2019 Medicare Member Resources

We’ve put together some information that might be important to our members. Check out the links below if you are interested in learning about a specific topic.

If you can’t find answers to all of your questions, please contact us. We’re here to help. You can reach Member Services at 1-877-739-1370 (TTY: 711). From October 1 to March 31, we are open daily from 8:00 am to 8:00 pm, 7 days a week. From April 1 through September 30, we are open Monday through Friday, 8:00 am to 8:00 pm. On certain holidays and weekends from April 1 through September 30, your call will be handled by our automated phone system.

Network Coverage

The Provider & Pharmacy Directories list the providers and pharmacies in the Virginia Premier network. We know that your coverage is important to you, so we’ve created a quick guide about network coverage with some information. For additional information regarding the Virginia Premier Medicare Advantage network, please see your plan’s Evidence of Coverage. 

Your Rights and Responsibilities as a Member of Our Plan

You will have certain rights, as well as responsibilities, as a member of a Virginia Premier Medicare Advantage plan. You can think of those rights and responsibilities as a type of agreement with us as part of our partnership for your health care. We also have information for your rights upon disenrollment.

Extra Help/Best Available Evidence Policy 

If you believe you have qualified for Extra Help (also called low-income subsidy (LIS) level) and you believe that you are paying an incorrect cost-share amount when you get your prescription(s) at a pharmacy; Virginia Premier has established a process that allows you to provide the evidence you already have to us.

You can provide us one of the following:

  • A copy of the Medicaid card with the member’s name and an eligibility date;
  • One of the following letters from Social Security Administration showing Extra Help and effective date:
    • “Important Information” Letter;
    • “Award” Letter;
    • “Notice of Change” Letter;
    • “Notice of Action” Letter

You may be asked to provide additional documentation if you are institutionalized.

To initiate the BAE review complete the Best Available Evidence Request Form or for further assistance please call Virginia Premier at 1-877-739-1370 (TTY: 711) or see the Centers for Medicare & Medicaid Services (CMS) website for more information.