VillageHealth is a Medicare Advantage Organization with a Medicare contract; and is an ESRD Special Needs Plan with a Point of Service (POS) option. This plan is available to (ESRD) dialysis patients, kidney transplant, and post-transplant patients.

Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium. You must have been diagnosed by your doctor with End Stage Renal Disease (ESRD), or be in a pre or post kidney transplant status. There are no restrictions to the time of year when you may enroll in VillageHealth.

VillageHealth is available in the following Southern California counties:

• Riverside County
• San Bernardino County

VillageHealth benefits, formulary, pharmacy network, premium, co-payments and/or co-insurance may change on January 1, from year to year.

VillageHealth offers a network of primary care doctors, specialists and hospitals. You are also covered when you receive services from providers who are not part of the VillageHealth network. You may self refer to any out-of-network provider who accepts Medicare. You share of the cost does not change for services received in, or out of network. Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances. Quantity limitations, copayments and restrictions may apply.

For those members who qualify for extra help and/or also carry additional Medi-Cal coverage: premiums, co-pays and deductibles may vary based on the level of help received. For more information contact the plan.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

This document is available in alternate formats or languages. Please call 1-877-586-1648 for more information. We are available to help you between the hours of 7:00 a.m. and 8:00 p.m., 7 days a week. TTY users please call 1-866-525-7833.

Este documento está disponible en otros formatos o idiomas. Llame al 1-877-586-1648 para obtener más información. Estamos disponibles para ayudarle entre las 7:00 a.m. y 8:00 p.m., los siete días de la semana. Los usuarios de TTY deben llamar al 1-866-525-7833.