Members

Members and Guests

If you are interested in learning more about Imperial Health Plan of California (HMO) (HMO SNP) please contact our prospective member toll-free line at: 1-800-838-5914.

Want to enroll in Imperial Health Plan, you can do so in one of the following ways:
  1. Enroll over the phone by calling us at 1-800-838-5648 and we will take your enrollment information over the phone
  2. Schedule a face-to-face appointment by calling 1-800-838-5914 and we can schedule an appointment with an employed Sales Representative or Independent Agent.
  3. Download the attached enrollment form and submit via:
  1. Complete online enrollment application via Medicare Online Enrollment Center (OEC) at http://www.medicare.gov . By accessing this link, you acknowledge that you have reviewed the Imperial Health Plan Summary of BenefitsDrug Formulary, and the Provider Search Function that are provided on https://imperialhealthplan.com or by calling the Membership Department at 1-626-380-9066.

If you detect or suspect FWA, please report it immediately. Your report is confidential and prohibits retaliation against anyone for reporting in good faith a possible violation of the code, law or regulation.

Enrollment Application

If you select PBP 005 Imperial Senior Value (HMO C-SNP), you must complete the SNP Assessment Form below.

Who can join?
To join any of our Plan Benefit Packages, you must meet all of the following requirements:

  • You live in our service area
  • You have both Medicare Part A and Medicare Part B
  • You are a United States Citizen

To join Imperial Senior Value (C-SNP), you must also have been diagnosed with diabetes, chronic heart failure (CHF), and/or cardiovascular disorders(s).

If you’re enrolled in a Medicare plan or enrolling for the first time, generally you can only enroll, switch plans, or disenroll from a plan during certain times of the year.

Annual Election Period (AEP) 

AEP is from October 15 through December 7 of every year. MA eligible individuals may enroll in or disenroll from an MA plan. The last enrollment request made, determined by the application date, will be the enrollment request that takes effect.

Initial Coverage Election Period (ICEP)

The ICEP is the period during which an individual newly eligible for MA may make an initial enrollment request to enroll in an MA plan. This period begins three months immediately before the individual’s first entitlement to both Medicare Part A and Part B and ends on the later of:

  1. The last day of the month preceding entitlement to both Part A and Part B, or;
  2. The last day of the individual’s Part B initial enrollment period.
Initial Enrollment Period for Part D (IEP for Part D)

The Initial Enrollment Period for Part D (IEP for Part D) is the period during which an individual is first eligible to enroll in a Part D plan. In general, an individual is eligible to enroll in a Part D plan when he or she is entitled to Part A OR is enrolled in Part B, AND permanently resides in the service area of a Part D plan. Ultimately, CMS provides a part D eligibility effective date and maintains it in CMS systems.

Open Enrollment Period for Institutionalized Individuals (OEPI)

The OEPI is continuous for eligible individuals. For purposes of enrollment under the OEPI election period, an institutionalized individual is defined as an individual who moves into, resides in, or moves out of an institution. The OEPI ends two months after the month the individual moves out of the institution.

Special Election Periods (SEP)

Special election periods constitute periods outside of the usual IEP, AEP or MA OEP when an individual may elect a plan or change his or her current plan election. As detailed below, there are various types of SEPs, including SEPs for dual eligible, and for individuals whose current plan terminates, who change residence and who meet “exceptional conditions”.

Medicare Advantage Open Enrollment Period (MA OEP)

During the MA OEP, MA plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during the MA OEP.

Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MA-PD or MA-only plans can switch to:

  • MA-PD
  • MA-only
  • Original Medicare (with or without a stand-alone Part D plan)

The effective date for an MA OEP election is the first of the month following receipt of the enrollment request.

To join Imperial Dual Plan (HMO Dual-SNP) you must have both Medicare and Medicaid.

As a member if you have any question please call us at 1-800-838-8271 for English and Spanish and 1-800-708-5976 for Chinese.

Prospective Members

If you are interested in enrolling into Imperial Health Plan you may do so in one of the following ways:

  1. Call us to enroll telephonically. Call 800-838-5914 and we will take your enrollment information over the phone.
  2. Call us to schedule a face-to-face appointment. Please call 1-800-838-5914 and we can schedule an appointment with an employed Sales Representative or Independent Agent.

And if you do not wish to make an appointment with one of our sales representatives, you may

  1. Download the attached enrollment form and submit it by fax 626-380-9066, Enrollment Form – [PDF, 739KB]
  2. Download the attached enrollment form and submit it by email enrollmentunit@imperialhealthplan.com
  3. Mail it to us at:

    Imperial Health Plan of California, Inc.
    Attn: Enrollment Department
    PO BOX 60874
    Pasadena, CA 91116

  1. On-line enrollment. Medicare beneficiaries may also enroll in Imperial Health Plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

By accessing these links, you acknowledge that you have reviewed the Imperial Health Plan Summary of BenefitsDrug Formulary, and the Provider Search Function which are all provided within this website or by calling the Enrollment Department.

Quality Assurance Programs

Quality Assurance programs at Imperial Health Plan address real-time review of medical operations and claims data to ensure our members are receiving safe and appropriate services. The focus of the program is on the medical needs of our members and services required in order to optimize one’s ability to function at the highest level of capacity. The program encompasses services provided by PCP’s, Specialists, Vendors, and Prescription Drugs. Should you have specific questions regarding the program, please contact us at 1-800-838-8271 TTY users should call 711 for additional information.

Our goal is to ensure our members are getting the best health care. We track the health care services that you get through a survey of our doctors called HEDIS®. This allows us to measure our progress toward making sure you are getting the best health care. We also ask how well we serve you through a member survey every year called CAHPS® to identify any barriers or areas of improvement.

Some of the things we measure include:

  • Appointment availability
  • After-hours services
  • Making sure the network of doctors in your area fits your needs
  • Member satisfaction surveys
  • Doctor satisfaction surveys
  • Quality of care studies to assure appropriate:
    • Immunizations
    • Cervical cancer screening
    • Breast cancer screening
    • Diabetes Care
    • Asthma Care
    • High Blood pressure
    • Prenatal and postpartum care
  • Cholesterol management

To read PDFs, you will need Adobe Acrobat Reader. You can download here.

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