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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 exams 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 $400 over-the-counter benefit
Buy your health and wellness items from the over-the-counter (OTC) catalog or use your Blue FlexCard in-store at in-network retailers, including Harris Teeter, Walmart, and more.1 Order online, by phone, or mail.
Fitness
FitOn Health2 is a fitness and health platform that gives you access to 13,000+ gyms and studios, including popular gyms like O2, Life Time, YMCAs and more.3 With $112 per month to spend, we’re giving you the flexibility to choose the best fitness options for you. Use the funds on:
- The gym(s) of your choice (even if it’s not in the FitOn network)
- In-person classes
- Premium FitOn equipment like yoga mats, dumbbells and more
Plus, enjoy unlimited use of the digital platform with live and on-demand classes from expert instructors, activity tracking, nutrition programs and more.
Meals-at-Home program ($0 copay)
Two home-delivered meals per day for 14 days, at no charge to you, after an inpatient stay in either a hospital or nursing care facility.
Once you are discharged to home a member of our case management team will reach out to you to determine if you want to access the benefit. The case manager will then send a referral to the meals vendor. The meals vendor will call you to set up delivery.
There is no coinsurance, copayment, or deductible for the meals benefit.
Transportation assistance ($0 copay)
Many of our Medicare Advantage plans make it easy to get to and from doctor appointments.4 With the non-emergency medical transportation benefit, you'll get:
- Up to 12 one-way rides, to and / or from approved locations such as your doctor of pharmacy
- Flexible options to book a ride in advance or on demand
- Wheelchair-accessible vans and non-emergency ambulances as needed
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
- Instrumental Activities of Daily Living (IADLs)
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.
Flexible vision benefits
Your eyes are important, and this benefit includes:
- Routine eye exams – $0 copay
- Vision allowance – $300 annual allowance to spend on eyewear, contacts and vision cost shares
Hearing benefits
Keep your hearing in top shape with5:
- Routine hearing exams – $0 copay
- Hearing aids – Members enjoy deep discounts that can save 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-year warranty
To schedule an appointment with a local audiologist for your hearing evaluation, contact TruHearing™ at 866-201-9212 (TTY: 711).
Personal emergency response system
Get help with the push of a button. Your plan includes a wearable device that will connect you with a call center that will get you the emergency services you need. Most devices also include fall detection, GPS tracking and an app to alert family or caregivers.
To request a personal emergency response device catalog be mailed to you, please call 877-909-4179 (TTY: 711).
Home safety devices ($0 copay)
Each year, you can receive two home safety devices at no cost to you. Home safety devices include night lights, grab bars, anti-slip mats, and more. Order your two devices from our Home Safety Device catalog online, by phone or mail order. Devices must be ordered from the approved list using the designated provider.
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
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
Disclosures:
Blue Cross and Blue Shield of North Carolina is an HMO plan with a Medicare contract. Enrollment in Experience Health Medicare Advantage (HMO) depends on contract renewal.
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.
The federal government requires all Medicare Advantage members to continue paying their Part B premium each month.
Blue Cross and Blue Shield of North Carolina does not discriminate based on race, ethnicity, national origin, religion, gender, age, mental or physical disability, health status, claims experience, medical history, genetic information, evidence of insurability, sexual orientation or source of payment. All Blue Cross and Blue Shield of North Carolina items and services are available to all eligible beneficiaries in the service area.
Links marked with an external site icon indicate that you're leaving BlueCrossNC.com and Blue Cross and Blue Shield of North Carolina's plan information. The site you're going to is either a third-party vendor contracted with Blue Cross NC to provide services or an external website independent of Blue Cross NC.
To view PDF documents, you need to download and install Adobe Acrobat Reader on your computer.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers several decision-support tools to aid you in making decisions around your health care experience. These tools are offered for your convenience and should be used only as reference tools. You should consult your own legal counsel, tax advisor or personal physician as applicable throughout your health care experience.
Out-of-network / non-contracted providers are under no obligation to treat Plan 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.
The Blue FlexCard is issued by Stride Bank, N.A., Member FDIC, pursuant to license by Mastercard International. Stride Bank is an independent company offering debit card services and is solely responsible for its products.
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.
Change Healthcare is an independent company providing revenue and payment cycle management on behalf of Blue Cross and Blue Shield of North Carolina.
FitOn Health is an independent company providing health and fitness services on behalf of Blue Cross and Blue Shield of North Carolina.
CareLinx is an independent company providing in-home care solutions on behalf of Blue Cross and Blue Shield of North Carolina.
TruHearing is an independent company providing hearing health and hearing aids on behalf of Blue Cross and Blue Shield of North Carolina.
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In-network stores are subject to change.
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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.
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In-network gyms are subject to change.
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Available on select plans.
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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.
Current as of 09/25/2024 | Y0079_12996_M CMS Accepted 09252024
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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