If you detect or suspect FWA, please report it immediately. Your report is confidential and prohibits retaliation against anyone for reporting in good faith a possible violation of the code, law or regulation.
Who can join?
To join any of our Plan Benefit Packages, you must meet all of the following requirements:
To join Imperial Senior Value (C-SNP), you must also have been diagnosed with diabetes, chronic heart failure (CHF), and/or cardiovascular disorders(s).
If you’re enrolled in a Medicare plan or enrolling for the first time, generally you can only enroll, switch plans, or disenroll from a plan during certain times of the year.
AEP is from October 15 through December 7 of every year. MA eligible individuals may enroll in or disenroll from an MA plan. The last enrollment request made, determined by the application date, will be the enrollment request that takes effect.
The ICEP is the period during which an individual newly eligible for MA may make an initial enrollment request to enroll in an MA plan. This period begins three months immediately before the individual’s first entitlement to both Medicare Part A and Part B and ends on the later of:
The Initial Enrollment Period for Part D (IEP for Part D) is the period during which an individual is first eligible to enroll in a Part D plan. In general, an individual is eligible to enroll in a Part D plan when he or she is entitled to Part A OR is enrolled in Part B, AND permanently resides in the service area of a Part D plan. Ultimately, CMS provides a part D eligibility effective date and maintains it in CMS systems.
The OEPI is continuous for eligible individuals. For purposes of enrollment under the OEPI election period, an institutionalized individual is defined as an individual who moves into, resides in, or moves out of an institution. The OEPI ends two months after the month the individual moves out of the institution.
Special election periods constitute periods outside of the usual IEP, AEP or MA OEP when an individual may elect a plan or change his or her current plan election. As detailed below, there are various types of SEPs, including SEPs for dual eligible, and for individuals whose current plan terminates, who change residence and who meet “exceptional conditions”.
During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP.
Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MA-PD or MA-only plans can switch to:
The effective date for an MA OEP election is the first of the month following receipt of the enrollment request.
To join Imperial Dual Plan (HMO Dual-SNP) you must have both Medicare and Medicaid.
If you are interested in enrolling into Imperial Health Plan you may do so in one of the following ways:
And if you do not wish to make an appointment with one of our sales representatives, you may
Imperial Health Plan of California, Inc.
Attn: Enrollment Department
PO BOX 60874
Pasadena, CA 91116
Quality Assurance programs at Imperial Health Plan address real-time review of medical operations and claims data to ensure our members are receiving safe and appropriate services. The focus of the program is on the medical needs of our members and services required in order to optimize one’s ability to function at the highest level of capacity. The program encompasses services provided by PCP’s, Specialists, Vendors, and Prescription Drugs. Should you have specific questions regarding the program, please contact us at 1-800-838-8271 TTY users should call 711 for additional information.
Our goal is to ensure our members are getting the best health care. We track the health care services that you get through a survey of our doctors called HEDIS®. This allows us to measure our progress toward making sure you are getting the best health care. We also ask how well we serve you through a member survey every year called CAHPS® to identify any barriers or areas of improvement.
Some of the things we measure include:
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