1-844-800-4693 Mon – Fri 8AM – 8PM, Sat 9AM – 6PM

Members

RESOURCE DETAILS
Member Services (Medical & Behavioral Health)
844-800-4693
Behavioral Health Crisis Line
855-765-9696
Envolve Benefit Options (Vision)
855-279-9680
Navitus (Pharmacy)
866-333-2757
For Hearing Impaired (TTY)
711
24 Hour Nurse Advice Line
855-880-7019
Liberty Dental Plan (Dental)
866-609-0426
Utilization Management
Click Here for Claims, Pre-Authorizations, Appeals, etc.
8:00 AM – 5:00 PM
Monday through Friday
excluding holidays
CHAP Expansion Member Reenrollment Documents
These documents are for the approved CHAP Expansion members for 2023 reenrollment.
They are not being used for any other members.
Click Here to get a complaint form.
Click Here to get a Notice of Appeal Request form in English.
Click Here to get a Notice of Appeal Request form in Spanish.
Click Here to get an Authorization to Disclose PHI form in English.
Click Here to get an Authorization to Disclose PHI form in Spanish.
Click Here for a Medical Claim Form. This form should be used by Members needing to submit a medical claim to IdealCare.
Please be advised that the medical claim form must be received within 95 days from date of service.

Welcome to the Sendero Health Plan wellness page. We strive to provide value added services and programs to support the health of our members and our community. This page will serve as a resource for members to use various services, programs and tools to better manage member health and health information. Sendero endorses and recommends referring IdealCare members to the following resources: 

An online personal health record helps you to keep track of your health data through a FREE PHR from WebMD, one of American’s most trusted sites for health care content. You can keep track of immunizations, lab results, food intake and much more. Click Here to create your personal health record.

WebMD provides valuable health information, tools for managing your health, and support to those who seek information. You can trust that content is timely and credible. Click Here to read more about WebMD.

The following tool will help you assess your current health status and risk factors that affect your health. The tool also has questions on healthy behaviors (e.g. smoking, alcohol use, diet and exercise, etc.). This is an important tool for you to complete because it helps you understand your health better. The tool can take between 20 – 30 minutes to complete. At the end of the assessment, the tool will provide you with a summary of your responses and some tips on how you can stay or become more healthy. You will also be able to download this information. Click Here for survey.

The following tool will help you assess your use of alcohol. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you with a score regarding your drinking habits and what this means for you. You will also be able to download information on alcohol use and its impact on your health. Click Here for survey.

The following tool will help you assess your Body Mass Index. The BMI is a measure of body fat. You only need to enter your height and weight. At the end of the assessment, the tool will provide you with your body mass index and what your index means. You will also be able to download information on how to maintain or improve your health. Click Here for survey.

The following tool will help you determine if you have any depressive symptoms. This tool has 22 questions and will take approximately 3 – 5 minutes to finish. These questions are related to your mood and lifestyle (for example, eating, sleeping, social engagement, etc.). At the end of the assessment, the tool will provide you with a score regarding your depressive symptoms and what this means for you. You will also be able to download information on depression and its impact on your health. Click Here for survey.

The following tool will help you assess your knowledge of how many calories there are in the different types of food items we eat on a daily basis. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you more information on the number of calories present in the different foods you eat. You will also be able to download information how to improve your eating habits at the end of the assessment. Click Here for survey.

The following tool will help you assess the level of stress in your life in the last 1 month. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you with a score related to your stress level and what this means for you. You will also be able to download information how to better deal with stress and improve your health. Click Here for survey.

Nicotine is the chemical in cigarettes that makes you want to keep smoking. Finding out how much you depend on nicotine will help you as you choose quit smoking strategies for your quit plan. Remember—no matter what your score, you’ll have to work hard to quit for good. Answer the following questions. The results will explain how much you depend on nicotine and provide ideas on how to reduce your cravings. Click Here for survey.

The following tool asks you questions about your physical activity. The questions also focus on possible barriers that prevent you from exercising. This tool has 21 questions and will take approximately 3-5 minutes to finish. At the end of the assessment, the tool will provide a score related to your physical activity and the barriers that affect your likelihood of exercising. You will also be able to download information on how to increase the amount of exercise you get and how this can improve your health. Click Here for survey.

Smoking Cessation – http://smokefree.gov/
This web site provides information and tools to help people of all ages quit smoking, manage withdrawal, eat healthier, and manage your mood. In English and Spanish.

Stop Smoking – http://www.lung.org/stop-smoking/
This web site provides information about smoking and how to quit.

Stay away from Tobacco – http://www.cancer.org/healthy/stayawayfromtobacco/quit-for-life
This web site has a smoking quiz, guide to stop smoking, guide to stop using smokeless tobacco, help with cravings, secondhand smoke information, and tobacco and cancer fact sheets.

Click Here for additional information on Sendero’s Smoking Cessation Program “Up In Smoke”.

PLANSCSR VARIATION TYPEDOCUMENTSDRUG COSTS
Silver
Sendero IdealCare Silver 100Off ExchangeEnglishLookup Cost
Sendero IdealCare Silver 101On ExchangeEnglishLookup Cost
Sendero IdealCare Silver 102AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Silver 103AI/AN Limited Cost SharingEnglishLookup Cost
Sendero IdealCare Silver 7373% AVEnglishLookup Cost
Sendero IdealCare Silver 87 87% AV EnglishLookup Cost
Sendero IdealCare Silver 94 94% AV EnglishLookup Cost
Gold
Sendero IdealCare Gold 200Off ExchangeEnglishLookup Cost
Sendero IdealCare Gold 201On ExchangeEnglishLookup Cost
Sendero IdealCare Gold 202AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Gold 203AI/AN Limited Cost SharingEnglishLookup Cost
Bronze
Sendero IdealCare Bronze 300Off ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 301On ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 302AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Bronze 303AI/AN Limited Cost SharingEnglishLookup Cost
Silver Direct
Sendero IdealCare Silver Direct 500Off ExchangeEnglishLookup Cost
Platinum
Sendero IdealCare Platinum 600Off ExchangeEnglish • SpanishLookup Cost
Bronze High Deductible
Sendero IdealCare Bronze High Deductible 700Off ExchangeEnglishLookup Cost
Sendero IdealCare Bronze High Deductible 701On ExchangeEnglishLookup Cost
Sendero IdealCare Bronze High Deductible 702AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Bronze High Deductible 703AI/AN Limited Cost SharingEnglishLookup Cost
Expanded Bronze
Sendero IdealCare Bronze 800Off ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 801On ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 802AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Bronze 803AI/AN Limited Cost SharingEnglishLookup Cost
Silver – Standardized Plans
Sendero IdealCare Silver 1700Off ExchangeEnglishLookup Cost
Sendero IdealCare Silver 1701On ExchangeEnglishLookup Cost
Sendero IdealCare Silver 1702AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Silver 1703AI/AN Limited Cost SharingEnglishLookup Cost
Sendero IdealCare Silver 177373% AVEnglishLookup Cost
Sendero IdealCare Silver 178787% AVEnglishLookup Cost
Sendero IdealCare Silver 179494% AVEnglishLookup Cost
Gold – Standardized Plans
Sendero IdealCare Gold 1800Off ExchangeEnglishLookup Cost
Sendero IdealCare Gold 1801On ExchangeEnglishLookup Cost
Sendero IdealCare Gold 1802AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Gold 1803AI/AN Limited Cost SharingEnglishLookup Cost
Bronze – Standardized Plans
Sendero IdealCare Bronze 1900Off ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 1901On ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 1902AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Bronze 1903AI/AN Limited Cost SharingEnglishLookup Cost
Expanded Bronze – Standardized Plans#colspan#
Sendero IdealCare Bronze 2000Off ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 2001On ExchangeEnglishLookup Cost
Sendero IdealCare Bronze 2002AI/AN Zero Cost SharingEnglishLookup Cost
Sendero IdealCare Bronze 2003AI/AN Limited Cost SharingEnglishLookup Cost

PLANSDOCUMENTS 
IdealCare Bronze, Silver and Gold PlansEnglish
IdealCare Platinum PlanEnglish

PLANSCSR VARIATION TYPEMedical-Surgical and Behavioral Health
Substance Abuse Disorder
Schedule of Coverage
Pharmacy Benefits
Schedule of Coverage
Silver
Sendero IdealCare Silver 100Off ExchangeEnglishEnglish
Sendero IdealCare Silver 101On ExchangeEnglishEnglish
Sendero IdealCare Silver 102AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Silver 103AI/AN Limited Cost SharingEnglishEnglish
Sendero IdealCare Silver 7373% AVEnglishEnglish
Sendero IdealCare Silver 8787% AVEnglishEnglish
Sendero IdealCare Silver 9494% AVEnglishEnglish
Gold
Sendero IdealCare Gold 200Off ExchangeEnglishEnglish
Sendero IdealCare Gold 201On ExchangeEnglishEnglish
Sendero IdealCare Gold 202AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Gold 203AI/AN Limited Cost SharingEnglishEnglish
Bronze
Sendero IdealCare Bronze 300Off ExchangeEnglishEnglish
Sendero IdealCare Bronze 301On ExchangeEnglishEnglish
Sendero IdealCare Bronze 302AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Bronze 303AI/AN Limited Cost SharingEnglishEnglish
Silver Direct
Sendero IdealCare Silver Direct 500Off ExchangeEnglishEnglish
Platinum
Sendero IdealCare Platinum 600Off ExchangeEnglish • SpanishEnglish • Spanish
Bronze High Deductible
Sendero IdealCare Bronze High Deductible 700Off ExchangeEnglishEnglish
Sendero IdealCare Bronze High Deductible 701On ExchangeEnglishEnglish
Sendero IdealCare Bronze High Deductible 702AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Bronze High Deductible 703AI/AN Limited Cost SharingEnglishEnglish
Expanded Bronze
Sendero IdealCare Bronze 800Off ExchangeEnglishEnglish
Sendero IdealCare Bronze 801 On ExchangeEnglishEnglish
Sendero IdealCare Bronze 802AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Bronze 803AI/AN Limited Cost SharingEnglishEnglish
Silver – Standardized Plans
Sendero IdealCare Silver 1700Off ExchangeEnglishEnglish
Sendero IdealCare Silver 1701On ExchangeEnglishEnglish
Sendero IdealCare Silver 1702AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Silver 1703AI/AN Limited Cost SharingEnglishEnglish
Sendero IdealCare Silver 177373% AVEnglishEnglish
Sendero IdealCare Silver 178787% AVEnglishEnglish
Sendero IdealCare Silver 179494% AVEnglishEnglish
Gold – Standardized Plans
Sendero IdealCare Gold 1800Off ExchangeEnglishEnglish
Sendero IdealCare Gold 1801On ExchangeEnglishEnglish
Sendero IdealCare Gold 1802AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Gold 1803AI/AN Limited Cost SharingEnglishEnglish
Bronze – Standardized Plans
Sendero IdealCare Bronze 1900Off ExchangeEnglishEnglish
Sendero IdealCare Bronze 1901On ExchangeEnglishEnglish
Sendero IdealCare Bronze 1902AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Bronze 1903AI/AN Limited Cost SharingEnglishEnglish
Expanded Bronze – Standardized Plans
Sendero IdealCare Bronze 2000Off ExchangeEnglishEnglish
Sendero IdealCare Bronze 2001On ExchangeEnglishEnglish
Sendero IdealCare Bronze 2002AI/AN Zero Cost SharingEnglishEnglish
Sendero IdealCare Bronze 2003AI/AN Limited Cost SharingEnglishEnglish
DESCRIPTIONDOCUMENTS 
Member HandbookEnglish 
Quick Reference GuideEnglish • Spanish
FormularyEnglish
Plan BrochureEnglish

PLANSDOCUMENTSDRUG COSTS
IdealCare Silver
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
73% AVEnglish • SpanishLookup Cost
87% AV English • SpanishLookup Cost
94% AV English • SpanishLookup Cost
IdealCare Gold
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Bronze
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Silver Direct
Off ExchangeEnglish • SpanishLookup Cost
IdealCare Platinum
Off ExchangeEnglish • SpanishLookup Cost
IdealCare Bronze High Deductible
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Expanded Bronze
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost

PLANSDOCUMENTS
IdealCare Bronze, Silver and Gold PlansEnglish
IdealCare Platinum PlanEnglish

PLANSMedical-Surgical and Behavioral Health
Substance Abuse Disorder
Schedule of Coverage
Pharmacy Benefits
Schedule of Coverage
IdealCare Silver – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Silver – On ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Silver – AI/AN Zero Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Silver – AI/AN Limited Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Silver – 73% AVEnglish • SpanishEnglish • Spanish
IdealCare Silver – 87% AVEnglish • SpanishEnglish • Spanish
IdealCare Silver – 94% AVEnglish • SpanishEnglish • Spanish
IdealCare Gold – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Gold – On ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Gold – AI/AN Zero Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Gold – AI/AN Limited Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Bronze – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Bronze – On ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Bronze – AI/AN Zero Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Bronze – AI/AN Limited Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Silver Direct – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Platinum – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Bronze High Deductible – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Bronze High Deductible – On ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Bronze High Deductible – AI/AN Zero Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Bronze High Deductible – AI/AN Limited Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Expanded Bronze – Off ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Expanded Bronze – On ExchangeEnglish • SpanishEnglish • Spanish
IdealCare Expanded Bronze – AI/AN Zero Cost SharingEnglish • SpanishEnglish • Spanish
IdealCare Expanded Bronze – AI/AN Limited Cost SharingEnglish • SpanishEnglish • Spanish

Member HandbookEnglish • Spanish
Quick Reference GuideEnglish • Spanish

PLANSDOCUMENTSDRUG COSTS
IdealCare Bronze High Deductible
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Expanded Bronze
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Gold
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Platinum
Off ExchangeEnglish • SpanishLookup Cost
IdealCare Silver
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
73% AVEnglish • SpanishLookup Cost
87% AV English • SpanishLookup Cost
94% AV English • SpanishLookup Cost
IdealCare Silver Direct
Off ExchangeEnglish • SpanishLookup Cost

PLANSDOCUMENTS
IdealCare Bronze, Silver and Gold PlansEnglish
IdealCare Platinum PlanEnglish

PLANSDOCUMENTS
IdealCare Bronze High Deductible
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Expanded Bronze
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Gold
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Platinum
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver Direct
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 73% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 87% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 94% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish

Member HandbookEnglish • Spanish
Quick Reference GuideEnglish • Spanish

2021 Rate Increase Justification for Affordable Care Act (ACA) products

Considerations for 2021 rate increases for Sendero Health Plans individual products include:

  • Anticipated medical trend in utilization costs and service costs
  • Anticipated fluctuations in average morbidity age
  • 2021 taxes and fees applicable for benefit year 2021 under the ACA
  • Anticipated payments and charges under the Federal Risk Adjustment Program
  • Absence of federal funding for the cost-sharing reductions, applicable to Individual Silver metal level plans
  • Shifts in cost-sharing levels
  • Redistribution of members to 2021 plans from 2020 plans that are being terminated in 2021
  • Anticipated utilization, cost of services, and changes in delivery system characteristics for provider networks

A subscriber’s actual rate increase may vary depending on their benefit plan.

PLANSDOCUMENTSDRUG COSTS
IdealCare Bronze High Deductible
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Bronze HSA
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Expanded Bronze
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Gold
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Platinum
Off ExchangeEnglish • SpanishLookup Cost
IdealCare Silver
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
73% AVEnglish • SpanishLookup Cost
87% AV English • SpanishLookup Cost
94% AV English • SpanishLookup Cost
IdealCare Silver Direct
Off ExchangeEnglish • SpanishLookup Cost
SelectCare Bronze High Deductible
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
SelectCare Expanded Bronze HSA
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost
SelectCare Expanded Bronze Simple
Off ExchangeEnglish • SpanishLookup Cost
On ExchangeEnglish • SpanishLookup Cost
AI/AN Zero Cost SharingEnglish • SpanishLookup Cost
AI/AN Limited Cost SharingEnglish • SpanishLookup Cost

PLANSDOCUMENTS
IdealCare Gold, Complete, Essential, Silver Direct, Bronze High Deductible, HSA and SelectCareEnglish • Spanish
PlatinumEnglish • Spanish

PLANSDOCUMENTS
IdealCare Bronze High Deductible
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Bronze HSA
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Expanded Bronze
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Gold
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Platinum
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver Direct
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 73% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 87% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
IdealCare Silver 94% AV
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
SelectCare Bronze High Deductible
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
SelectCare Expanded Bronze HSA
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish
SelectCare Expanded Bronze Simple
Medical-Surgical & Behavior Health/Substance Abuse DisorderEnglish • Spanish
Pharmacy BenefitsEnglish • Spanish

Member HandbookEnglish • Spanish
Quick Reference GuideEnglish • Spanish

PLANSDOCUMENTSDRUG COSTS
IdealCare Essential (Bronze)
Standard Off ExchangeEnglish • SpanishLookup Cost
Standard On ExchangeEnglish • SpanishLookup Cost
Zero Cost SharingEnglish • SpanishLookup Cost
Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare HSA (Bronze)
Standard Off ExchangeEnglish • SpanishLookup Cost
Standard On ExchangeEnglish • SpanishLookup Cost
Zero Cost SharingEnglish • SpanishLookup Cost
Limited Cost SharingEnglish • SpanishLookup Cost
Bronze High Deductible
Standard Off ExchangeEnglish • SpanishLookup Cost
Standard On ExchangeEnglish • SpanishLookup Cost
Zero Cost SharingEnglish • SpanishLookup Cost
Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Complete (Silver)
Standard Off ExchangeEnglish • SpanishLookup Cost
Standard On ExchangeEnglish • SpanishLookup Cost
Complete 73% AVEnglish • SpanishLookup Cost
Complete 87% AVEnglish • SpanishLookup Cost
Complete 94% AVEnglish • SpanishLookup Cost
Zero Cost SharingEnglish • SpanishLookup Cost
Limited Cost SharingEnglish • SpanishLookup Cost
IdealCare Silver Direct
Standard Off ExchangeEnglish • SpanishLookup Cost
IdealCare Gold
Standard Off ExchangeEnglish • SpanishLookup Drug Cost
Standard On ExchangeEnglish • SpanishLookup Drug Cost
Zero Cost SharingEnglish • SpanishLookup Drug Cost
Limited Cost SharingEnglish • SpanishLookup Drug Cost
IdealCare Platinum
Standard Off ExchangeEnglish • SpanishLookup Drug Cost

PLANSDOCUMENTS
Gold, Complete, Essential, Silver Direct, Bronze High Deductible and HSAEnglish
PlatinumEnglish

PLANSDOCUMENTS
IdealCare Essential (Bronze)
SOC Medical Surgical & Behavior Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
IdealCare HSA (Bronze)
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
Bronze High Deductible
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
IdealCare Complete (Silver)
Complete Standard SOC Medical Surgical & Behavior Health ServicesEnglish
Complete Standard SOC Pharmacy BenefitsEnglish
Complete Silver 73 AV SOC Medical Surgical & Behavior Health ServicesEnglish
Complete Silver 73 AV SOC Pharmacy BenefitsEnglish
Complete Silver 87 AV SOC Medical Surgical & Behavior Health ServicesEnglish
Complete Silver 87 AV SOC Pharmacy BenefitsEnglish
Complete Silver 94 AV SOC Medical Surgical & Behavior Health ServicesEnglish
Complete Silver 94 AV SOC Pharmacy BenefitsEnglish
IdealCare Silver Direct
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
IdealCare Gold
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
IdealCare Platinum
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish

Member HandbookEnglish • Spanish
Quick Reference GuideEnglish • Spanish

PLANSDOCUMENTS
Bronze (IdealCare Essential)
Standard Off ExchangeEnglish • Spanish
Standard On ExchangeEnglish • Spanish
Zero Cost SharingEnglish • Spanish
Limited Cost SharingEnglish • Spanish
Bronze HSA (IdealCare Essential HSA)
Standard Off ExchangeEnglish • Spanish
Standard On ExchangeEnglish • Spanish
Zero Cost SharingEnglish • Spanish
Limited Cost SharingEnglish • Spanish
Silver (IdealCare Complete)
Standard Off Exchange 1English • Spanish
Standard Off Exchange 2English • Spanish
Standard On ExchangeEnglish • Spanish
Complete 73% AVEnglish • Spanish
Complete 87% AVEnglish • Spanish
Complete 94% AVEnglish • Spanish
Zero Cost SharingEnglish • Spanish
Limited Cost SharingEnglish • Spanish
Gold (IdealCare Total)
Standard Off ExchangeEnglish • Spanish
Standard On ExchangeEnglish • Spanish
Zero Cost SharingEnglish • Spanish
Limited Cost SharingEnglish • Spanish
Platinum (IdealCare Premier)
Standard Off ExchangeEnglish • Spanish

PLANSDOCUMENTS
Bronze, Silver and Gold (IdealCare Essential, Complete and Total)English
Platinum (IdealCare Premier)English

PLANSDOCUMENTS
Bronze (IdealCare Essential)
SOC Medical Surgical & Behavior Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
Silver (IdealCare Complete)
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
Gold (IdealCare Total)
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish
Platinum (IdealCare Premier)
SOC Medical Surgical & Behavioral Health ServicesEnglish
SOC Pharmacy BenefitsEnglish

Member HandbookEnglish • Spanish
Quick Reference GuideEnglish • Spanish

Sendero offers access to Seton, St David’s, ARC and many more local physicians to make sure you get the care you need. Additionally, we are happy to announce free telemedicine for all Marketplace members!

IdealCare is here to provide coverage for the most important person . . . you!

We offer lower costs and increased coverage to keep you healthy with insurance coverage that fits your needs. You may qualify for tax credits to lower your premium or cost-sharing reductions to decrease your out-of-pocket cost for IdealCare.

Coverage includes doctor visits, hospitalization, maternity care, emergency room care, and prescriptions.

You qualify for IdealCare if you have no health insurance and are between the ages of 18-64 years old. You also must be a U.S. citizen or resident and live in Travis, Hays, Bastrop, Burnet, Lee, Caldwell, Fayette or Williamson counties.

Sendero Health Plans is offering IdealCare through the Health Insurance Marketplace. The marketplace promises fair treatment for patients.

Sendero Health Plans can help you complete the IdealCare application. We will tell you the cost and explain the coverage for the plan you choose in easy-to-understand language. There are no hidden fees and no fine print.

Simple. Local. IdealCare.

The Sendero Health Plans Quality Improvement Program is committed to continuously improving the quality of care and service for Sendero’s members and practitioners. Sendero is accredited by the National Committee of Quality Assurance (NCQA).

Sendero’s Quality Improvement Committee (QIC) reports to the Sendero Board of Directors and is responsible for implementation of the Quality Improvement Program. The QIC, in conjunction with four subcommittees (Provider Advisory, Compliance, Member Advisory, and Delegation Oversight), addresses all aspects of member, practitioner, and organizational quality.

This includes:

Implementation of programs that improve member health.
Implementation of clinical practice guidelines, preventive health guidelines, medical necessity criteria, and medical, pharmaceutical and behavioral health policies.
Evaluation of outsourced and delegated services – claims, vision, pharmacy, behavioral health services, customer service.
Evaluation of the effectiveness of quality improvement interventions.
Evaluating member and practitioner satisfaction.
Maintaining an adequate practitioner and facility network.
Monitoring internal and external audits and investigations for the purpose of identifying troublesome issues and deficient areas experienced by the company and implementing corrective and preventive action.
Determining the appropriate strategy/approach to promote compliance with the program and detection of any potential violations, such as through hotlines and other fraud reporting mechanisms.

Welcome to the Sendero Health Plan wellness page. We strive to provide value added services and programs to support the health of our members and our community. This page will serve as a resource for members to use various services, programs and tools to better manage member health and health information. Sendero endorses and recommends referring IdealCare members to the following resources: 

An online personal health record helps you to keep track of your health data through a FREE PHR from WebMD, one of American’s most trusted sites for health care content. You can keep track of immunizations, lab results, food intake and much more. Click Here to create your personal health record.

WebMD provides valuable health information, tools for managing your health, and support to those who seek information. You can trust that content is timely and credible. Click Here to read more about WebMD.

The following tool will help you assess your current health status and risk factors that affect your health. The tool also has questions on healthy behaviors (e.g. smoking, alcohol use, diet and exercise, etc.). This is an important tool for you to complete because it helps you understand your health better. The tool can take between 20 – 30 minutes to complete. At the end of the assessment, the tool will provide you with a summary of your responses and some tips on how you can stay or become more healthy. You will also be able to download this information. Click Here for survey.

The following tool will help you assess your use of alcohol. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you with a score regarding your drinking habits and what this means for you. You will also be able to download information on alcohol use and its impact on your health. Click Here for survey.

The following tool will help you assess your Body Mass Index. The BMI is a measure of body fat. You only need to enter your height and weight. At the end of the assessment, the tool will provide you with your body mass index and what your index means. You will also be able to download information on how to maintain or improve your health. Click Here for survey.

The following tool will help you determine if you have any depressive symptoms. This tool has 22 questions and will take approximately 3 – 5 minutes to finish. These questions are related to your mood and lifestyle (for example, eating, sleeping, social engagement, etc.). At the end of the assessment, the tool will provide you with a score regarding your depressive symptoms and what this means for you. You will also be able to download information on depression and its impact on your health. Click Here for survey.

The following tool will help you assess your knowledge of how many calories there are in the different types of food items we eat on a daily basis. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you more information on the number of calories present in the different foods you eat. You will also be able to download information how to improve your eating habits at the end of the assessment. Click Here for survey.

The following tool will help you assess the level of stress in your life in the last 1 month. This tool has 10 questions and will take approximately 3 minutes to finish. At the end of the assessment, the tool will provide you with a score related to your stress level and what this means for you. You will also be able to download information how to better deal with stress and improve your health. Click Here for survey.

Nicotine is the chemical in cigarettes that makes you want to keep smoking. Finding out how much you depend on nicotine will help you as you choose quit smoking strategies for your quit plan. Remember—no matter what your score, you’ll have to work hard to quit for good. Answer the following questions. The results will explain how much you depend on nicotine and provide ideas on how to reduce your cravings. Click Here for survey.

The following tool asks you questions about your physical activity. The questions also focus on possible barriers that prevent you from exercising. This tool has 21 questions and will take approximately 3-5 minutes to finish. At the end of the assessment, the tool will provide a score related to your physical activity and the barriers that affect your likelihood of exercising. You will also be able to download information on how to increase the amount of exercise you get and how this can improve your health. Click Here for survey.

Smoking Cessation – http://smokefree.gov/
This web site provides information and tools to help people of all ages quit smoking, manage withdrawal, eat healthier, and manage your mood. In English and Spanish.

Stop Smoking – http://www.lung.org/stop-smoking/
This web site provides information about smoking and how to quit.

Stay away from Tobacco – http://www.cancer.org/healthy/stayawayfromtobacco/quit-for-life
This web site has a smoking quiz, guide to stop smoking, guide to stop using smokeless tobacco, help with cravings, secondhand smoke information, and tobacco and cancer fact sheets.

Click Here for additional information on Sendero’s Smoking Cessation Program “Up In Smoke”.

DATENOTICEDOCUMENTS
11/16/2022Q4 NewsletterEnglish • Spanish
07/19/2022Q3 NewsletterEnglish • Spanish
04/22/2022Q2 NewsletterEnglish • Spanish
01/31/2022Q1 NewsletterEnglish • Spanish
01/30/2022How to make the most out of your coverageEnglish

DATENOTICEDOCUMENTS
11/2021COVID-19 BoostersEnglish & Spanish
11/2021COVID-19 Vaccine FactsEnglish & Spanish
11/2021Q4 Member NewsletterEnglish • Spanish
07/2021Q3 Member NewsletterEnglish • Spanish
04/2021Q2 Member NewsletterEnglish • Spanish
01/2021Q1 Member NewsletterEnglish • Spanish

DATENOTICEDOCUMENTS
12/2020Q4 Member NewsletterEnglish • Spanish
12/2020COVID-19 VaccineEnglish
12/2020eMD AccessEnglish • Spanish
10/2020Boo the Flu 2020English • Spanish
10/2020Q3 Member NewsletterEnglish • Spanish
07/2020Q2 Member NewsletterEnglish & Spanish
04/17/2020Member Survey NotificationEnglish & Spanish
04/10/2020COVID-19 Testing and Treatment * UpdateEnglish • Spanish
03/11/2020COVID-19 Testing and TreatmentEnglish • Spanish
03/2020Q1 Member NewsletterEnglish & Spanish

NOTICEDOCUMENTS
Fall Movie NightsEnglish • Spanish
Q4 Member NewsletterEnglish • Spanish
Back to School Event 2019English • Spanish
Explanations of Benefits (EOB) UpdateEnglish • Spanish
Q3 Member NewsletterEnglish • Spanish
Community Event: 06/15/2019 – 06/16/2019 Univision CopaEnglish • Spanish
Q2 Member NewsletterEnglish • Spanish
Q1 Member NewsletterEnglish • Spanish
Beacon Health Options Termination Notice (01/08/19)English • Spanish

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*This amount was announced in June 2022.