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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

Made with FlippingBook Annual report