888-239-6469 |
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| PacifiCare Select Plan (S5921-001) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| WellCare Complete (S5967-101) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| Community Care Rx CHOICE (S5803-169) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Blue Cross MedicareRx Gold (S5596-035) |
Blue Cross of California | Generic Only | Non-Members 1-866-892-5340 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| CIGNATURE Rx Plus Plan (S5617-160) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| WellCare Premier (S5967-135) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| Aetna Medicare Rx Plus (S5810-168) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| PacifiCare Comprehensive Plan (S5921-003) |
UnitedHealthcare | Generic Only | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| Prescription Pathway Silver Plan Reg32 (S5597-196) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| MedicareRx Rewards Premier (S5960-102) |
Unicare | Generic Only | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| Prescription Pathway Silver Plan Reg 32 (S5581-142) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Community Care Rx GOLD (S5803-135) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| AdvantraRx Premier Plus (S5674-059) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5178 TTY Users should call: 1-866-823-5178 |
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| CIGNATURE Rx Complete Plan (S5617-202) |
CIGNA HealthCare | Generic Only | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| Prescription Pathway Gold Plan Reg 32 (S5597-064) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Gold Plan Reg 32 (S5581-046) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| Humana PDP Complete S5884-060 (S5884-060) |
Humana Insurance Company | Generic and Brand | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Aetna Medicare Rx Premier (S5810-202) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| SilverScript Plus (S5601-065) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-235-4582 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Prescription Pathway Platinum Plan Reg 32 (S5581-070) |
Marquette National Life Insurance Company | No gap coverage | Non-Members 1-800-845-2551 TTY Users should call: 1-866-222-3904 Members 1-800-698-8395 TTY Users should call: 1-800-698-8395 |
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| 14 Medicare Special Needs Plans in California This list is to familiarize you with Medicare Special Needs Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
|---|---|---|---|---|---|---|
| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Special Rules for Enrolling | Contact Service Phones |
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| CCHP Senior Select Program (H0571-005-0) |
Chinese Community Health Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-415-397-3190 TTY Users should call: 1-877-681-8888 Members 1-415-834-2118 TTY Users should call: 1-877-681-8888 |
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| Health Net Seniority Plus (H0562-055-0) |
Health Net Of CA | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-935-6565 TTY Users should call: 1-800-929-9955 Members 1-800-275-4737 TTY Users should call: 1-800-929-9955 |
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| Health Net Seniority Plus (H0562-056-0) |
Health Net Of CA | For people with certain chronic or disabling conditions. | Non-Members 1-800-935-6565 TTY Users should call: 1-800-929-9955 Members 1-800-275-4737 TTY Users should call: 1-800-929-9955 |
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| HPSM CareAdvantage (H5428-001-0) |
Health Plan of San Mateo | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-866-880-0606 TTY Users should call: 1-800-735-2929 Members 1-866-880-0606 TTY Users should call: 1-800-735-2929 |
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| Medcore Gold Select (Medicare & Medi-Cal) (H5811-002-0) |
Medcore HP | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-320-5688 TTY Users should call: 1-800-258-6810 Members 1-800-320-5688 TTY Users should call: 1-800-258-6810 |
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| Molina Advantage (H5810-001-0) |
Molina Healthcare of California | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-665-0898 TTY Users should call: 1-800-479-3310 Members 1-800-665-0898 TTY Users should call: 1-800-479-3310 |
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| OneCare (H5433-001-0) |
OneCare | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-877-412-2734 TTY Users should call: 1-714-246-8496 Members 1-877-412-2734 TTY Users should call: 1-714-246-8496 |
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| POSITIVE HEALTHCARE PARTNERS (H5852-001-0) |
POSITIVE HEALTHCARE PARTNERS | For people with certain chronic or disabling conditions. | Non-Members 1-800-263-0067 TTY Users should call: 1-800-263-0067 Members 1-800-263-0067 TTY Users should call: 1-800-263-0067 |
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| Secure Horizons Gold Plan (H0543-078-0) |
Secure Horizons Medicare Advantage Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-385-5588 TTY Users should call: 1-800-685-9355 Members 1-800-228-2144 TTY Users should call: 1-800-387-1074 |
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| Secure Horizons Gold Plan (H0543-079-0) |
Secure Horizons Medicare Advantage Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-385-5588 TTY Users should call: 1-800-685-9355 Members 1-800-228-2144 TTY Users should call: 1-800-387-1074 |
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| Secure Horizons Gold Plan (H0543-081-0) |
Secure Horizons Medicare Advantage Plan | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-385-5588 TTY Users should call: 1-800-685-9355 Members 1-800-228-2144 TTY Users should call: 1-800-387-1074 |
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| SecureCare (H0564-040-0) |
Blue Cross of California | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-800-765-2585 TTY Users should call: 1-877-247-1657 Members 1-800-765-2585 TTY Users should call: 1-877-247-1657 |
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| Universal Care Health Advantage SMI Plan (H0838-020-0) |
HMO California | For people with certain chronic or disabling conditions. | Non-Members 1-800-227-3482 TTY Users should call: 1-866-321-5955 Members 1-800-635-6668 TTY Users should call: 1-866-321-5955 |
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| VillageHealth (H5943-001-0) |
VillageHealth | For people with certain chronic or disabling conditions. | Non-Members 1-877-916-1234 TTY Users should call: 1-877-586-1648 Members 1-877-586-1648 TTY Users should call: 1-877-586-1648 |
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