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.
Coverage
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, 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.
2024 BENEFITS
HMO
TOTAL HEALTH (HMO)
CLASSIC (HMO)
Medicare-covered hearing exam
$35
$30
$30
Routine hearing exam with an HCS provider (1 per year)
$0
$0
$0
Routine hearing exam with a non-HCS provider (higher copay applies to exams by all other providers)
$35
$30
$30
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 preventive 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 preventive visit with your dentist.
2024 BENEFITS
ALL PLANS
Annual Max
$1500 allowance - Classic HMO & Total Health $1000 allowance - HMO $0
Annual Comprehensive Deductible
$25 annual deductible for all plans
INCLUDED SERVICES
IN-NETWORK COVERAGE
Preventive
$0 copay for exams, fluoride, cleanings, and X-rays.
Comprehensive
$0 copay for covered comprehensive dental services, like fillings, extractions, crowns, and dentures.
Refer to your Evidence of Coverage (EOC) for limitations
Vision
Do you wear eyeglasses or contacts? Receive up to $250 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 $250 for your purchase. Search our provider directory to see if your optometrist is in-network.
2024 BENEFITS
HMO
TOTAL HEALTH (HMO)
CLASSIC (HMO)
Monthly premium
Included
INCLUDED SERVICES
IN-NETWORK COVERAGE
Routine eye exam (1 per year)
$20
$0
$0
Hardware reimbursement allowance per calendar year
$150
$200
$250
Medicare-covered diabetic retinopathy screening (1 per year)
Included
FitOn Health®
Fitness Membership from FitOn Health. All 2024 Premera Blue Cross Medicare Advantage members can enjoy their no-cost FitOn Health fitness membership.
You will have access to the best digital and in-person fitness experiences, with membership in the number one health and fitness platform.
- Unlimited premium digital fitness classes
- Nutrition programs with over 500 exclusive recipes
- Chronic disease courses and wellness content
- 13,000+ gyms, studios, and national fitness clubs like YMCA, LA Fitness and others
Register with an email and password at fitonhealth.com/register. You may also email at help@fitonhealth.com or call toll-free 855-378-6683 (TTY: 711), Monday through Friday, 5 a.m. – 8 p.m. (PST).
On behalf of Premera Blue Cross, FitOn Health is an independent company which provides the fitness benefit. Fitness Membership provided by FitOn Health.
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.
*These programs are not insurance and may be discontinued at any time.