STAGE DEV MAY, 2013

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2017 Benefit Highlights

 

Finding the Right Plan

All 2017 CCHP plans in Covered California SHOP meet the new health care law’s requirements which includes the Essential Health Benefits that are designed to help everyone stay healthy and well. See the complete list: Essential Health Benefit List

There are several CCHP plan options available through Covered California:

CCHP Platinum90 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Gold80 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Silver70 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

CCHP Bronze60 HMO
Summary of Benefits
Evidence of Coverage
Health Plan Benefits and Coverage Matrix

(By clicking on this link, you will leave CCHP's website.)
 
(By clicking on this link, you will leave CCHP's website.)

 

** (Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.)

You can find the details of these plans from our Summary of Benefits and Coverage pages or you can review the complete 2017 Evidence of Coverage.

 

Find a Physician

We think it is important for you choose a caring physician who is conveniently located near you. You can see CCHP’s provider list at  www.cchphealthplan.com/doctor-locations.

Check the Formulary

To see if a prescription medication you need is covered, check with our CCHP Exchange Complete Formulary. * (No changes made since 08/2017).

Formulary Changes for 2017 (English)

* There are four tiers in the drug formulary. Tiers include the types of drugs that are covered. Please refer to your Evidence of Coverage and Disclosure Form for details.

Tier Definition
1 1) Most generic drugs and low cost preferred brands.
2 1) Non-preferred generic drugs or;
2) Preferred brand name drugs or;
3) Recommended by the plan's pharmaceutical and therapeutics (P&T) committee based on drug safety, efficacy and cost.
3
 
1) Non-preferred brand name drugs or;
2) Recommended by P&T committee based on drug safety, efficacy and cost or;
3) Generally have a preferred and often less costly therapeutic alternative at a lower tier.
4

 

1) Food and Drug Administration (FDA) or drug manufacturer limits distribution to specialty pharmacies or;
2) Self administration requires training, clinical monitoring or;
3) Drug was manufactured using biotechnology or;
4) Plan cost (net of rebates) is >$600.

Pharmacy Directory

Pharmacy Directory (English)

CCHP Pharmaceutical Management Procedures (English)

STAGE DEV MAY, 2013