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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:

  • Coverage for inpatient hospital care, as well as skilled nursing facility and home health care coverage.
  • Preventive services to help you stay healthy.
  • A large network of doctors, hospitals, specialists, and pharmacies.
  • Great service and personal attention.

Plus, you'll get extra benefits, including:

  • Dental, vision, and hearing benefits not covered by Original Medicare.
  • Wellness education including smoking cessation and a nurse hotline.
  • Transportation to your provider.

Below is a brief summary of key benefits.

You may also view:

Find a provider in our network for the benefits listed 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

We pay up to $1,000 every year for preventive dental benefits.

$0 copay for Medicare-covered dental benefits.

$0 copay for the following preventive dental benefits:

  • Up to 1 oral exam every 6 months.
  • Up to 1 cleaning every 6 months.
  • Up to 1 fluoride treatment every 6 months.
  • Dental X-rays every year.

We offer additional supplemental comprehensive dental benefits.

We pay up to $2,000 every year for supplemental comprehensive dental benefits. This benefit includes coverage for minor restorations (such as fillings), simple extractions, dentures and denture repair, surgical extractions, oral surgery, periodontics, and endodontics.

Hearing

$0 copay for Medicare-covered diagnostic hearing exams.

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

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

$1,000 allowance for hearing aids every 2 years 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 1 supplemental routine eye exam every year.
  • 1 pair of Medicare-covered eyeglasses (lenses and frames) or contact lenses after cataract surgery.
  • Up to 1 pair of eyeglasses (lenses and frames) every year or up to 1 pair of contact lenses every year.

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

Transportation

$0 for up to 80 one-way trips to plan-approved locations every year. May consist of car, shuttle, or van service depending on appropriateness for situation.

Authorization and scheduling rules apply.

Over-the-counter (OTC) items

You may spend up to $150 per quarter for (OTC) items from our OTC catalog (PDF — April 7, 2020). Money not spent in a quarter does not roll over into the next quarter.

Spanish OTC catalog (PDF).

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 therap

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