Platinum 90 HMO

Platinum 90 HMO

Platinum 90 HMO Plan Information

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2018 Benefit Highlights
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Plan Benefit Highlights (PDF)
Pediatric Dental Summary (PDF)
Pediatric Vision Summary (PDF)
 
Rates
Individual & Family Plans Rate - San Francisco County (PDF)
Individual & Family Plans Rate - San Mateo County (PDF)
California Plain-Language Rate Filing Description (PDF)
Summary of Benefits (SBC)    Chinese    Spanish
Health Plan Benefits and Coverage Matrix (PDF)
Evidence of Coverage (EOC) (PDF)
CCHP Provider Directory - Covered CA (English and Chinese) (PDF)
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CCHP Pharmacy Directory - Covered CA (English) (PDF)
 
Pharmacy Locator
List of Covered Drugs (Formulary) (English)* (No changes made since 5/2018)

 

Covered CA Drug Preview Tool - San Francisco ** (coming soon)

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Covered CA Drug Preview Tool - San Mateo ** (coming soon)

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** (Note: Please note that this is an estimate only. Actual cost depends on the status of your deductible balance, if any, and any applicable limitations or exceptions.)

 

CCHP Pharmaceutical Management Procedures (English) (PDF)

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