Medicare Advantage 2023 additional benefits

Five seniors take a selfie while sitting in a car.

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

See 2022 additional benefits

Dental

We partnered with Delta Dental to provide you dental benefits with no waiting periods or deductibles. 

Benefits include:

  • Preventive and diagnostic services: $0 copay
  • Comprehensive services: 50% coinsurance
  • $1,000 of dental services per year
  • We cover in-network and out-of-network dentists
    • Members receive preferred pricing at in-network dentists
    • Members are balanced-billed if they use an out-of-network provider  


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 120 hours per year 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 products
  • Vitamins & minerals
  • Oral care products


You can shop:

 

After you receive your OTC card in the mail, visit Medline 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. If you'd like a ride to an upcoming appointment, call the Customer Care Center and see our Lyft instructions to set up service.

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 One Pass fitness benefit includes:

  • Fitness center membership: Choose from a large nationwide network of gyms and fitness locations from leading national brands to boutique studios. Get started by going to One Pass fitness. 
  • Home fitness kit: You can select one home fitness kit per year 
  • Members get online access to BrainHQ. We provide brain training to help think faster, focus better and remember more.

Vision

We cover one $0 routine vision exam.

On SSM FlexSpend and SSM Harmony plans, you can use your $500 FlexSpend benefit on eyewear at in-network or freestanding vision providers.

Hearing

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

On SSM FlexSpend and SSM Harmony plans, you can use your $500 FlexSpend benefit on hearing aids at in-network or freestanding hearing aid providers. 

Living Healthy Rewards

You can earn up to $150 rewards 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).
  • You must enter 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 12 routine chiropractic visits every calendar year.

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. 

View our Medicare disclaimer.
H8019_wellfirsthealth.com
Updated: 10/1/22