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  • Added Benefits

    PHP (HMO SNP) offers additional benefits that Original Medicare doesn’t for no cost. These additional benefits are designed to provide comprehensive health coverage for plan members where Original Medicare doesn’t.

           Benefit

     Original Medicare

    2020 PHP2021 PHP
    AcupunctureNot covered.$0 copay for up to 2 acupuncture visits per month.$0 copay for up to 2 acupuncture visits per month.
    Dental ServicesPreventive dental services (such as cleaning) not covered.

    $0 copay for preventive dental services such as oral exams, cleanings, fluoride treatments and dental x-rays, and other dental services.

    In addition to the preventive services above, plan covers up to $800 a year for comprehensive dental services such as non-routine, diagnostic, and restorative services; endontics, periodontics, and extractions; and prosthodontics, oral and maxillofacial surgery, etc.

    $0 copay for preventive dental services such as oral exams, cleanings, fluoride treatments and dental x-rays, and other dental services.

    In addition to the preventive services above, plan covers up to $700 a year for comprehensive dental services such as non-routine, diagnostic, and restorative services; endontics, periodontics, and extractions; and prosthodontics, oral and maxillofacial surgery, etc.

    Health and WellnessSupplemental health and wellness programs not covered.

    $0 copay for choice of gym membership at 24 Hour Fitness OR up to $200 in over-the-counter pharmacy merchandise, such as vitamins, fiber supplements, first aid supplies, sunscreen, tooth brushes and pastes, cold medication, antacids, etc.

    $0 copay for access to 24 hour nurse hotline.

    $0 copay for choice of gym membership at 24 Hour Fitness OR up to $200 in over-the-counter pharmacy merchandise, such as vitamins, fiber supplements, first aid supplies, sunscreen, tooth brushes and pastes, cold medication, antacids, etc.

    $0 copay for access to 24 hour nurse hotline.

    Hearing ServicesSupplemental routine hearing exams and hearing aids not covered.

    $0 copay for a routine hearing exam every year.

    $0 copay for up to 2 hearing aids every year including a fitting evaluation.

    Plan covers up to $400 a year for hearing aids.

    $0 copay for a routine hearing exam every year.

    $0 copay for up to 2 hearing aids every year including a fitting evaluation.

    Plan covers up to $400 a year for hearing aids.

    In-Home Support Services (IHSS)Not covered.$0 copay for up to 16 hours a week of IHSS for up to 2 weeks. IHSS include personal care and domestic services. IHSS are available to members after discharge from an acute hospital or skilled nursing facility.$0 copay for up to 16 hours a week of IHSS for up to 2 weeks. IHSS include personal care and domestic services. IHSS are available to members after discharge from an acute hospital or skilled nursing facility.
    Meal BenefitNot covered.$0 copay for up to 2 meals per day for up to 28 days. (56 meal limit per year.) Meal benefit is available to members after discharge from an acute hospital or skilled nursing facility.$0 copay for up to 2 meals per day for up to 28 days. (56 meal limit per year.) Meal benefit is available to members after discharge from an acute hospital or skilled nursing facility.
    Non-Emergency TransportationNot covered.$0 copay for up to 12 round trips to plan-approved locations every year.$0 copay for unlimited round trips to plan-approved locations every year.
    Therapeutic MassageNot covered.Therapeutic massage is not covered.$0 copay for up to 2 therapeutic massages per month for members diagnosed with AIDS-related neuropathy.
    Transportation to Cancer Treatment VisitsNot covered.$0 copay for unlimited transportation to cancer treatment visits at plan-approved locations.Not covered. This benefit has been superseded by the non-emergency transportation benefit above.
    Transportation to Dialysis VisitsNot covered.$0 copay for unlimited transportation to dialysis visits at plan-approved locations.Not covered. This benefit has been superseded by the non-emergency transportation benefit above.
    Vision ServicesSupplemental routine eye exams and glasses not covered.

    $0 copay for one routine eye exam every year.

    $0 copay for glasses, lenses or contacts.

    Plan covers up to $100 a year for eye wear.

    $0 copay for one routine eye exam every year.

    $0 copay for glasses, lenses or contacts.

    Plan covers up to $150 a year for eye wear.

    More information about the additional benefits is in the 2020 Summary of Benefits and 2021 Summary of Benefits.

    If all of this looks good to you and you’d like to enroll, we make it easy and convenient.


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