Introduction
GEMCare Medicare Plus (GHP) is a Medicare Advantage prescription drug plan (MA-PD) offered by GEMCare Health Plan, Inc.. You are eligible to join GEMCare Medicare Plus if you are entitled to Medicare Part A, enrolled in Medicare Part B, and live in Kern County. Members receive all benefits offered by original Medicare and more.
Service Area
GHP is a local Kern County MA-PD plan serving the Kern County geographic area.
Benefits, Premiums and Cost Sharing
GEMCare Health Plan is competitive with other MA-PD plans in the area when it comes to benefits offered, premiums paid by the member, and cost-sharing requirements.
Click here for a Summary of GHP benefits.
(Note: County of Kern retirees should click here to contact GHP Member Services for more information.)
Click here to view the Evidence of Coverage document for more detail on GHP benefits. (Note: County of Kern retirees should click here to contact GHP Member Services for more information.)
Conditions and Limitations
For information about conditions and limitations of benefits and coverage, click on the following link to view the Evidence of Coverage document. Potential for Contract Termination GEMCare Health Plan has a contract with Medicare and CMS to offer its plan in Kern County. This contract between GHP and the Centers for Medicare & Medicaid Services (CMS) is reviewed annually, so the availability of coverage beyond the end of the current contract year can not be guaranteed.
Potential for Contract Termination
There is the possibility that at some time GEMCare Health Plan may terminate, refuse to renew, or modify its contract with Medicare and vice-versa. In the event that any of these events occur, your rights are protected. You will be notified in writing of any and all changes in a timely manner and provided with instructions as to how to proceed and the options available to you. Once you are notified in writing that we are leaving the Medicare program or the area where you live, you may enroll in another plan.
If the contract is terminated, your membership in GHP will end, and you will need to enroll in another MA-PD Plan in order to continue your health care and prescription drug coverage.
Disenrollment Rights
In the event you decide to end your membership in GHP, you should be aware of your rights related to the disenrollment. For more information about disenrollment and your rights click and refer to Section 6 of the Evidence of Coverage Document.
Frequently Asked Questions About GEMCare Health Plan
FAQ's About Medicare Advantage and GHP
Links to Member Newsletters - Past Editions
GEMCare Health Plan Newsletter - Spring 2007
GEMCare Health Plan Newsletter - Winter 2008
GEMCare Health Plan Newsletter - Spring 2009
GEMCare Health Plan Newsletter - Fall 2009
GEMCare Health Plan Newsletter - Spring 2010
Learn More about GHP (Note: County of Kern retirees should click here to contact GHP Member Services for more information.)
GHP Summary of Benefits document (PDF)
Evidence of Coverage Document with detailed GHP Benefits (PDF)
More Information about Dental Plan and Coverage
Out of Network Coverage for Medial Services (PDF)
Transitioning Prescription Drugs for New Members (PDF)
Premium Information for those Receiving Extra Help with GHP Benefits
Enrollment in GEMCare Health Plan
GHP Enrollment Form with Instructions (PDF) - Download, complete & return to GHP
Find a Provider or Pharmacy
2010 Medical Provider Directory (PDF)
Prescription Drugs
Search the GHP Formulary for Covered Prescription Drugs (001 Plan)
Search the GHP Formulary for Covered Prescription Drugs (801 Plan for County of Kern Retirees)
Formulary Changes and Update Information
Available in Kern County. GEMCare Medicare Plus is a Medicare Advantage Plan offered by GEMCare Health Plan Inc., a Medicare Advantage Organization that contracts with the federal government. GEMCare Medicare Plus is available to persons who reside in the service area and are entitled to Medicare Part A and enrolled in Part B, including those with Medicare based on entitlement to Social Security Disability Benefits. You must continue to pay your Medicare Part B premiums if not otherwise paid for under Medicaid or by another third party. If you obtain routine care from out-of-plan providers neither Medicare nor GEMCare Health Plan will be responsible for the costs. Medicare beneficiaries may be enrolled in only one Part D plan at a time.