IEHP DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. It is an organization made up of doctors, hospitals, pharmacies, providers of long-term services and supports, behavioral health providers, and other providers. It also has care coordinators and care teams to help you manage all your providers and services. They all work together to provide the care you need.
Medicare-Medicaid Plan
What is IEHP DualChoice (HMO D-SNP) Plan?
What is the goal of this program?
The goal is to improve care by integrating the following healthcare services:
- Medicare and Medi-Cal benefits
- Long-term care
- Behavioral health
- Home and community-based services (HCBS) such as Community-Based Adult Services (CBAS) and Multipurpose Senior Services Program (MSSP).
Who is eligible for IEHP DualChoice (HMO D-SNP)?
People who have both Medicare and Medi-Cal. For a complete list of who is included or excluded, visit Who Qualifies?
Plans and Benefits
IEHP DualChoice (HMO D-SNP) integrates healthcare services to better coordinate care and improve health.
How to Enroll
To enroll, please call:
- IEHP DualChoice (HMO D-SNP) Team at 1-800-741-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347.
For more information, visit the DHCS website. By clicking on this link, you will be leaving the IEHP DualChoice (HMO D-SNP) website. You may also call IEHP DualChoice (HMO D-SNP) for help at 1-877-273-IEHP (4347), 8am – 8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347 (4347).
- Plan Benefits and Cost-Sharing: Find out about plan benefits which are the types of medical care that are covered. Also view information on cost-sharing which is how much you will pay for services or prescription drugs, including monthly plan premium and co-payment.
- Part D Prescription Drugs: Get information on pharmacy benefits, IEHP network pharmacies, out-of-network coverage, pharmacy transition process, drug utilization management, and prescription mail order.
- Provider Access Information: Learn about network providers, primary care providers, specialists and how to choose a provider in our network. Read about our quality assurance activities and find out what happens if your doctor leaves our plan.
- Grievances, Coverage Determination and Appeals Process: Find out what to do if you have a problem or complaint about your medical care or Part D.
- For some types of problems, you need to use the process for coverage decisions and making appeals."
- For Part C: Coverage Determination and Appeals - https://www.iehp.org/en/browse-plans/dualchoice/problems-with-part-c
- Part D: Coverage Determination and Appeals - https://www.iehp.org/en/browse-plans/dualchoice/problems-with-part-d
- For some types of problems, you need to use the process for coverage decisions and making appeals."
- Helpful Information: View your rights and responsibilities upon disenrollment and as a Member of IEHP. You will also find important forms, such as our Privacy Notice, Plan Transition Process and the section of CMS' website regarding Best Available Evidence.
- Service Area: Only people who live in our service area can join IEHP DualChoice. Our service area includes all of Riverside and San Bernardino counties.
IEHP DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.
Information on this page is current as of October 01, 2023.
H8894_DSNP_24_4164896_M Pending Accepted.
