2022 Benefits That Cover you head to toe.

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

INCREASED $400 Over-the-Counter (OTC) Benefit

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!
  • View the OTC Catalog

SilverSneakers® Fitness Membership

  • 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 for up to 20 home-delivered meals for each inpatient stay in either a Hospital or Skilled Nursing Facility
  • Your choice from a menu of meals
  • Includes heart-healthy and carb-conscious selections, as well as pizza and other all-American favorites!
  • Order when you wish: up to 30 days after discharge

NEW Transportation Services

  • Knowing you can get to your doctor matters, for your health and peace of mind
  • With Transportation Services, you get up to 12 one-way rides, to and/or from approved locations
  • Make your appointments worry-free
  • For non-emergency trips

NEW IN-HOME SUPPORT SERVICES

  • $0 copay to receive up to 6 hours of companion care each month assisting with:
    • Setting up technology
    • Shopping for groceries
    • Light housework or chores
    • Accompaniment to appointments
    • Picking up health care supplies or medications
    • Meal preparation
    • Other errands
  • Enhanced peace of mind

NEW PERSONAL EMERGENCY SUPPORT SERVICES (PERS)

  • $0 copay for a medical alert system (wristband and pendant options) through NationsResponse®, powered by ADT®
  • Lets you call for help at the push of a button
  • Alerts emergency responders and updates family
  • You don’t have to fear those times when you’re by yourself
  • Maintain your lifestyle and peace of mind

IMPROVED Mental Health BENEFITS

Experience Health is working with Quartet to make it easy for members to get the mental health care they need.

  • Members are matched with options based on their needs, preference and coverage
  • Large network that includes in-person and virtual therapy options
  • $0 copay for outpatient office visits

Acupuncture

A benefit that’s becoming more and more popular.

  • $50 reimbursement allowance per visit for up to 20 visits per year (in addition to Medicare coverage for chronic lower back pain)
  • Your choice of any NC licensed acupuncturist

Part D Senior Savings Model (PDSS)

Huge savings for anyone with an insulin prescription.

  • $35 copay for on-formulary insulins
  • $87.50 copay for 90-day supply of on-formulary insulins through our mail order pharmacies
  • More choices with our expanded formulary in 2022!
  • $35 copay applies through the Part D initial coverage and coverage gap phases
  • PDSS is not available to members who receive Extra Help

INCREASED $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 as you see fit toward:

  • Fillings, Restorations
  • Crowns, Root Canals or other care
** Confirm your dentist has not opted out of Medicare.

ENHANCED VISION BENEFITS

Routine Eye Exams — $0 copay
Eyewear — $250 annual allowance, use as you wish for:

  • Contact Lenses
  • Eyeglass Frames
  • Eyeglass Lenses

ENHANCED HEARING BENEFITS

Routine hearing Exams — $0 copay
Hearing Aids — Members enjoy deep discounts, compared to the avg. cost of $2,700 per aid §

  • $599 low member copay: advanced 32-channel models
  • $899 low member copay: premium 48-channel models
  • Multiple models to choose from
  • All with smartphone connectivity and 3-yr. warranty

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.

§ Based on a 2018 third-party survey of nationwide provider and manufacturer retail pricing

Worldwide Travel Coverage

Health care coverage when you travel, includes:

  • $50 copay for Urgent Care
  • $90 copay for Emergency Room
  • $375 copay for Ambulance
  • Note: Travel anywhere in the United States or Canada covered for Emergency coverage

Already a member?

You can find plan benefit information, download reimbursement forms and more at our Member portal.