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SUMMARY OF BENEFITS
Alameda County Fresno County Imperial County Kern County Kings County Los Angeles County Madera County ... medical services for the year. Inpatient Hospital $100 copay per day for days 1-6 ... Emergency Care $0 – $100 copay Copayment waived if admitted to
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PLAN 02 – Classic Care Drug Savings HMO 2021
bndhmo.comJan 01, 2021 · PLAN 02 – Classic Care Drug Savings HMO 8 Brand New Day Embrace Care Plan (HMO CSNP) 39-1. Kern County. Los Angeles County. Orange County. Riverside County. San Bernardino County. San Diego County. 2021. SUMMARY OF BENEFITS. H0838_2087.200829_M
SUMMARY OF BENEFITS
bndhmo.com$3.95 copay or 5% (whichever costs more) for generic drugs or a preferred multi-source drug and $9.85 copay or 5% (whichever costs more) for all other drugs. Cost-Sharing may change depending on the pharmacy you choose and when you enter a new phase of the Part D benefi t. CLASSIC CARE III PLAN 46. Classic Care III Plan (HMO) 46
SUMMARY OF BENEFITS
bndhmo.comPlease call Brand New Day Member Services Department at 1-866-255-4795, TTY 711 Monday – Friday 8 am - 8 pm between April 1 and September ... Dental Services • Preventive dental (e.g., oral exam, x-rays, cleanings) ... If you have questions about your Medi-Cal eligibility and what benefits you are entitled to, please call: 1-800-541-5555 .
SUMMARY OF BENEFITS
bndhmo.comPlease call Brand New Day Member Services Department at 1-866-255-4795, TTY 711 Monday – Friday 8 am - 8 pm between April 1 and September ... Medi-Cal does not cover cost-sharing ... Dental Services • Preventive dental (e.g., oral exam, x-rays, cleanings)
Get Over-the-Counter Products Every Quarter Over-The-Counter
bndhmo.com1090 Cetirizine HCL (Allergy Tablets) 14 ct 10 mg Compare to Zyrtec $6.00 2003 Cetirizine HCL (Allergy Tablets) 45 ct 10 mg Compare to Zyrtec $11.00 1426 Children’s Allergy and Nasal Decongestant Liquid 4 oz 1mg/5ml 3mg/5ml Compare to Zyrtec $7.00 1008 Chlorpheniramine Maleate Antihistamine (Allergy Tablets) 100 ct 4 mg - $7.00 1009
SUMMARY OF BENEFITS
bndhmo.comDental Services •Preventive dental (e.g., oral exam, x-rays, cleanings) Comprehensive dental • Diagnostic services • Restorative services •Endodontics • Periodontics •Extractions • Implant Services, Prosthodontics, other oral/ maxillofacial surgery, other services • Non-routine services $0 copay $0 copay $25 – $400 copay $25 ...
BRAND NEW DAY HEALTH PLAN
bndhmo.comNAI-1502064614v2 3 Pre-Treatment Estimate – an estimation of the allowable Benefits under the Plan for the services proposed. Procedure Code – the Current Dental Terminology® (CDT) number assigned to a Single Procedure by the American Dental Association. Reasonable means that a Member exercises prudent judgment in determining that a dental ...
SUMMARY OF BENEFITS
bndhmo.comMedi-Cal does not cover cost-sharing for Medicare covered services. Transportation $0 copay for unlimited round trips to approved locations Services may require authorization. Medicare Part B Drugs • Chemotherapy drugs • Other Part B drugs $0 copay $0 copay Services may require authorization. Your costs may be more if your
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2021 PROVIDER DIRECTORY 1 - Alameda, CA
alamedaalliance.orgAlameda Alliance for Health 2021 PROVIDER DIRECTORY If you have a question about the availability of a provider please call Member Services at 510.747.4567 or 1.877.932.2738. We’re here Monday through Friday, 8 AM to 5 PM. The call is free. *See Disability Access Code and Definition Table for more information. Welcome to Alameda Alliance for ...