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Summary of Benefits

You have options for your Medicare Advantage coverage. Think about your needs and what type of benefits will help you most. AmeriHealth Caritas VIP Care (HMO-SNP) offers all the benefits of regular Medicare, plus more.

AmeriHealth Caritas VIP Care provides:

  • $0 copay for Medicare-covered dental and vision benefits.
  • Coverage for inpatient hospital care, skilled nursing facilities, and home health care coverage.
  • A large network of providers, hospitals, specialists, and pharmacies.

Plus, you'll get extra benefits, including:

  • Preventive services to help you stay healthy.
  • Wellness education including smoking cessation and a 24-hour Nurse Call Line.
  • Great service and personal attention.

Questions? Call us toll free at 1-855-241-3648 (TTY/TDD 711), 8 a.m. - 8 p.m., 7 days a week.

Below is a brief summary of key benefits.

You may also view:

Find a provider in our network for the benefits listed below.

Or contact AmeriHealth Caritas VIP Care for more information.

Find a provider in our network for the benefits below.

Premium $0 monthly plan premium.
Doctor office visits $0 copay for each Medicare-covered primary care provider (PCP) visit
Specialist visits

$0 copay for each Medicare-covered specialist visit.

No referral required.

Preventive and comprehensive dental

$0 copay for Medicare-covered dental benefits.

$0 copay for the following preventive dental benefits:

  • Up to one oral exam every six months.
  • Up to one cleaning every six months.
  • Up to one fluoride treatment every six months.
  • Up to one dental X-ray every year.

We offer additional supplemental comprehensive dental benefits.

We pay up to $1,000 every two years for supplemental comprehensive dental benefits. This benefit includes coverage for minor restorations (such as fillings), simple extractions, dentures, and denture repair.

Hearing exams and aids

$0 copay for Medicare-covered diagnostic hearing exams.

$0 copay for up to 1 routine hearing exam every year.

$0 copay for 1 fitting evaluation for a hearing aid every three years.

$0 copay for up to 1 hearing aid every three years.

$1,000 every 3 years for hearing aids for both ears combined.

Vision services

$0 copay for Medicare-covered diagnosis and treatment for diseases and conditions of the eye, including an annual glaucoma screening for people at risk.

$0 copay for:

  • Up to one routine eye exam every year.
  • One pair of Medicare-covered eyeglasses (lenses and frames) or contact lenses after cataract surgery.
  • Up to one pair of eyeglasses (lenses and frames) every two years.
  • Up to one pair of contact lenses every two years.

We pay up to $200 every two years for contact lenses and eyeglasses (frames and lenses).

Transportation

$0 for up to 30 one-way trips to plan-approved locations every year. May consist of car, shuttle, or van service depending on appropriateness for situation.

Scheduling rules apply.

Over-the-counter (OTC) items You may spend up to $70 per quarter for items from our OTC catalog (PDF) (Spanish OTC catalog) (PDF). Money not spent in a quarter does not roll over into the next quarter.
Home health care $0 copay for Medicare-covered home health visits.
Outpatient mental health care

$0 copay for each Medicare-covered individual therapy visit.

$0 copay for each Medicare-covered group therapy visit.

$0 copay for each Medicare-covered individual therapy visit with a psychiatrist.

$0 copay for each Medicare-covered group therapy visit with a psychiatrist.

$0 copay for Medicare-covered partial hospitalization program services.

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