By focusing on preventive care and wellness, we can work together to help you avoid illness and stay well. Our members receive preventive screenings and other valuable services, at no additional cost when using an in-network provider*. Review your summary of benefits and coverage for network provider details.
As soon as you enroll in Medicare Part B, you can schedule your welcome to Medicare visit. This visit is covered at no cost to you by Medicare.
During this visit, your primary care physician (PCP) will record your medical history and check your vision, blood pressure, and weight and height to measure your body mass index. It's a great way to get up-to-date on important screenings and shots and to talk with your doctor about your family’s medical history and ways to manage your health.
At this visit, preventive services and more are covered at no ($0) out-of-pocket costs to you when received by an in-network provider. Review your summary of benefits and coverage for network provider details.
During this visit, your PCP will take a medical/family history and perform a head-to-toe general health assessment with hands-on examination of all the body systems.
We cover 24 one-way rides each year to medical appointments or to the local pharmacy to help keep you well. If you would like a ride to an upcoming appointment, call the Customer Care Center at 877-301-3326 (TTY:711) or visit our extra benefits page to set up this service at no additional cost to you.
Telehealth can be used to assess your risk for certain health conditions. It may also be used for your annual preventive visit or for other appointments if you do not need lab work or vaccines. Telehealth annual preventive visits should be done using audio and visual technology (a smart phone or computer). Talk with your PCP and ask if a telehealth appointment is right for you.
All preventive services are listed in your Evidence of Coverage. See the Medical Benefits chart in Chapter 4, Section 2.1. You will see an apple listed next to the preventive services in the benefits chart.
Non-preventive care is care given to manage chronic or acute (sudden) illness. If you receive non-preventive care at your PCP's office, you'll have a $0 copay. Many other non-preventive services will have out-of-pocket costs (copays). Examples include, but are not limited to:
Many don’t even realize they are caregiving. Over 50 million of us are a caregiver during a given year, according to the AARP. Whether you work in a field where you are paid to be a caregiver or you have a loved one in need, caregiving and burnout go hand-in-hand. When your needs are put on hold for others, it can be detrimental to:
Take care of yourself. Give yourself a break! Use the following strategies a few hours a week to reduce the effects of compassion fatigue.
If you are feeling overburdened by caregiving, consider joining a support group such as the Family Caregiver Alliance.
Papa connects you with screened and trained Papa Pals who provide 120 hours per year of in-home or virtual assistance each month with light housework, organization, technology and transportation. Call 1-888-840-1609 (TTY: 711), or visit our extra benefits page to enroll.
Medicare Advantage (MA) health plans, also called Part C plans, combine Original Medicare (Parts A and B) and often Part D into one plan with a network of providers. In addition to services covered by Original Medicare (Parts A and B), your MA plan may provide many other health care services at no additional cost to you. Visit our extra benefits page to see the added services we provide you at no additional cost.
Medicare Part A covers care at hospitals and other facilities. You typically pay a deductible and coinsurance and/or copayments.
Part A insurance covers things like:
In general, Medicare Part B covers your outpatient (office-based) medical care.
Part B insurance covers things like:
Medicare Part D covers most of your medications and some vaccinations. There are times when you will need to use your Part B coverage for prescriptions, vaccinations and other items at the pharmacy.
Part D insurance covers things like: