Teammate Open Enrollment 2021
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.
Medicare Plans
CCPOA Medicare Supplement (Association Plan)
Kaiser Permanente Senior Advantage
Anthem Medicare Preferred (PPO)
Sharp Direct Advantage (HMO)
UnitedHealthcare Group Medicare Advantage (PPO)
BENEFITS
Emergency Services (waived if admittedor hospitalizedas anoutpatient) $50 $50
$50
$50
No Charge
Ambulance Services
No Charge
No Charge
No Charge
No Charge
No Charge
Surgery/Anesthesia
No Charge inpatient; $10 outpatient
No Charge
No Charge
No Charge
No Charge
Physician Services (including Mental Health and Substance Abuse) Office Visits $10 $10
$10
$10
$10
Inpatient Visits Outpatient Visits Urgent Care Visits Preventive Services
No Charge
No Charge
No Charge
No Charge
No Charge
$10 $10
$10 $25
$10 $25
$10 $25
$10
No Charge No Charge
No Charge
No Charge
No Charge
No Charge
Diagnostic X-Ray/Lab
No Charge
No Charge
No Charge
No Charge
No Charge
Durable Medical Equipment
10% (co-insurance)
No Charge
No Charge
No Charge
No Charge
26 | 2021 Health Benefit Summary
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