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Experience Health

Plan benefits

With Experience Health, you can count on great coverage and benefits.

Benefits that cover you from head to toe

The Experience Health Medicare Advantage℠ (HMO) plan includes valuable extras:

$2,000 flexible dental benefits

With no dental network – see any dentist you prefer! $500 preventive dental care reimbursement allowance each year – use as you see fit toward:

  • Oral exam and cleanings
  • Dental x-ray(s), fluoride treatments and more
  • $1,500 comprehensive dental care reimbursement allowance each year – use for fillings, restorations, crowns, root canals or other care 

Up to $600 over-the-counter benefit

Up to $150 / quarter to help you with over-the-counter medications, health, and wellness products and first aid supplies. Choose from hundreds of quality products, including:

  • First aid supplies
  • Cold and flu remedies
  • Pain relievers and vitamins
  • And more

Order online, by phone, or mail. Shipping is FREE!

To request a catalog be mailed to you, please call 866-311-3607 (TTY: 711)

SilverSneakers fitness membership

Enjoy fitness and lifestyle benefits – included at NO cost to you:

  • Membership to thousands of fitness locations: over 190 in the Triangle
  • Group exercise classes for all abilities
  • Fun activities outside the gym
  • SilverSneakers® On-Demand online workout videos
  • SilverSneakers GO™ mobile app

Meals-at-Home program ($0 copay)

Up to 20 home-delivered meals at no charge to you after an inpatient stay in either a hospital or skilled nursing facility.

  • ‌Your choice from a menu of meals
  • ‌Includes heart-healthy and carb-conscious selections and other all-American favorites
  • ‌Order when you wish: up to 7 days before or 30 days after discharge

For more information, contact Care Support at 919-660-3426, 8 AM to 5 PM, Monday – Friday.

Transportation assistance ($0 copay)

Knowing you can get to your doctor matters, for your health and peace of mind.

  • Get up to 12 one-way rides, to and / or from approved locations such as your doctor of pharmacy
  • Make your appointments worry-free
  • For non-emergency trips only

Call NationsBenefits to get started: 866-311-3607 (TTY: 711), 24/7

In-home assistance ($0 copay)

This benefit includes up to 6 hours per month of in-home assistance, helping you with things such as:

  • Meal preparation
  • Bathing and grooming
  • Medication reminders
  • Light housekeeping
  • Instrumental Activities of Daily Living (IADLs)

Call CareLinx to get started: 866-241-7930. Monday – Friday 9 AM to 8 PM EST and Saturday and Sunday 11 AM to 7 PM EST

Personal emergency response and home safety devices ($0 copay)

Personal emergency response devices let you call for help at the push of a button, and home safety products can give you peace of mind when you're home by yourself.

  • Home safety devices, such as safety rails, can help prevent an accident at home
  • In the event of an accident, emergency response devices can alert first responders and family members

To request a home safety device catalog be mailed to you, please call 866-311-3607 (TTY: 711).

Acupuncture

A benefit that’s becoming more and more popular.

  • $50 reimbursement allowance per visit for up to 20 visits per year. 
  • $20 visits for chronic lower back pain
  • Your choice of any NC-licensed acupuncturist

Mental health

Great mental health is important to great physical health, and with this benefit, you get:

  • $0 copays for outpatient individual or group visits and group therapy sessions with a mental health provider through our provider network
  • Experience Health’s Care Support Team to help find a provider based on your needs, preference, and coverage

Flexible vision benefits

Your eyes are important, and this benefit includes:

  • Routine eye exams – $0 copay
  • Eyewear – $300 annual allowance, use as you wish for:
    • Contact lenses
    • Eyeglass frames
    • Eyeglass lenses

Hearing benefits

Keep your hearing in top shape with1:

  • Routine hearing exams – $0 copay
  • Hearing aids – Members enjoy deep discounts that can save you hundreds of dollars.
    • $599 low member copay: Advanced 32-channel models
    • $899 low member copay: Premium 48-channel models
    • Multiple models to choose from, including rechargeable ($50 for rechargeable option)
    • All with smartphone connectivity and 3-yr. warranty

To schedule an appointment with a local audiologist for your hearing evaluation, contact TruHearing™ at 866-201-9212 (TTY: 711).

Worldwide travel coverage

You’re covered for urgent and emergency care across the US and across the world:

  • $60 copay for urgent care
  • $120 for emergency room
  • $295 copay for ambulance

Contact our Worldwide Care experts for assistance in coordinating further care.

Members can get help locating providers and obtain information regarding submitting a claim for out-of-country emergency services by calling 800-810-2583 or by calling collect at 804-673-1177.

Find care that's right for you

Find in-network doctors and pharmacies, search for prescription medications, and more.

Contact us

Available 8 AM to 8 PM, 7 days a week

Not yet a member?

833-905-1311 (TTY: 711)

Disclosures:

© 2024 Experience Health, Inc. All rights reserved.

For accommodation of persons with special needs at sales meetings, call 833-905-1311 (TTY: 711), 8 AM through 8 PM, 7 days a week.

Experience Health is an HMO plan with a Medicare contract. Enrollment in Experience Health Medicare Advantage (HMO) depends on contract renewal.

The federal government requires all Medicare Advantage members to continue paying their Part B premium each month.

To join Experience Health Medicare Advantage (HMO), you must have Medicare Part A and Part B, and live in the service area (Durham, Franklin, Granville, Lee, Orange, Person, Vance or Wake counties, North Carolina). Please contact the plan for more information. Medicare beneficiaries may also enroll in Experience Health Medicare Advantage (HMO) through the CMS Medicare Online Enrollment Center located at www.medicare.gov.

This information is not a complete description of benefits. Call 833-905-1311 (TTY: 711) for more information. Other providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat Experience Health Medicare Advantage (HMO) members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

ATTENTION: If you speak a non-English language, call 833-905-1311 (TTY: 711) and you will be connected to an interpreter who will assist you at no cost.

SilverSneakers® is a registered trademark of Tivity Health. © 2023 Tivity Health, Inc. All rights reserved. Tivity Health is an independent company providing fitness services on behalf of Experience Health.

Blue Cross NC contracts with independent companies to provide supplemental benefits. Those companies are responsible for the services they provide. They do not provide Blue Cross or Blue Shield products or services. Marks and trade names are property of their respective owners.

®, ℠ Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Experience Health is an independent licensee of the Blue Cross and Blue Shield Association, serving North Carolina.

This page was last updated 2024-03-01

H3777_EX5028_M_2024 CMS Accepted 02282024

  1. Coverage provided by TruHearing.

    Hearing aid purchase includes: first year of follow-up provider visits, 60-day trial period, 3-year extended warranty and 80 batteries per aid for non-rechargeable models.