Medicare Advantage additional benefits — 2021

Your WellFirst Health — Provided by SSM Health Plan — Medicare plan includes additional benefits not covered under Original Medicare (Medicare Parts A and B)

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Dental

We have joined with Delta Dental to provide you dental benefits with no waiting periods, deductibles or coinsurance. 

Benefits include: 

  • Preventive and diagnostic services: $0 copay 
  • Gum disease maintenance and bridge/implants/dentures repairs: $45 copay. 
  • Fillings, gum disease treatment and extractions: $95 copay. 
  • Root canals, bridges, implants, dentures and crowns: $595 copay. 


Our plan will cover $1,500 of dental services per year.  See the Dental Certificate of Coverage for a full list of covered dental procedures. 


In-home/virtual support & companionship

SSM Health Plan Companion and SSM Health Plan Harmony plans only 

We have partnered with Papa, a company that connects screened and trained Papa Pals with our members. Papa Pals help members who seek companionship, house help, technology help and transportation. This includes: 

  • Companionship: Papa Pals can socialize, watch a movie, and play games in the member’s home, in a public space, over the phone, or by video chat. 
  • House help: Papa Pals help around the house with light cleaning, laundry, cooking/meal prep, and taking care of pets. 
  • Technology help: Papa Pals teach members how to use a computer, smart phone and tablet. Papa Pals can also assist with how to use social media, accessing a telehealth provider and starting a video chat with loved ones. 
  • Transportation: Papa Pals assist members with transportation to doctor appointments, grocery/pharmacy shopping and other errands. Pals will pick members up at their homes, take members to the store or appointment, carry shopping bags, take members back home and help carry your bags into the home. 


Papa Pals can support members either in their homes or virtually. Members are eligible for 10 hours per month of Papa services. Members can call Papa to enroll at 888-282-7665.

Over-the-counter allowance 

Members are eligible for a $60 quarterly benefit to be used towards the purchase of select over-the-counter (OTC) health and wellness products available through our catalog via select retailers. This benefit is available at the beginning of each quarter (January, April, July, October). Unused dollars will not carry forward to the next quarter. 

Your OTC card can be used to purchase items in the following categories: 

  • Acid controller liquids/tablets 
  • Adult aspirin & pain relief 
  • Allergy, sinus & combo liquids & tablets 
  • Cough, cold & flu liquids or tablets 
  • Digestive aids (probiotics & prebiotics) 
  • Heart health & essential fatty acids (fish oil, flax, GLA, etc.) 
  • Laxatives (stool softeners & fiber acid) 
  • Ear drops & eye wash 
  • Incontinence 
  • Vitamins & minerals 
  • Oral care


You can shop:


After you receive your OTC card, visit OTCNetwork.com to see the list of all participating retailers, a full list of covered items and to check your card balance. See the flyer for more details.

Fitness

Our members have access to the following at no-cost:

  • Fitness center membership: You can go to any Silver&Fit fitness club or exercise center* that takes part in the program
  • Home fitness kits: Pick up to two kits per benefit year from our 34 unique options, including Aqua, Tai Chi, Chair-Based Exercise, and more.
  • Stay fit kits: Pick one of the following per benefit year: Garmin or Fitbit Wearable Fitness Tracker Kit; Yoga Kit with a mat and hand towel; Beginner, Intermediate, or Advanced Strength Kit with exercise bands and dumbbells
  • Digital workout videos: Go to www.SilverandFit.com or download the Silver&Fit ASHConnect™
  • mobile app to view yoga, strength, Pilates, walking, cardio, and many other workout videos, perfect for all fitness levels.
  • Daily workout videos: Join daily workout classes on Facebook Live and the Silver&Fit YouTube channel.


Go to SilverandFit.com to get started today!

*Non-standard services that call for an added fee are not part of the Silver&Fit program and will not be reimbursed. The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a federally registered trademark of ASH.

Vision

All of our plans include a $0 routine vision exam and a $200 eyewear allowance every year at our in-network eyewear providers.  

Where can I buy eyeglasses?

Find a location.

Hearing

All of our plans include a $0 hearing exam and a $750 hearing aid allowance every year at in-network hearing aid providers. 

Where can I buy hearing aids? 

Find a location.

Living Healthy rewards

We will reward members up to $150 for your healthy lifestyle. Here's how it works:

  • Choose the healthy activities you want to complete.
  • Each completed activity is worth reward points (example: 500 points = $50)
  • Earn up to 1,500 points for a maximum of $150 per calendar year (before Dec. 31, 2021)
  • Rewards come in the form of gift card(s) of your choice to many national retailers, restaurants and other popular merchants.


Members must enter and redeem all points by Dec. 31, 2021 to be eligible for rewards. For complete details and to redeem reward points, log in to the Living Healthy Portal. See flyer for more information about the program and how to log into Living Healthy.

Meals post-discharge

If you are discharged from the hospital or skilled nursing facility, all of our plans cover 14 meals delivered to your door. Someone from our care management team will reach out to members upon notification of the discharge. If meals are not coordinated through your care manager as part of discharge planning, reach out to the Customer Care Center to access the Moms Meals benefit.

Transportation

We cover 24 one-way Lyft rides each year to medical appointments or to the local pharmacy to help keep you well. If you would like a Lyft ride to an upcoming appointment, call the Customer Care Center at 877-301-3326. We can schedule a Lyft driver to pick you up at no cost to you.

Learn about Lyft rides

Routine footcare

We cover 10 routine footcare visits every calendar year. This includes treatment of the foot which is generally considered preventive, i.e., cutting or removal of corns, warts, calluses or nails.

24-Hour Nurse Advice Line 

Experienced registered nurses are always available to answer your questions and concerns. Nurses are available 24 hours a day, 365 days a year. If you're not sure you need to see a doctor—or you're wondering if you have a problem—give us a call 833-925-0398 

e-visits

With an SSM Health e-visit, you can get a diagnosis, a treatment plan and a prescription if needed for common conditions like upper respiratory infection or allergies, urinary tract infections, tick bites and skin problems from anywhere in Illinois at any time. See conditions treated and complete an online health interview. An SSM Health provider will respond within one hour during office hours, or first thing the next morning if after hours. E-visits are available to members through age 80. To ensure members receive the highest quality of care, those age 81 and above should be seen at a clinic or doctor’s office. 

Start an e-visit

View our Medicare disclaimers

H8019_wellfirsthealth.com
Updated 10/1/21