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    Formerly Known as HMO California
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About Brand New DayAbout Brand New Day

Brand New Day -2010 BenefitsBrand New Day - 2010 Benefits

        Summary of Benefits (Spanish)

        Evidence of Coverage (Spanish)

        Plan Premium for People Getting Help

Prospective MembersProspective Members

Member ServicesCustomer Service

Provider DirectoryProvider Directory

Prescritption Drug Coverage Prescription Drug Coverage

2010 Formulary (Spanish)

Changes to the Brand New Day Formulary

Prior Authorization Guidelines

Step Therapy Guidelines

Quantity Limits

Coverage Determinations, Appeal & Grievance Guide

Transition Policy

Programs to help manage medications

Best Available Evidence Policy

Pharmacy Directory

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    Kern County

    Orange County

    Riverside County

    San Bernadino County

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open your mind to a
different kind of coverage

Welcome to Brand New Day HMO for the Seriously and Persistently Mentally Ill. Brand New Day members actively participate in setting the goals they want to achieve. A team gathers periodically to determine how to better help the member reach these goals. The member’s team consists of some or all of the following: life coach, social workers, addiction specialist, prescription specialist, primary care physician, specialty physicians, therapists, nurse and family care giver.

The Brand New Day includes the following features:

  • Personal Services Coordinator (Life Coach)
  • Primary Care Physician (PCP)
  • Primary Treating Psychiatrist (PTP)
  • Wellness Activity Center
  • Medical Case Manager (as needed)
  • Dental and Vision services
  • Hospital Services
  • Pharmacy Benefits
  • Pharmacy Directory

Brand New Day for the Seriously and Persistently Mentally Ill is a Medicare Advantage Part D Prescription Drug Special Needs Plan that contracts with the Federal Government. This plan is available to persons entitled to Medicare Part A and enrolled in Part B. You must continue to pay Medicare Premiums. If applicable, share of cost applies. You must reside in the service area which includes Kern, Los Angeles, Orange, San Bernardino and Riverside Counties. You must use contracted providers for all routine care except for emergency care, urgently needed care when our network is not available or our network is not available or out-of-area dialysis care. If you obtain any other care from non-plan providers, neither Medicare nor Brand New Day HMO will be responsible for the costs. All Medicare Advantage Plans agree to stay in the program for a full year at a time. Each year, the plans decide whether to continue for another year. Even if a Medicare Advantage Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area

 

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Information last update 9/1/2010

CMS Approved 6/15/10 - H0838_2010_WEB

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