Medicare Advantage 2022 additional benefits

Your Medicare plan includes additional benefits not covered under Original Medicare (Medicare parts A and B)


Dental

We cover both preventive and comprehensive dental benefits through our partner Delta Dental. Our plan has no waiting period, no 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
  • We cover $1,500 in dental services per year


See the Dental Certificate of Coverage for a full list of covered dental procedures.


In-home support 

We partnered with Papa, a company that connects you with screened and trained Papa Pals. Pals provide assistance with organization, light housework, technology and transportation. 

This includes:

  • Household tasks: Pals help around the house with light cleaning, organization, laundry, cooking/meal prep and taking care of pets. 
  • Technology help: Pals teach you how to use a computer, smart phone and tablet. This includes assistance with using social media, accessing a telehealth provider, starting a video chat with loved ones and accessing health plan resources online. 
  • Transportation: Pals assist you with transportation to doctor appointments, grocery/pharmacy shopping and other errands. Pals will pick you up at home, take you to the store/appointment, bring you back home and help you carry bags into the home. 


We cover 10 hours per month of Papa services. Pals can support you either in your home or virtually. You can call Papa to enroll at 888-282-7665.

Over-the-counter 

We cover $60 quarterly to be used towards the purchase of eligible over-the-counter (OTC) health and wellness products. 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 such as:

  • 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 in the mail, visit OTCNetwork.com or download the OTC app to see the list of all participating retailers, a full list of covered items and to check your card balance. 

See the OTC Overview for more details about the program.


Transportation

We partnered with Lyft to cover 24 one-way personal rides each year to medical appointments and to the pharmacy. Contact the Customer Care Center one business day in advance if you would like a ride to an upcoming appointment.


Meals

If you are discharged from the hospital or skilled nursing facility, you are eligible to receive 14 meals delivered to your door. 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.


Fitness

The Silver&Fit program includes:

  • Fitness center membership: You can visit participating fitness centers near you that take part in the program.
  • Home fitness kit: You can select one home fitness kit with Fitbit, Garmin or other exercise equipment per year 
  • Get started program: By answering a few online questions about your areas of interest, you will receive a customized program for your exercise of choice, including instructions on how to get started and suggested online workout videos.
  • 8,000+ on-demand videos through the website and mobile app digital library, including the Silver&Fit Signature Series Classes®.
  • The Silver&Fit Connected™ tool for tracking your activity.
  • Online Healthy Aging classes.
  • Online quarterly newsletter.


Go to SilverandFit.com to register for the program. 

*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

We cover one $0 routine vision exam and a $200 eyewear allowance per year at our in-network eyeglass providers.


Hearing

We cover one $0 routine hearing exam and a $750 hearing aid allowance per year at in-network hearing aid providers. 


Living Healthy Rewards

You can earn up to $150 in gift cards as a reward for completing healthy activities. 

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 of the plan year).
  • Rewards come in the form of gift card(s) of your choice to many national retailers, restaurants and other popular merchants.
  • You must enter and redeem all points by Dec. 31 of the plan year to be eligible for rewards. 


See Living Healthy Overview for more information about the program and how to log into Living Healthy.

Log into the Member Portal to access Living Healthy Rewards.


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. You pay your plan’s specialist copay for routine footcare services.


Routine chiropractic

We cover 24 routine chiropractic visits every calendar year. Integrity members pay $15 per visit for routine chiropractic services. Harmony members pay $10 per visit for routine chiropractic services.


Worldwide emergency

We provide coverage for emergency and urgently needed services outside of the United States. Members must pay out-of-pocket for worldwide urgent and emergency care services and then request reimbursement by submitting a member paid claim form. Your pay your plan’s emergency copay for emergency and urgently needed services outside of the United States.


24-hour nurse line

Experienced registered nurses are always available to answer your questions and concerns. Nurses are available 24 hours a day, 365 days a year. Call if you're unsure if you need to see a doctor, or if you have other health related questions.


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 or Missouri 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 aged 81 and above should be seen at a clinic or doctor's office. 

View our Medicare disclaimers

H8019_wellfirsthealth.com
Updated 10/16/21