Evidence of Coverage
Medical
Click the applicable plan below to view corresponding Evidence of Coverages.
Anthem Blue Cross
2023
2023 Anthem EOCs will be posted when available
2022
California HMO (For Member Residing in California only)
2022 Anthem HMO Member under age 65 or 65+ with only Medicare Part B and no Part D
2022 Anthem HMO Member 65+ with only Medicare Part B and Part D
California PPO (For Member Residing in California only)
2022 Anthem PPO for Member under age 65 (CA)
2022 Anthem PPO Member age 65+ with only Medicare Part B and Part D (CA)
Non-California PPO (For Member Residing in the U.S. & Its Territories only)
2022 Anthem PPO for Member under age 65 (non-CA)
2022 Anthem PPO Member age 65+ with only Medicare Part B and Part D (non-CA)
Medicare
2022 Anthem Medicare Preferred (PPO) with Senior Rx Plus - Part A and B MAPD
2022 Anthem MedicareRx (PDP) with Senior Rx Plus - Part B PDP
Anthem PPO Out of Country (For Member Residing Outside the U.S. & Its Territories)
2022 Anthem Member – Out of Country
Kaiser Permanente
2023
Kaiser Senior Advantage (Southern CA)
2023 Kaiser Senior Advantage HMO with Part D Southern CA
2023 Kaiser Chiropractic and Acupuncture Services and Silver&Fit Southern CA
Kaiser Senior Advantage (Northern CA)
2023 Kaiser Senior Advantage HMO with Part D Northern CA
2023 Kaiser Chiropractic and Acupuncture Services and Silver&Fit Northern CA
Kaiser (non-Medicare) (Southern CA)
2023 Kaiser Traditional HMO Southern CA
2023 Kaiser non-Medicare Retiree Chiropractic and Acupuncture Services and Silver&Fit Southern CA
Kaiser (non-Medicare) (Northern CA)
2023 Kaiser Traditional HMO Northern CA
2023 Kaiser non-Medicare Retiree Chiropractic and Acupuncture Services and Silver&Fit Northern CA
2022
Kaiser Senior Advantage (Southern CA)
2022 Kaiser Senior Advantage HMO with Part D Southern CA
2022 Kaiser Chiropractic and Acupuncture Services and Silver&Fit Southern CA
Kaiser Senior Advantage (Northern CA)
2022 Kaiser Senior Advantage HMO with Part D Northern CA
2022 Kaiser Chiropractic and Acupuncture Services and Silver&Fit Northern CA
Kaiser (non-Medicare) (Southern CA)
2022 Kaiser Traditional HMO Southern CA
2022 Kaiser non-Medicare Retiree Chiropractic and Acupuncture Services and Silver&Fit Southern CA
Kaiser (non-Medicare) (Northern CA)
2022 Kaiser Traditional HMO Northern CA
2022 Kaiser non-Medicare Retiree Chiropractic and Acupuncture Services and Silver&Fit Northern CA
SCAN Health Plan
2023 SCAN EOC will be posted when available
UnitedHealthcare
2023
2023 UHC EOCs will be posted when available
2022
Dental
Click the applicable plan below to view corresponding Evidence of Coverages.
DeltaCare USA HMO
2023 DeltaCare USA HMO EOC will be posted when available.
Delta Dental PPO
2023 Delta Dental PPO EOC will be posted when available.
Vision
Anthem Blue View Vision for vision coverage is available to those enrolled in a LACERS medical plan other than Kaiser Permanente. Kaiser Permanente members obtain their vision benefits from Kaiser; please see the above Medical section for Kaiser’s medical EOC.
2023 Anthem Blue View Vision EOC will be posted when available