Anthem MediBlue Coordination Plus (HMO) is a Medicare Advantage and prescription drug plan. It includes hospital, medical and prescription drug benefits in one plan. To join this plan, you must:

Be entitled to Medicare Part A,
Enrolled in Medicare Part B, and
Live in our service area (see below).

With this plan, if you’re enrolled in the state’s Medicaid [Medi-Cal] program, you may pay nothing or get help with your share of the costs (such as monthly payment, coinsurances, copays or deductibles) you must remain enrolled in Medicaid [Medi-Cal] under the state Medicaid plan to get these benefits.

Anthem MediBlue Coordination Plus (HMO) – H0544 071

The service area includes San Bernardino and Riverside counties.

 

Anthem MediBlue Coordination Plus (HMO) – H0544 072

The service area includes Los Angeles and Orange counties.

 

Historical

Anthem MediBlue Coordination Plus (HMO) – H0564 078

The service area includes the county of San Diego.

Anthem MediBlue Coordination Plus (HMO) – H0564 079

The service area includes certain zip codes in San Bernardino county and Riverside county. See the Summary of Benefits for the list of zip codes.

Anthem MediBlue Coordination Plus (HMO) – H0564 080

The service area includes Los Angeles and Orange counties.

4 comments on “Co-Ordination Plan – Medi-Medi

  1. Hello
    I have SHARE OF COST medi-cal, where I have to pay $649 every MONTH before medi-cal will pay any benefits.

    I also have medicare, and am currently enrolled in the Blue Shield 65 Plus plan.

    I understand that with this coordination plan Anthem pays 80% & medi-cal pays 20%, but what happens to my medi-cal share of cost?

    Will I be required to pay that share of cost BEFORE medi-cal will cover the 20% that Anthem does not pay?

    I am trying to understand what my deductibles will be with this plan.

    In addition, are you able to tell me what my premium would be for this coordination plan?

    I do receive “Extra Help” through medicare for [Rx – Prescription Drug] co-pay assistance etc, and it seems that may make a difference with the premium.

      • I’ve looked through everything you linked and where you highlighted in the evidence of coverage.

        I see where you noted that Medicare will pay first and is the primary.

        I don’t see where it says what becomes of my $649 share of cost from Medi-Cal (medicaid).

        As medi-cal is the secondary, and they are responsible for the 20% the Medicare Plan does not pay, do I need to pay that share cost first before Medi-Cal kicks in their portion?

        • Here’s more information….

          I’ll have a copy of the LIS rider soon.

          Regarding the share of cost – the Coordination Plus Plan is designed for individuals that are Full Benefit Dual Eligible (so no share of cost).

          If the member has a share of cost the plan will not work the same for him.

          He would have a premium and would have to pay co-insurance/co-pays.

          We don’t have a way to determine what that would be unfortunately.

          Were not sure if the Medi-Cal validation line can confirm it either (844.274.6355) but try giving them a call with the member’s Medicare Number and Medi-Cal Number and see if they’re able to assist.

          FYI since you have Medi-Cal – Medicaid, you can change plans anytime. This complex document would give exact details, as I guess, but am not certain that share of cost is the same as Medi-Cal. Here’s a more plain English document

Leave a Reply

Your email address will not be published.