VHP PPT Template 2014
Transcript of VHP PPT Template 2014
VALLEY HEALTH PLAN
Covered California Plan & Individual & Family Plan
© 2014 Valley Health Plan
WELCOME
Goal: To share information about Valley Health Plan (VHP) and
establish a relationship with trusted organizations to work
together to reach communities in need of health coverage.
– About Valley Health Plan
– HMO vs PPO
– Why Choose Valley Health Plan?
– Steps to Navigate: VHP Provider Search
– Steps to Navigate: Covered California Shop and Compare Tool
– How to Enroll
– Member Materials
© 2012 Valley Health Plan 2
Agenda
ABOUT VALLEY HEALTH PLAN
• As the only locally based health plan in Santa Clara
County, we understand the community’s health
coverage needs.
• VHP, is a HMO that has been providing health insurance
coverage to employer groups since 1985.
• VHP is now publically available, where ANY resident of
Santa Clara County can choose quality, affordable
health coverage.
© 2014 Valley Health Plan 3
For Residents of Santa Clara County
ABOUT VALLEY HEALTH PLAN
© 2014 Valley Health Plan 4
Region 7 Service Area – County of Santa Clara
Northern Area
• Los Altos
• Los Altos Hills
• Mountain View
• Palo Alto
• Sunnyvale
Western Area
• Campbell
• Cupertino
• Los Gatos
• Monte Sereno
• Saratoga
Central /Eastern Area
• Milpitas
• San Jose
• Santa Clara
Southern Area
• Gilroy
• Morgan Hill
KEY DIFFERENCES BETWEEN HMO VS. PPO
• Health Maintenance Organization (HMO)
– All your health care services go coordinated by a Primary Care
Physician
– Need a referral to see a specialist (except in an emergency)
– Visits to out-of-network providers are not typically covered
• Preferred Provider Organization (PPO)
– No need for a referral to see a specialist
– Can access care both inside and outside the provider network
– Typically pay a higher percentage of cost for out-of-network care
– Choice = Higher Cost Share
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Valley Health Plan is an HMO
WHY CHOOSE VALLEY HEALTH PLAN?
• Covered California Plan
– Subsidies may be available based on age, family size and income
– Proof of legal status, residency, and income required
– VHP does not offer Small Business Health Options Plan (SHOP) at this time
• VHP Individual & Family Plan
– The applicant only needs to sign the application which attests that everything on the application is true
– Subsidies are not available
– Mirrored product for rates, copays, provider network, and benefits
All plans include Pediatric Dental (Liberty) & Vision (VSP) benefits
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Products Offered
WHY CHOOSE VALLEY HEALTH PLAN?
• Every HMO Qualified Health Plan offers the same essential health benefits and co-pay/coinsurance.
• Multilingual staff and member materials
• Lowest HMO prices for the most popular Exchange plans
• Quality network of primary and specialty care providers
– Primary Care: Community Clinics, Independent Providers, and Santa Clara Valley Medical Center (SCVMC)
– Hospitals: Lucile Packard Children’s, Saint Louise Regional, SCVMC, and Stanford
– Safeway and Walgreens pharmacies (Nationwide)
– Quest Labs (Statewide locations)
• Free health & wellness services
• Easy process for non-subsidy eligible applicants to enroll into mirrored VHP Individual & Family Plan
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Connecting the coverage you need with the care you deserve
PROVIDER NETWORK
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Covered California Plan and VHP Individual & Family Plan
FREE HEALTH AND WELLNESS SERVICES
• Chronic Disease Prevention & Management Classes
– Diabetes prevention, nutrition, tobacco cessation, Weight Watchers
• Prenatal Classes
– Childbirth, Breastfeeding, Labor & Delivery, Infant CPR
• Fitness Classes
– Aquatic, Jazzercise, Pilates, Total Body Fitness, Tai Chi, Yoga, Zumba
• Online Wellness Tools
– Personal Health Assessment, workshops, recipes, nutrition tracking
• Care Management Program
– Disease Management and Complex Case Management
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For All VHP Members
STEPS TO NAVIGATE: PROVIDER SEARCH
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Step 1: Visit www.valleyhealthplan.org
STEPS TO NAVIGATE: PROVIDER SEARCH
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Step 2: Click on Provider Search
STEPS TO NAVIGATE: PROVIDER SEARCH
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Step 3: Click Provider
STEPS TO NAVIGATE: PROVIDER SEARCH
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Step 4: Filter Results
STEPS TO NAVIGATE: PROVIDER SEARCH
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Compare Providers
STEPS TO NAVIGATE: PROVIDER SEARCH
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Provider Profile
STEPS TO NAVIGATE: PROVIDER SEARCH
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Provider Profile
STEPS TO NAVIGATE: SHOP AND COMPARE TOOL
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Step 1: Visit www.coveredca.com
FIND THE PLAN THAT MEETS YOUR NEEDS
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Step 2: Input your information
COVERED CALIFORNIA: VALLEY HEALTH PLAN
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Step 3: Plan Options (HMO vs. PPO)
Highlights
• You can toggle
metal options
• Tax credits same
for all
• Total monthly
premium
payments differ
by Plan choice
PLAN PREMIUM COMPARISON
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Example for a 25 year old
PLAN PREMIUM COMPARISON
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Example for a 40 year old
HOW TO ENROLL
• Buying through Covered California
– Visit coveredca.com
– Call 1.800.300.1506 (toll-free)
• Buying Directly From VHP
– Visit valleyhealthplan.org
– Call 1.888.421.8444 (toll-free)
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Individuals and Families
MEMBER MATERIALS
• “We Speak the Language of Health”
– Covered California Plan (English, Spanish & Vietnamese)
– Individual & Family Plan (English, Spanish & Vietnamese)
• “Compare and Save”
– Example of premiums for 25-year olds
– Example of premiums for 40-year olds
• Summary of Benefits and Coverage (SBC)
– All Metal Tiers
• Premium Rates by Age
• How to Read Your VHP ID Card
Folder Contents
Thank You!