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

   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
Medicare Help & Information, Medicare Part D In California, Medicare help

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.
 

California Medicare; CA; Medicare Part D in California

California Medicaid: Medicaid assistance and California Medicaid help Were you looking for California Medicaid instead of California Medicare? This link provides a directory of Medicare web sites, articles, publications, brochures
 
The Medicare Coverage Gap (The Doughnut Hole) A directory of web sites, articles, and publications that helps explain what and how the Prescription Drug Coverage Gap works.

California Medicare Coverage, Prescription Drug Plans
California Medicare Help Articles & Resources

Information from varied resources about Medicare in California
Important advice about how to use this data: This Web Site links you to other Web Sites on the Internet. We cannot take responsibility for information found on third party Web sites outside our control. While we attempt to provide links only to Web Sites that comply with all applicable laws and regulations and appear to have responsible information, please understand that the content on these third-party Web Sites is subject to change without notice to us. We therefore cannot be responsible for, and accept no liability for, any information or opinion contained in any third-party Web Site. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action. Use this web page for informational purposes only.

 
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medicaid
 
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 Web Page:
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
.
Medicare brochure or publication:
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
.
Medicare Web Page:
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.... "
.
Medicaid brochure or publication:
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 Web Page:
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..."
.
Medicare Web Page:
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 ..."
.
Medicaid brochure or publication:
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
.
Medicare brochure or publication:
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 Web Page:
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, ..."
.
Medicaid brochure or publication:
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.
.
Medicare brochure or publication:
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."

How to get more information about California Medicare Prescription Drug Programs

Medicare.gov has summary information about the plans offered by the companies listed in the tables below. The data sheets are called "Landscapes".
  1. The Landscape of Local Plans is a list of all plans available in your area. You can get answers to important questions for people with Medicare based on what matters to them, including:
    • Cost (premiums, deductibles and payments)
    • Coverage (important issues around what and how drugs are covered)
    • Convenience (pharmacy and mail-order options)
  2. Medicare.gov has an important help page that explains how to read and interpret the information in both Medicare Prescription Drug Plan "Landscapes. You can access the help page through this link: How to read the Medicare Prescription Drug Plans Landscape
  3. We have provided links to the landscape documents for this state in the list of publications above. 
.
.


 

Medicare prescription drug coverage plans offered in California, Medicare Advantage Plans

Important advice about how to use this data: The data for the table below came from www.medicare.gov, "The Official U.S. Government Site for People with Medicare", in December, 2006, and is subject to change at any time. To check for changes and the newest data, you should visit www.medicare.gov. Your state insurance administrator might have different data; be sure to check with them before making any decisions. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.

 
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.)
Plan Name and
ID Numbers
Company
(w. link to
plan web site)
Coverage in
the Gap
About the gap
Contact Service
Phones
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Prescription Pathway Bronze Plan Reg 32
(S5597-097)
Pennsylvania Life Insurance CompanyNo 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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


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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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Plain Talk about Nursing Home Life
A family's experience. Gentle advice. Books & gifts for seniors. No selling, just facts.
Nursing Home Plain Talk

 
To buy or not to buy?
Plain Talk about Long Term Care Insurance
Costs, expectations, the good and the bad. Decide for yourself. No selling, just facts.
Plain Talk About Long Term Care Insurance

 

 

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