2023 Benefits That Cover you head to toe.

The Experience Health Medicare Advantage SM (HMO) plan includes valuable extras like these:

Increased $440 Over-the-Counter (OTC) Benefit

Choose from hundreds of quality products including:

  • First aid supplies

  • Cold and flu remedies

  • Order online, or by phone or mail

  • Free shipping!

SilverSneakers® Fitness Membership

  • Membership to thousands of fitness locations — over 190 in the Triangle!

  • Group Exercise classes for all abilities

  • Fun activities outside the gym

  • SilverSneakers® On-Demand online workout videos

  • SilverSneakers GO™ mobile app

Meals-at-Home Program

  • $0 copay for up to 20 home-delivered meals for each inpatient stay in either a Hospital or Skilled Nursing Facility

  • Your choice from a menu of meals

  • Includes heart-healthy and carb-conscious selections, as well as pizza and other all-American favorites!

  • Order when you wish: up to 30 days after discharge

Transportation Assistance

  • Knowing you can get to your doctor matters, for your health and peace of mind

  • With Transportation Assistance, you get up to 12 one-way rides, to and/or from approved locations

  • Make your appointments worry-free

  • For non-emergency trips


IN-HOME SUPPORT SERVICES

$0 copay to receive up to 6 hours of companion care each month assisting with:

  • Setting up technology

  • Shopping for groceries

  • Light housework or chores

  • Accompaniment to appointments

  • Picking up health care supplies or medications

  • Meal preparation

  • Other errands

  • Enhanced peace of mind

PERSONAL EMERGENCY SUPPORT SERVICES (PERS)

  • $0 copay for a medical alert system (wristband and pendant options) through NationsResponse®, powered by ADT®

  • Lets you call for help at the push of a button

  • Alerts emergency responders and updates family

  • You don’t have to fear those times when you’re by yourself

  • Maintain your lifestyle and peace of mind

Mental Health BENEFITS

Experience Health’s Care Support Team makes it easy for members to get the mental health care they need.

  • Care Support helps members find a provider based on their needs, preference and coverage

  • Large network that includes in-person and virtual therapy options

  • $0 copay for outpatient office visits

Acupuncture

A benefit that’s becoming more and more popular.

  • $50 reimbursement allowance per visit for up to 20 visits per year (in addition to Medicare coverage for chronic lower back pain)

  • Your choice of any NC licensed acupuncturist


Part D Senior Savings Model (PDSS)

  • $35 copay for on-formulary insulins

  • $87.50 copay for 90-day supply of on-formulary insulins through our mail order pharmacies

  • $35 copay applies through the Part D initial coverage and coverage gap phases

  • PDSS is not available to members who receive Extra Help

$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 Exam and Cleanings

  • Dental X-ray(s), Fluoride Treatments and more.

$1,500 Comprehensive Dental Care reimbursement allowance each year — use as you see fit toward:

  • Fillings, Restorations

  • Crowns, Root Canals or other care

INCREASED VISION BENEFITS

Routine Eye Exams — $0 copay
Eyewear — $300 annual allowance, use as you wish for:

  • Contact Lenses

  • Eyeglass Frames

  • Eyeglass Lenses

HEARING BENEFITS

Routine hearing Exams — $0 copay
Hearing Aids †† — Members enjoy deep discounts that can save you hundreds of dollars.

  • $599 low member copay: advanced 32-channel models

  • $899 low member copay: premium 48-channel models

  • Multiple models to choose from

  • All with smartphone connectivity and 3-yr. warranty

To schedule an appointment with a local audiologist for your hearing evaluation, contact TruHearing at 1-866-201-9212 (TTY: 711).

 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.

Worldwide Travel Coverage

Health care coverage when you travel, you’re covered when visiting:

  • $35 copay for Urgent Care

  • $90 for Emergency Room

  • $295 copay for Ambulance

  • Note: Travel anywhere in the United States or Canada covered for Emergency coverage

New Bathroom Safety Devices

  • $0 copay for up to two products per year.

  • You can install additional safety precautions to help prevent accidents.

  • Contact plan for an approved list of products.

A full list of eligible devices can be found in the OTC catalog.

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Contact Us

Members call 1-833-777-7394 (TTY:711)

Providers call 1-877-397-4584 (TTY: 711)

Agents visit ExperienceHealthNC.com/Brokers

8 a.m. to 8 p.m., Monday through Friday
(8 a.m. to 8 p.m., 7 days a week from October 1 to March 31)