Freedom is living in the best of both worlds
With a Medicare Advantage PPO plan, you have the freedom to be choosy about which doctors and hospitals you want to visit without referrals and – you’re freedom to reap even greater savings when you access our robust network of quality providers. 

What are the advantages of a Medicare Advantage PPO plan?
The great advantage of an PPO plan is that you have the freedom of seeking care either within the network at a modest cost to you or out-of-network at an additional cost. It’s your choice.

Plus – you’ll have access to hundreds of preventive and wellness programs, discounts on products and services and tools and kits that can help educate and guide you about ways to live healthier. 

Got a great doctor?
You can keep it that way. Finding a great doctor can often take years of trying. We know how important it is to find (and stay with) a doctor you trust. That’s what’s great about our PPO – you have the freedom to choose any doctor whether they’re in or out-of our network. And, if you’re in the market for a new doctor, you’ll be happy to know that you’ll find thousands of extremely qualified physicians with established practices and high levels of credentials right in our network. 

Part D (Prescription Drug) Coverage is included.
As a member of a Medicare Advantage PPO, you are automatically enrolled in Medicare Part D, Medicare’s prescription drug coverage. So you won’t need to enroll in a separate Part D plan.  

What are the costs? 
In most cases, you’ll be responsible for a monthly premium and a small copayment when you see a doctor (except for most Medicare-covered preventive services). You must also continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party. If you choose to use out-of-network providers, you can expect to pay more for these services.

Let’s check to see if you’re eligible.
You’re eligible for a Medicare Advantage PPO plan if you’re entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area (counties and states that have access to Anthem coverage). However, individuals with End-Stage Renal Disease are generally not eligible to enroll in a Medicare Advantage plan. 

We’ll help you choose which PPO plan is right for you.

Take a look! We’ve made it easy for you to compare coverage and rates. Just click here for plan details and benefits.

 Questions? Need help? Call us at 1-866-861-0477.

Exclusions and Limitations

• Conditions covered by workers’ compensation or similar law.
• Experimental or investigative services.
• Services provided by a local, state, federal or foreign government, unless you have to pay for them.
• Services or supplies not specifically listed as covered under the Policy/EOC.
• Services received before your effective date or after coverage ends.
• Any services received by Medicare benefits without payment of additional premium.
• Services or supplies that are not medically necessary.
• Routine physical exams, except for preventive care services (e.g., physical exams for insurance, employment, licenses or school are not covered), except as specifically stated in the Policy/EOC.
• Any amounts in excess of the maximum amounts listed in the Policy/EOC.
• Sex changes.
• Cosmetic surgery.
• Services primarily for weight reduction except medically necessary treatment of morbid obesity.
• Dental care, dental implants or treatment to the teeth, except as specifically stated in the Policy/EOC.
• Hearing aids.
• Contraceptive drugs and/or certain contraceptive devices, except as specifically stated in the Policy/EOC.
• Infertility services.
• Private duty nursing.
• Eyeglasses or contact lenses, except as specifically stated in the Policy/EOC.
• Vision care including certain eye surgeries to replace glasses, except as specifically stated in the Policy/EOC.
• Mental and nervous disorders and substance abuse, except as specifically stated in the Policy/EOC.
• Certain orthopedic shoes or shoe inserts, except as specifically stated in the Policy/EOC.
• Services or supplies related to a preexisting condition.
• Telephone or facsimile machine consultations.
• Outdoor treatment programs.
• Educational services except as specifically provided or arranged by Anthem Blue Cross.
• Nutritional counseling or food or dietary supplements, except for formulas and special food products to prevent complications of phenylketonuria (PKU).
• Care or treatment furnished in a non-contracting hospital, except as specifically stated in the Policy/EOC.
• Personal comfort items.
• Custodial care.
• Certain genetic testing.
• Outpatient speech therapy, except as specifically stated in the Policy/EOC.
• Any amounts in excess of maximums stated in the Policy/EOC.
• Outpatient drugs, medications or other substances dispensed or administered in any outpatient setting.
• Services or supplies provided to any person not covered under the Agreement in connection with a surrogate pregnancy.

Vital Shield^SM Plus* offers valuable California health insurance coverage for individuals and families, as a low-cost option for those who rarely go to the doctor, but want to know they’re covered when they do. Built on the success of the Vital Shield* plans, the Vital Shield Plus plans offer all the same great benefits plus a whole lot more.

Get a quote and apply online now!
Get Prices for Vital Shield Plans

Ideal for individuals and families

Individuals who only expect to go to the doctor a few times a year Individuals who are not planning to have children or additional children in the near future Younger adults may want to consider lower deductibles ($400 for “young invincibles”, $900 for couples) Older adults may want to consider higher deductibles ($2,900 for established families and empty nesters) Tips for families Families can save money with Vital Shield Plus by enrolling as a family instead of enrolling individually If there are three or more family members, total family deductibles and out-of-pocket maximums would be lower per person on a family plan than with individual plans Benefits are per member, so each family member gets the same number of office visits Get a quote and apply online now! Get Prices for Vital Shield Plans Vital Shield Plus Plan Benefits2  Available for individuals and families  Office visits and preventive exams First 5: $30 (deductible n/a), then $0 after out-of-pocket maximum  Brand Rx $45 after $500 brand Rx deductible (optional)  Generic Rx $10 (deductible n/a)  Gynecological  40% (deductible n/a) + preventive exam copayment  Lab and X-ray  $0 after out-of-pocket maximum  Emergency room  $100 + 40% after deductible  Ambulance  40% after deductible  Hospitalization  40% after deductible  Maternity  Not covered   Deductible and out-of-pocket maximum options  Plan  400 900  2900  Deductible  $400 / $800 (family) $900 / $1,800 (family)  $2,900 / $5,800 (family)  Out-of-pocket maximum  $2,900 / $5,800 (family) $3,900 / $7,800 (family)  $4,900 / $9,800 (family)   1  Please note that Vital Shield Plus plans do not include maternity benefits. 2  Amounts shown represent the member’s financial responsibility when using Blue Shield network provides. * Vital Shield and Vital Shield Plus plans are underwritten by Blue Shield of California Life and Health Insurance Company and are pending regulatory approval.

Get a quote and apply online now!
Get Prices for the RightPlan PPO 40

Lower premiums

The Aetna Advantage Managed Choice Open Access High Deductible 3000 Plan is designed to work in conjunction with contributions to a Health Savings Account (HSA). An HSA allows you to pay for qualified medical expenses on a tax-advantaged basis. Your premium payments could be lower. The “high-deductible” part means that you’ll pay more out of pocket than with most other plans before coverage kicks in.

Features of the Managed Choice Open Access High Deductible 3000 Plan (in-network rates)
Lower Premiums

• Annual deductible $3,000 individual; $6,000 family
• Out-of-pocket maximum $3,000 individual; $6,000 family
• Office visit copay 0% after deductible***
• Prescription drug copay 0% after deductible****
• Hospitalization 0% after deductible***
• Skilled nursing, physical/occupational therapy, chiropractic care, home health care, durable medical equipment 0% after deductible***

Like other Aetna Managed Choice health insurance plans, the Managed Choice Open Access High Deductible 3000 Plan gives you the freedom to go directly to any recognized health care provider, including specialists, for covered expenses. The above costs apply if you choose a health care provider from Aetna’s network of participating physicians, dentists and hospitals. Costs will be higher if you choose out-of-network health care providers.

Your next step
This page gives a quick overview of this health insurance plan and does not include all of its features and specifications. Health insurance plans contain exclusions and limitations. Before you decide if it’s right for you, be sure to get more detailed information below, or Get a Quote.

Review the coverages available to you:

• Plan Design/Options
• Dental Plan Design/Options
• Plan Brochure
• Rates
• Enrollment Form

Are you a small business looking to insure 2 to 50 employees? If so, please visit the Small Group Employer section of our website.

* Aetna Advantage Plans for individuals, families and the self-employed are underwritten by Aetna Life Insurance Company (Aetna) directly and/or through an out of state blanket trust and Aetna Health Inc. In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans.

** Investment services are independently offered through JPMorgan Institutional Investors, Inc., a subsidiary of JPMorgan Chase Bank.

*** For covered expenses.

**** Integrated Medical/Rx Deductible.

As the economy changes some employers who provided family care have eliminated paying for anyone except the employee and in many cases leaving for single parents to search for affordable health insurance for their children.

Divorce is another situation where we may accidentally leave Children “out” of health insurance coverage. After one divorce a Husband was to carry the child/ children on his group insurance policy and all seems ok until the Husband is laid off. The options are for the ex employee to take advantage of COBRA which is up to 102% of the cost of the insurance coverage. Unfortunately this may not be the best insurance solution.

Purchasing insurance separately may also be advantageous for parents who are independent contractors and do not work for large companies who provide health benefits. Even if a parent works for a companies it still may be a good idea to provide a separate coverage if the stability of the job is questionable. If these is a loss of job, the health coverage is not affected.

These plans can be customized for every child’s and family’s situation. In addition there are several benefits that can be added to these “Stand alone’ plans to enhance them.

Matt is seriously concerned “Many large health insurers have set up programs to cover “child only” plans at very reasonable cost. And we hope all take advantage of our website which will provide for quotes for children to age 18.

Costs not covered by the Medicare program are higher than ever. On average, Medicare beneficiaries spend almost a quarter of their annual income (22 percent) on health care.1 For 2008, just one stay in the hospital under the Medicare program will cost you more than $1,000. (That is the $1,024 Part A hospital deductible.) And that’s just your hospital bill. In addition, you are also required to pay 20 percent of all your doctor bills, lab tests, X-rays and other medical expenses.

Medicare expects you to pay for a portion of almost every medical treatment you receive. If you depend on just Medicare Parts A and B for your health care coverage, you will have to pay a deductible and/or copayment for most services. This includes inpatient hospital stays, outpatient services, blood products, skilled nursing care, doctors’ services, surgical services, physical therapy, diagnostic tests and medical equipment. Plus, you will not be covered if you travel outside of the U.S. and need emergency care.

Individual Medicare Supplement Plan insurance policies help you get more of the protection you need. With a of the Medicare supplement plan, you will find the level of protection you need to help cover the deductibles, copayments and coinsurance that Medicare Parts A and B do not pay. Don’t wait until the bills pile up because of an unexpected medical treatment or hospital stay. Act now to help protect your savings — and your peace of mind.

New to Medicare?
You are guaranteed acceptance during your open enrollment period. If you are at least 65 and enrolling in Medicare Part B for the first time, you are eligible for guaranteed acceptance. This is called your open enrollment period. It lasts for six months and begins on the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B.*

Don’t wait, because if you apply for our Medicare supplement plan after your open enrollment period, you may have to answer health questions to be eligible for coverage.

Help protect your hard-earned savings.

Applying for an Individual Medicare Supplement Plan insurance policy during your open enrollment period has many great advantages. Make sure you know what they are before you make your health care coverage decision.

• Guaranteed acceptance. You are automatically qualified for coverage, regardless of your medical   history, when you apply during your Medicare open enrollment period.**
• No health questions to answer during this time.
• Protection from many of Medicare’s major out-of-pocket costs.

The advantages of choosing a MedicareSupplement Insurance policy

1. You can use any doctor or hospital that accepts Medicare.
Go to any doctor or hospital — there are no networks or referrals.
And all Medicare-approved services are covered.
2. You are automatically qualified for coverage during your open
enrollment period.
You will not have to answer health questions when you apply during your
open enrollment period.***
3. Your policy cannot be canceled.
As long as you continue to pay your premiums when due, your policy
cannot be canceled.
4. You have virtually no claim forms to file.
Your doctor or hospital sends claims directly through the Medicare program
to us. This means the only time you may have paperwork or bills is if you
have emergency expenses when traveling internationally under Plans C or F.
5. Your satisfaction is guaranteed.
After you are approved, you will receive your insurance policy. You then
have 30 days to review the coverage and decide if it is right for you. If you
are not completely satisfied, simply return the policy with a request to
cancel your coverage within 30 days. Your policy will be canceled and we
will refund any premium payment you have made.

Which plan is right for you?

Choose Plan A if:
… you are looking for the most basic coverage offered. Plan A will help you
pay Medicare’s Part A and B coinsurance amounts, which are the additional
amounts you pay after you have paid the Medicare Part A and B deductibles.
However, Plan A does not cover the $1,024 Medicare Part A hospital
deductible, the $135 Medicare Part B deductible, or the $128 a day
coinsurance you pay for days 21 to 100 in a skilled nursing facility.
Emergency coverage during foreign travel is not offered under Plan A.

Choose Plan B if:
… you want the basic coverage provided by Plan A, but also need
coverage for the $1,024 Medicare Part A deductible. Like Plan A,
emergency coverage during foreign travel and skilled nursing
coinsurance are not offered under Plan B.

Choose Plan C if:
… you want even more coverage. Plan C covers everything Plan B covers,
plus it provides coverage for: the $135 Part B deductible, $128 a day for days
21 to 100 of a skilled nursing stay, and foreign travel emergency services.

Choose Plan F if:
… you want the most coverage offered by Aetna in a Medicare Supplement
Plan. Plan F covers everything Plan C covers — the $1,024 Medicare Part A
deductible, the $135 Medicare Part B deductible, $128 a day for days 21 to
100 of a skilled nursing stay, and foreign travel emergency services — plus it
provides coverage for the difference between what the doctor charges and the
Medicare-approved amount (what is called Part B excess charges).

Eligibility
You are eligible to apply for an Individual Medicare Supplement Plan policy if:

1. You have signed up for enrollment in Medicare Parts A and B, and
continue to pay your Part B premium, and
2. You live in a state where our Medicare supplement plans are available.

Application instructions

1. Review the Outline of Medicare Supplement Coverage and choose the
plan that meets your needs and budget.
2. Complete all areas of the application. Sign and date where indicated.
Include a check or money order for your first month’s premium.
3. Mail the application and payment (if required) to:
Matt Lockard
Medicare Supplement Application Processing
172 Yale Ave
Ventura CA 93003

Once you’ve applied … what happens next?
Once we approve your completed application, you will receive a welcome
packet with your insurance policy and your Aetna Individual Medicare
Supplement Plan insurance identification card. It will also include
information on our electronic funds transfer program, which automatically
deducts your monthly plan premium from the account of your choice if you
choose this option.
Your coverage will begin on the first day of the month after your application
is processed. So if your application is processed on August 28, your coverage
will begin on September 1.
You will have virtually no paperwork to complete to get your claims paid. We
take care of everything with the Medicare program and your doctor.

* Note: You may be eligible for guaranteed acceptance under certain other conditions. See the Guaranteed Issue Guidelines section of the enclosed Outline of Medicare Supplement Coverage for details. Or, you can get more information on Medicare Supplement Insurance at www.medicare.gov or from your state insurance department.
** In New York only: Continuous open enrollment and guaranteed acceptance apply.
*** In New York only: Continuous open enrollment and guaranteed acceptance apply.
**** Call Center statistics, October 2007.

Freedom Blue PPO (RPPO)
What does the Freedom Blue PPO Plan offer?
When you join the Freedom Blue PPO (a Regional Preferred Provider Organization), you’ll have quick, easy, direct access to a robust network of doctors, medical personnel and top healthcare facilities.
As a member of a Freedom Blue PPO, you are automatically enrolled in Medicare Part D, Medicare’s prescription drug coverage. You don’t need to enroll in a separate Part D plan.

What are the advantages of the Freedom Blue PPO Plan?
The biggest advantage of the Freedom Blue PPO is the choice of doctors and medical services within the network. And you can see any physician or specialist from the network without a referral. You may also seek care outside the network, although it can be more expensive. The plan even includes premier preventative care programs to help you stay healthy.

You’re in good company with Anthem.
For decades Anthem has provided access to the highest quality health care coverage for millions of Americans. Thanks to the strength, stability and experience of Anthem, you too will sleep a lot easier.

Who should choose the Freedom Blue PPO Plan?
If you’re someone who wants to select their own doctor or if you want to keep your medical costs low by choosing from our list of providers, then Freedom Blue PPO is an excellent choice.

Freedom Blue PPO (RPPO) Details

Freedom Blue PPO – Plan I

Download an Application Here

Need Help? Call Matt Lockard, California Health Insurance Agent