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CalPERS Health Plans Benefit Comparison — Medicare Plans, Continued CalPERS Health Plan Benefit Comparison— Medicare Plans, Continued
For more details about the benefits provided by a specific plan, refer to that plan’s Evidence of Coverage (EOC) booklet. All benefits subject to regulatory approval.
Medicare Plans
Anthem Medicare Preferred (PPO)
Blue Shield Medicare (PPO)
Sharp Direct Advantage (HMO)
UnitedHealthcare Group Medicare Advantage (PPO)
Kaiser Permanente Senior Advantage Summit (HMO)
Kaiser Permanente Senior Advantage (HMO)
BENEFITS
Surgery/Anesthesia
No Charge inpatient; $10 outpatient
No Charge
No Charge
No Charge
No Charge
No Charge
Physician Services (including Mental Health and Substance Abuse) Office Visits $10 No Charge
$10
No Charge No Charge No Charge No Charge No Charge
No Charge No Charge No Charge No Charge No Charge
$10
Inpatient Visits Outpatient Visits Urgent Care Visits Preventive Services
No Charge
No Charge No Charge No Charge No Charge
No Charge
No Charge
$10 $10
$10 $25
$10 $25
No Charge
No Charge
No Charge
Diagnostic X-Ray/Lab
No Charge
No Charge
No Charge
No Charge
No Charge
No Charge
Durable Medical Equipment
10% (coinsurance)
No Charge
No Charge
No Charge
No Charge
No Charge
26 | 2023 Health Benefit Summary
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