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What is the Medicare Plan?

The Medicare plan offers quality health insurance to working adults with lower incomes who do not qualify for Medicaid

Medicare Plan Benefit Highlights

Clinic and Office Visits

Services covered:

  • Clinic, doctor office visits, therapy visits
  • Physical therapy
  • Urgent care, telehealth, doctor or therapist calls
  • Foot care (8 podiatry visits/year)*

Hospitalization and Support Services

Low cost for the first 60 days

Low cost for 100 nursing home days

20 meals*

Lab and Radiology

Lab tests, radiology**
(e.g. Ultrasound, X-ray, CT, MRI)

Health Care Rides*

48 no-cost one-way rides to your clinic or doctor’s office. No prior approval is needed.

Contact Customer Service two days before your trip to arrange transportation.

Flexible Spending**

Did you know you get a Flexible Spending Allowance of $155/month to be used for:

  • Internet, phone, and cable service
  • Utilities: electric and gas
  • Over-the-counter medicines, groceries, PERS, and bathroom safety devices

Get your card by calling the Customer Service Team. Unused balance does not roll over to the next month.

 

*Only for MetroPlus Advantage Plan (HMO D-SNP) and MetroPlus UltraCare (HMO D-SNP) plans

**Individual benefits may vary

†Only for MetroPlus Advantage Plan (HMO D-SNP)

Pharmacy†

$0 copa on generic pharmacy drugs

Vision Care*

Services covered at no cost (limited to $450/year):

  • Eye Exams
  • Lenses and Frames
  • Contact Lenses
  • 1 Exam per Plan Year
  • 1 Prescribed lenses and frames per Plan Year

Comprehensive and Preventive Dental*

GREAT NEWS!! Your dental provider is DentaQuest. Enjoy a large network which means more dentists near you! Members are eligible for 1 visit every 6 months for each of the following services:

  • Oral exam
  • Dental x-rays
  • Cleaning
  • Flouride Treatment
  • Plus more

Diagnostic services and extractions were added to our comprehensive dental services.

Other Bonuses

  • $500 covered for hearing aids every year*
  • $450 covered per year for glasses/contacts*
  • Up to $500 reimbursed gym memberships*
  • Medical equipment, prosthetics, and diabetes supplies

 

last updated: July 19, 2024