2024 Plan Information

The information provided here is intended to be a summary of our plan, effective January 1, 2024.

Annual Notice of Changes (ANOC) 

Member Handbook - Evidence of Coverage (EOC)

Combined Pharmacy/Provider Directory 

List of Covered Drugs (Formulary) 

Summary of Benefits 

Over-the Counter (OTC) Benefit

Forms

Additional Member Resources

Please click on the following link to access Centers for Medicare & Medicaid Services website:

www.cms.gov

Please click on the following link to access the Medicare and You Handbook:

Medicare and You Handbook

Please click on the following link to obtain information on help with prescription drug costs:

https://www.ssa.gov/benefits/medicare/prescriptionhelp/

Disclaimers

CommuniCare Advantage (HMOD-SNP) is an HMO D-SNP health plan with a Medicare contract and a contract with the Medi-Cal program.  Enrollment in CommuniCare Advantage depends on contract renewal.

 

ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Call 1-888-244-4430 , TTY users should call 1-855-266-4584, 24 hours a day, 7 days a week. The call is free.

 

ATENCIÓN: Si habla español, hay servicios de asistencia de idiomas disponibles sin cargo. Llame al 1-888-244-4430 (TTY: 1-855-266-4584). Las llamadas a estos números son gratuitas.

 

请注意:如果您说简体中文,可免费获得语言援助服务。请致电 1-888-244-4430 (听障专线:1-855-266-4584)。通话免费。

 

PANSININ: Kung nagsasalita kayo ng ibang wika, may mga paglingkod na pagtulong sa wika na maabot ninyo, na libre. Tawagan ang 1-888-244-4430 (TTY: 1-855-266-4584). Liber ang tawag na ito.

 

請注意:如果您說繁體中文,可免費獲得語言援助服務。請致電 1-888-244-4430 (聽障專線:1-855-266-4584)。通話免費。

 

CHÚ Ý: Nếu bạn nói tiếng Việt, các dịch vụ hỗ trợ ngôn ngữ, miễn phí, sẽ có sẵn cho bạn. Gọi số 1-888-244-4430 (TTY: 1-855-266-4584). Cuộc gọi được miễn phí.

 

1-888-244-4430 تنبيه: إذا كنت تتحدث اللغة العربية ، فأن خدمات المساعدة اللغوية متاحة لك بدون اي مقابل. إتصل بالرقم :

1-855-266-4584او الهاتف النصي :

كلا الرقمين متوفرين ٢٤ ساعة باليوم ٧ أيام بالاسبوع.

 

توجه: اگر به زبان فارسی صحبت می‌کنید، خدمات کمک زبانی، به صورت رایگان، در اختیار شماست. با3313-232-800-1 (پیام‌نگار: 4584-266-855-1) تماس بگیرید. تماس با این شماره‌ها رایگان است.

 

Last Website Update 7/01/2024
H4733_Website2024