Health Choice Generations
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Health Choice Arizona
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Most of the documents posted on the Health Choice Generations' Web sites are available for viewing or printing in Adobe PDF format. If you do not have Adobe Reader installed, please download from here for free:
 
 2010 Summary of Benefits - English
        H5587_2010_2 CMS Approved 11/19/09
 2010 Summary of Benefits - Spanish
        H5587_2010_2_SP

Health Choice Generations Summary of Benefits

Overview

Health Choice Generations HMO(HC Generations) is a Medicare Advantage Coordinated Care Plan with Prescription Drug Coverage (MA-PD) contracted with the Centers of Medicare and Medicaid Services (contract H5587) to provide medical and prescription drug coverage to members enrolled in Medicare and Medicaid.

HC Generations contract with CMS is renewed annually. CMS may refuse to renew HC Generations contract or HC Generations may refuse to renew its annual contract. If either of these situations occurs, the termination or non-renewal of the contract may result in termination of a beneficiary's enrollment into the Plan.

To join the HC Generations plan you must live in one of the nine counties in the service area covered by HC Generations: Apache, Coconino, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz and Yuma. HC Generations may reduce its service area and no longer offer services in the areas where you reside. If this happens, we will notify you - in writing - 90 days in advance.

In addition, you can join HC Generations if you are entitled to Medicare Parts A and B (except those who have End-Stage Renal Disease unless certain exception apply); enrolled in Arizona's Medicaid plan, Arizona Health Care Cost Containment System or AHCCCS; or you may be enrolled in ALTCS, Arizona's Long-Term Care Services. You must use plan providers except in emergent or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-plan providers, neither Medicare nor HC Generations will be responsible for the costs.

Generally, Prescription Drug benefits are only available at contracted network pharmacies (under emergency circumstances, benefits may be obtained out-of-network). Types of pharmacies included in the HC Generations Pharmacy Network are Retail, Mail Order, Long Term Care, Indian, Tribal, Urban and Home Infusion.

For more information about mail order feature please contact HC Generations Member Services at 1-800-656-8991 (TTY users call 1-800-842-4681); or by e-mail Comments@iasishealthcare.com; or by mail: Health Choice Generations, Attention: Member Services, 410 N. 44th Street, Ste. 900 Phoenix, AZ 85008. HC Generations Member Services office hours are 8 am - 8 pm, 7 days a week.

Beneficiaries may enroll or leave a Medicare Prescription Drug plan during specific times of the year. For more information on enrollment periods and Health Choice Generations benefit structure (e.g. routine physical exams, emergency services, diabetic services etc.) please contact Health Choice Generations Member Services, 8 am - 8 pm, 7 days a week at 1-800-656-8991. TTY users call 1-800-842-4681. Or, you may e-mail HC Generations at Comments@iasishealthcare.com.

If you are not receiving this additional assistance, and would like to see if you might qualify for additional assistance, you can call you local Social Security Administration office at 1-800-772-1213. For more information about Medicare you can call Medicare directly at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You can call 24 hours a day, 7 days a week.