Important Plan Documents

The following documents provide important information on services and benefits to help you make an informed decision about enrolling.

Summary of Benefits for Monterey County

Evidence of Coverage

Annual Notice of Change

Multi-Language Interpreter Services

Enrollment Instructions and Forms

Directories

Search for a provider or pharmacy

When you’re ready, check out our Enrollment page. Or call 831-574-4938 (local), 855-570-1600 (toll free) to speak with a representative.

If you would like to request a mailed copy of the current Provider and Pharmacy Directory, or if you need help finding a network provider and/or pharmacy, please call member services toll free at (855) 570-1600 (TTY users call 711) or click on the following link for more information.

2017 Pharmacy and Provider Directory Notice PDF
Also available in Spanish (en español) PDF

Benefit Highlights

Enhanced Health Benefits

Aspire Health Plan provides comprehensive medical and pharmacy benefits, including preventive care and screenings for all our Medicare Advantage plans. But if you’re looking for the advantage of enhanced dental, vision and hearing aid coverage to add to your Aspire Health Plan, consider our Enhanced Health Benefit.

For an additional monthly premium, you can add more comprehensive benefits to your existing dental, vision, and hearing coverage. Benefits include up to $1,000 a year in dental coverage; $10 co-pays on eye exams and $25 co-pays on frames and contact lenses; $20 co-pay for routine hearing exams and significant discounts on hearing aids.

  • Aspire Health Advantage Value Plan (HMO) -- $33/month
  • Aspire Health Advantage Plan (HMO) -- $29/month
  • Aspire Health Advantage Plus Plan (HMO-POS) -- $29/month

2017 Enhanced Health Benefits

Enhanced Health Optional Supplemental Benefits Enrollment Form
Also available in Spanish (en español)

Enhanced Health Optional Supplemental Benefits Disenrollment Form
Also available in Spanish (en español)

Claim Reimbursement Request Form

Care in an Emergency or Disaster

Getting Medical Care & Prescription Drugs In Disaster Or Emergency Areas

If the Governor of California, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in Monterey County, you can still get medical care and prescription medications from Aspire Health Plan.

Generally, during a disaster or emergency, Aspire Health Plan will allow you to obtain medical care from out-of-network providers at in-network cost-sharing rates without prior authorization requirements. In cases where payment is required up front for the out-of-network care you may submit a request for reimbursement to the plan.

Aspire Health Plan has a national network of pharmacies available to fill prescriptions for medications. If you cannot use a network pharmacy during a disaster, you may be able to fill your prescription drugs at an out-of-network pharmacy. In cases where payment for the cost of the drugs is required at the time the prescription is filled you may submit a request for reimbursement to the plan.

For more information on how to obtain needed care and medications during a disaster or emergency please call the Aspire Health Plan customer service team toll free at 855-570-1600(TTY users call 711), 8 am to 8 pm PST Monday through Friday (except certain holidays) from February 15 through September 30 and 8 am to 8 pm PST seven days a week for the period of October 1 through February 14.

Aspire Health Privacy Notice

Authorization to Disclose Personal Health Information