Medicare Advantage Plan Details

At Health Net Medicare Advantage for California, we offer a Medicare Advantage Plan. Our Medicare insurance plans give you access to caring case managers, friendly, helpful member service representatives and a 24-hour nurse line for medical advice when you need it.

Do You Qualify for Extra Help?

Medicare's "Extra Help" Program

Medicare provides "Extra Help" to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you get help paying for any Medicare drug plan's monthly premium, yearly deductible, and prescription co-payments. This Extra Help also counts toward your out-of-pocket costs.

Some people automatically qualify for Extra Help and don't need to apply. Medicare mails a letter to people who automatically qualify for Extra Help.

To see if you qualify for getting Extra Help:

  • Call 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048.  Get information 24 hours a day, 7 days a week.  You can also visit www.medicare.gov to view a copy of the 'Medicare and You' handbook- see section 'Programs for People with Limited Income and Resources'; or 
  • Call the Social Security Administration at 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users call 1-800-325-0778; or
  • Call your State Medicaid Office

After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.

Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

Low Income Subsidy Premium Benefit

If you qualify for a Low Income Subsidy, you do not pay a separate monthly plan premium for our plan. Medicare pays this on your behalf because you are eligible for both Medicare and Extra Help.

You must continue to pay your Medicare Part B premium.  However, as a dual eligible, the state of California will cover your Part B premium as long as you retain your Medicaid eligibility.

Best Available Evidence (BAE) for Low-Income Subsidy (LIS) Members

In certain cases, it's possible that the Centers for Medicare and Medicaid Services (CMS) does not accurately reflect a beneficiary's correct Low-Income Subsidy (LIS) status at any given point in time. As a result, the most up-to-date and accurate subsidy information has not been communicated to the health plan.

In order to best prevent these situations, CMS created the Best Available Evidence (BAE) policy in 2006. This policy requires sponsors to follow through with an appropriate amount of cost sharing for low-income beneficiaries when presented with evidence that shows inaccuracies in the beneficiaries' information.

Go to the CMS.gov website  (Please note, by clicking on this link, you will be leaving the Health Net Medicare Advantage for California website)