Advantage D-SNP Summary of Benefits

Over-the-counter (OTC) supplemental benefit:

Each quarter you are enrolled with the plan you receive a $150 allowance loaded to your &more card to purchase OTC items such as aspirin, vitamins, cold and cough preparations, and bandages. OTC items are non-prescription drugs that are not normally covered by a Medicare Prescription Drug Plan.

Call our Customer Service team at 1-888-361-7526 (TTY 711) from 8:00 a.m. to 8:00 p.m., seven days a week from October 1 – March 31, & Monday – Friday, April 1 – September 30. The call is free.

Vision care:

With Advantage D-SNP you have access to a large network of optometrists through the Vision Care Provider Network.  Benefits include a routine eye exam one time per year with supplemental benefit coverage that provides an allowance for eye wear and other vision equipment.

Read more about Vision Care in your Summary of Benefits and Member Handbook.  These materials explain what is covered, excluded and describe how to access the services you need.

Choose “Member Materials” from the side bar to view your Member Handbook for a full list of your benefits and services.

Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO) is for people with both Medicare (Part A and B) and Medi-Cal.

With mandatory enrollment for Medi-Cal benefits, including Long-Term Services and Supports (LTSS) benefits and Medicare benefits.

You are eligible for Advantage D-SNP as long as you:

• Live in our service area. Our service area includes San Joaquin, Stanislaus, El Dorado, and Alpine (incarcerated individuals are not considered living in the geographic service area even if they are physically located in it) and
• Are age 21 and older at the time of enrollment and
• Have both Medicare Part A and Medicare Part B and
• Are currently eligible for Medi-Cal and
• Are a full-benefit dual eligible beneficiary and
• Enroll in Advantage D-SNP for your Medicare benefits and Health Plan of San Joaquin (HPSJ) for San Joaquin and Stanislaus members or Mountain Valley Health Plan (MVHP) for El Dorado and Alpine members for your Medi-Cal benefits. This is known as “Exclusively Aligned Enrollment” and
• Are a United States citizen or are lawfully present in the United States

For questions please call 1-888-361-7526, TTY users should call 711.

Interested in becoming a D-SNP Member? Click here for assistance.

Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP is an HMO with a Medicare and a Medi-Cal contract.
Enrollment in Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP depends on contract renewal.