Medicare Advantage
Coverage
& Benefits
Supporting your whole-body health and well-being is our focus. Because we believe your good health is everything, your plan covers the following head-to-toe benefits to help support the whole you.
Medical Coverage
Your Evidence of Coverage (EOC) outlines all your medical benefits. There is an EOC for each plan. You can view your EOC online or download a copy by going to premera.com/ma, choosing Coverage & Benefits, and finding your plan name. You can also view your Annual Notice of Change and Summary of Benefits.
Hearing
All of our Medicare Advantage plans include a Medicare-covered diagnostic hearing exam. You can use any of the providers in our provider network.
For the plans listed below, we offer a routine hearing exam and hearing aid benefit through Hearing Care Solutions (HCS). If you choose a HCS provider, your routine hearing exam is covered at a $0 copay.
If you use hearing aids, all of our plans include a hearing aid allowance of $1,000 per ear per year through HCS.
To set up an appointment, call HCS at 866-344-7756. You can learn more at hearingcaresolutions.com.
On behalf of Premera Blue Cross, Hearing Care Solutions is an independent company which provides the hearing aid benefit.
included services
In-Network Coverage Through HCS:
Routine hearing exam (1 per year) with HCS
$0
Hearing aids
$1,000 per ear/per year
Dental
All of our Medicare Advantage plans include preventive and comprehensive dental coverage, offering access to hundreds of local dentists in our Medicare Advantage Select Dental network.
Things to know about your dental coverage:
- Your plan has Medicare-covered dental benefits under Part A. These Part A benefits will pay for certain dental services you get when you're in a hospital.
- Your plan covers routine preventative and comprehensive services up to an annual maximum that is specific to your plan.
- You have an annual comprehensive deductible that must be met.
- You see the greatest savings when you see an in-network dental provider.
Prioritizing your oral health care is just as important now as it was when you were younger. Make sure to schedule a preventative visit with your dentist.
Annual Max
$1500 allowance - Classic HMO & Alpine
$1300 allowance - Sound + Rx
$1000 allowance - HMO $0 & Peak + Rx
Annual Comprehensive Deductible
$75 annual deductible (all plans except Alpine)
$25 annual deductible on Alpine
included services
In-Network Coverage
Preventive and Comprehensive
Routine cleanings/periodontal maintenance, flouride treatments, bite wing and panoramic x-rays, periodontal exam
Vision
Do you wear eyeglasses or contacts? Receive up to $300 a year to purchase new frames, lenses, and contacts depending on the plan you’re on.
Visit any optometrist in the United States who accepts Medicare. Find what you like and send us a copy of your receipt. After we’ve received the receipt, we’ll reimburse you up to $300 for your purchase. Search our provider directory to see if your optometrist is in-network.
Monthly premium
Included
included services
In-Network Coverage
Routine eye exam
(1 per year)
(1 per year)
$20
$0
$0
$20
Hardware reimbursement allowance
(every 12 months)
(every 12 months)
$150
$200
$250
$300
Medicare-covered diabetic retinopathy screening
(1 per year)
(1 per year)
Included
Monthly premium
included
included services
In-Network Coverage
Routine eye exam
(1 per year)
(1 per year)
$20
$0
Hardware reimbursement allowance
(every 12 months)
(every 12 months)
$150
$200
Medicare-covered diabetic retinopathy screening
(1 per year)
(1 per year)
included
Monthly premium
included
included services
In-Network Coverage
Routine eye exam
(1 per year)
(1 per year)
$0
$40
$20
Hardware reimbursement allowance
(every 12 months)
(every 12 months)
$250
$150
$300
Medicare-covered diabetic retinopathy screening
(1 per year)
(1 per year)
included
Silver&Fit®
You have access to the no-cost Silver&Fit fitness program as part of your Premera Medicare Advantage plan. Your Silver&Fit membership includes:
- Access to our network that includes more than 16,500 local and national fitness clubs like select YMCA locations, LA Fitness, Snap Fitness, and others
- Healthy aging coaching – coaches can answer questions related to healthy eating and nutrition, sleep, self-advocacy, coping with isolation, starting a home fitness routine, and other lifestyle questions
- Home Fitness Kits – pick one kit per benefit year and choose from wearable fitness trackers, Pilates, strength, swim, or yoga kit options
- No-cost, live, daily workouts on Facebook Live and YouTube
- Access over 8,000 digital workout videos available via the Silver&Fit ASHConnect™ mobile app or website
- Access to a national social club program of over 120,000 social clubs with activities such as walking, chess, bridge, HAM radio, cooking clubs, and more
Once your plan starts, create your membership account at silverandfit.com or by calling 877-427-4788 (TTY: 711).
On behalf of Premera Blue Cross, the Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a federally registered trademark of ASH and used with permission herein. Other names may be trademarks of their respective owners. Kits are subject to change.
Premera Senior Discounts program*
The Premera Senior Discounts program gives you discounts on things like health products, eye care and hardware, contact lenses, and hearing aids.
View all discounts
*These programs are not insurance and may be discontinued at any time.
