A Medicare Advantage HMO Plan for people with both Medicare and Medi-Cal benefits

A Medicare Advantage HMO Plan for people with both Medicare and Medi-Cal benefits

CCHP Senior Select Program (HMO SNP) 

All your plan benefit materials can be accessed below for your convenience. For additional questions, you are invited to call our friendly Member Services staff that is available by phone or in-person to take care of your needs.

tab01 medicare-advantage-hmo-plan-people-both-medicare-and-medi-cal-benefits

The following PDF links open in a new window.

Download Adobe PDF reader

For more information on your benefits and coverage, please refer to:

Find a doctor

To search for a CCHP doctor by specialty, gender or zip code, or to find a doctor who speaks additional languages, click on the link below.

Hospitals

We contract with several hospitals, including:

  • Chinese Hospital (By clicking on this link, you will leave CCHP's Medicare Advantage plan website.)
  • St. Francis Memorial Hospital
  • California Pacific Medical Center
  • St. Mary's Medical Center
  • Seton Medical Center
 

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

 

The formulary contains information about how the list of covered drugs may change during the year

Can the Formulary change? Generally, if you are taking a drug on our formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the coverage year except when a new, less expensive generic drug becomes available or when new adverse information about the safety or effectiveness of a drug is released. Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year. We feel it is important that you have continued access for the remainder of the coverage year to the formulary drugs that were available when you chose our plan, except for cases in which you can save additional money or we can ensure your safety. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost sharing tier, we must notify affected members of the change at least 60 days before the change becomes effective, or at the time the member requests a refill of the drug, at which time the member will receive a 60-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. To get updated information about the drugs covered by the Plan, call our Member Services Center at 1-888-775-7888 from 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 1-877-681-8898. If we make any mid-year non-maintenance changes to the formulary, we will send an errata sheet to you. You can also find the changes on our Web site. 

If you have any feedback or concerns about CCHP Senior Select Program (HMO SNP), you may submit them directly to Medicare using the form below.

Disclaimer

CCHP Senior Select Program (HMO SNP) is an HMO plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in CCHP Senior Select Program (HMO SNP) depends on contract renewal. This plan is available to anyone who is enrolled in Medicare Part A and Part B, receives Medi-Cal benefits, and resides in San Francisco County. You must continue to pay your Medicare Part B premium. The Part B premium is covered by the State for dual eligible individuals. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.  The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

This information is available for free in other languages. Please contact our customer service number at 1-888-775-7888 (TTY 1-877-681-8898) from 8:00 a.m. to 8:00 p.m., seven days a week.

Esta información está disponible gratuitamente en otros idiomas. Por favor póngase en contacto con nuestro número de servicio al cliente al 1-888-775-7888 (TTY 1-877-681-8898) de 8:00 a.m. a 8:00 p.m., siete días a la semana.

此文件有其它的語言版本免費提供。了解詳情請致電 1-888-775-7888 與會員服務中心聯絡(聽力殘障人士請電 TTY 1-877-681-8898),每週七天,上午8 時至晚上 8 時。

 

H0571_2018_275 Approved

Last updated 11192018

tab02 medicare-advantage-hmo-plan-people-both-medicare-and-medi-cal-benefits

The following PDF links open in a new window.

Download Adobe PDF reader

For more information on your benefits and coverage, please refer to:

Find a doctor

To search for a CCHP doctor by specialty, gender or zip code, or to find a doctor who speaks additional languages, click on the link below.

Hospitals

We contract with several hospitals, including:

  • Chinese Hospital (By clicking on this link, you will leave CCHP's Medicare Advantage plan website.)
  • St. Francis Memorial Hospital
  • California Pacific Medical Center
  • St. Mary's Medical Center
  • Seton Medical Center
 

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

 

The formulary contains information about how the list of covered drugs may change during the year

Can the Formulary change? Generally, if you are taking a drug on our formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the coverage year except when a new, less expensive generic drug becomes available or when new adverse information about the safety or effectiveness of a drug is released. Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year. We feel it is important that you have continued access for the remainder of the coverage year to the formulary drugs that were available when you chose our plan, except for cases in which you can save additional money or we can ensure your safety. If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost sharing tier, we must notify affected members of the change at least 60 days before the change becomes effective, or at the time the member requests a refill of the drug, at which time the member will receive a 60-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. To get updated information about the drugs covered by the Plan, call our Member Services Center at 1-888-775-7888 from 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 1-877-681-8898. If we make any mid-year non-maintenance changes to the formulary, we will send an errata sheet to you. You can also find the changes on our Web site. 

If you have any feedback or concerns about CCHP Senior Select Program (HMO SNP), you may submit them directly to Medicare using the form below.

Disclaimer

CCHP Senior Select Program (HMO SNP) is an HMO plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in CCHP Senior Select Program (HMO SNP) depends on contract renewal. This plan is available to anyone who is enrolled in Medicare Part A and Part B, receives Medi-Cal benefits, and resides in San Francisco County. You must continue to pay your Medicare Part B premium. The Part B premium is covered by the State for dual eligible individuals. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.  The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

This information is available for free in other languages. Please contact our customer service number at 1-888-775-7888 (TTY 1-877-681-8898) from 8:00 a.m. to 8:00 p.m., seven days a week.

Esta información está disponible gratuitamente en otros idiomas. Por favor póngase en contacto con nuestro número de servicio al cliente al 1-888-775-7888 (TTY 1-877-681-8898) de 8:00 a.m. a 8:00 p.m., siete días a la semana.

此文件有其它的語言版本免費提供。了解詳情請致電 1-888-775-7888 與會員服務中心聯絡(聽力殘障人士請電 TTY 1-877-681-8898),每週七天,上午8 時至晚上 8 時。

 

H0571_2018_275 Approved

Last updated 12032018