LA Care: Medicare Advantage Plan

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L.A. Care’s Medicare Advantage Special Needs Plan

Benefit Highlights (PDF) / How to Enroll / Service Area / See a Doctor / Member Resources / Part D & Prescription Drugs / Appeals and Grievance / Disclaimer Information / 24-Hour Nurse Advice Line / Contact Us / Notice of Privacy Practices, (PDF)

Welcome!

L.A. Care’s Medicare Advantage Special Needs plan is a plan designed for people eligible for both Medicare and Medi-Cal. This plan provides both programs’ benefits in one, easy-to-use plan -- including Medicare’s Part D Prescription Coverage.

One plan takes care of it all:

• We coordinate your care,
• Offer 24-hour customer service, and
• Provide information in your language.

Benefit Highlights:

• Doctor visits, including specialists: $0
• Non-emergency transportation, 12 one-way trips: $0
• Prescription drugs, $0 copay for generics; low copays for brand*

*Once your total drug costs reach $2,270, you pay $1.05 for generic drugs. You pay $1.05 or $3.10 for brand name drugs.

For information on how to enroll in L.A. Care's Medicare Advantage Special Needs plan, click "How to Enroll" at the top of this page.

Contact Us:

Current members: 1-888-839-9909 (TTY 1-866-522-2731) for questions related to the Medicare Advantage program.

Prospective members: 1-888-4LA-CARE (1-888-452-2273) for questions related to the Medicare Advantage program. (TTY 1-866-522-2731).

For questions related to the Medicare Part D Prescription Drug program , current and prospective members should call: 1-888-839-9909. (TTY 1-866-522-2731).

For more information about Medicare, please call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You can call 24 hours a day, 7 days a week . Or, visit www.medicare.gov on the Web.

FAX:

1-213-438-5712

WRITE or VISIT:

L.A. Care Health Plan
555 W. 5th Street
Los Angeles, CA 90013

L.A. CARE’S 24-HOUR NURSE ADVICE LINE:

1-800-249-3619. L.A. Care’s Nurse Advice Line is available for members 24 hours a day, seven days a week .

Disclaimer Information

L.A. Care Health Plan is a MA organization with a Medicare contract. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medi-Cal or by another third party. You must use plan providers except in emergent or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-plan providers, neither Medicare nor L.A. Care Health Plan will be responsible for costs. Plan member materials are available in other formats (like braille, large type, audio, etc.), if requested.

For full information on L.A. Care’s Medicare Advantage Special Needs Plan benefits, call our Member Services department at 1-888-839-9909 (TTY 1-866-522-2731).

Potential for Contract Termination

L.A. Care Health Plan has a contract with the Centers for Medicare & Medicaid Services (CMS), the government agency that runs Medicare. This contract renews each year. At the end of each year, the contract is reviewed, and either L.A. Care or CMS can decide to end it. You will get 90 days advance notice in this situation. It is also possible for our contract to end at some other time during the year, too. In these situations we will try to tell you 90 days in advance, but your advance notice may be as little as 30 or fewer days if CMS must end our contract in the middle of the year.

Page last updated: 03/08

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