Medicare Extra Benefits

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Medicare Extra Benefits

When you have the Virginia Premier Advantage Elite (HMO D-SNP) plan, you get extra benefits on top of your medical, hospital, and prescription drug coverage. Need to know how to use your benefits? Select the benefit below to find out.

Please refer to your Evidence of Coverage for specific benefit limits.

You have dental benefits that cover an exam, cleaning, fluoride treatment, and X-rays every 12 months at no cost to you. You also have a $4,000 allowance to use for fillings, extractions, crowns, dentures, and more. You must use a DentaQuest in-network provider for these services.

To find a dentist near you:

  1. Go to the DentaQuest website.
  2. Enter your address, city, or ZIP code.
  3. Select Virginia Premier Advantage Elite (HMO D-SNP) under plan name.

You can also call DentaQuest directly to find a dentist in your area at 1-844-822-8115 (TTY: 711), Monday through Friday, 8:00 am to 5:00 pm.

Every 12 months, you can get an eye exam for a $0 copay. You also have a $300 allowance to purchase eyeglasses or contact lenses every 12 months.

You will need to see an in-network provider through our vision partner, Community Eye Care (CEC). First, create an account online with CEC to locate a provider or call CEC Member Services. Easily create an account by going to CEC.

Once the account is created, you can review your benefit information, access eligibility and plan coverage details, and find a provider. You can also call CEC Member Services for assistance at 1-844-493-4232 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week, 365 days a year.

Every quarter, you have $350 to buy non-prescription drugs and health care products from the NationsOTC® plan catalog. The catalog includes hundreds of health and wellness items that can be delivered to your door.

Download the OTC Catalog

You have three easy ways to place an order – online, by phone, and by mail. We’ll then ship your items directly to you at no additional cost. If you need assistance with your order, call NationsBenefits® at 1-888-357-6863 (TTY: 711), 8 a.m.–8 p.m. 7 days a week.

  1. Online. Visit NationsOTC.
  2. Phone. Call 1-888-357-6863 (TTY: 711).
  3. Mail. Complete and mail the order form found in your NationsOTC® catalog.

Receive a $350 allowance per quarter:
Quarter 1:  January – March
Quarter 2:  April – June
Quarter 3:  July – September
Quarter 4:  October – December

Your OTC allowance cannot be carried over to the next quarter.

Shop for a variety of brand-name and generic health foods with a $100 monthly grocery allowance1. Shop in stores, or order groceries online through your NationsBenefits® member portal, or by phone at 1-888-357-6863 (TTY: 711), 8:00 am–8:00 pm, 7 days a week. If you order groceries online or by phone, they will be delivered to your home at no charge.

Your grocery allowance will reload with $100 on the first day of the month and expires on the last day of every month.

Order your grocery allowance online or by calling 1-888-357-6863 (TTY: 711), 24 hours a day, 7 days a week, 365 days a year. Retail stores where you can use your card include:

  • Food Lion
  • Harris Teeter
  • Kroger
  • Walmart

1 Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit.

To order by mail, use the order form located in your NationsOTC® catalog. If you order groceries online, by mail, or by phone, they will be delivered to your home at no charge.

Your benefit includes a free hearing exam once every 12 months. If hearing aids are needed, we provide free fittings and a set of hearing aids up to a $2,000 allowance every 12 months. Your benefit also includes the following at no cost:

  • Three follow-up care visits in the first year
  • One-year supply of hearing aid batteries
  • A 12-month warranty

To find a hearing provider call 1-888-357-6863 (TTY: 711), Monday through Friday, 8:30 am to 6:00 pm, or visit NationsHearing.

Get active with SilverSneakers® fitness programs.  This benefit includes:

  • SilverSneakers LIVE™ online classes and workshops
  • On-demand workout videos in the SilverSneakers OnDemand™ library
  • SilverSneakers GO™ mobile app with digital workouts
  • Free membership at over 15,000 fitness locations in your community and nationwide

For more information, contact SilverSneakers® at 1-866-584-7389 (TTY: 711), Monday through Friday, 8:00 am to 8:00 pm.

We will get you to your medical appointment or pharmacy if you don’t have transportation with 48 one-way trips to medical plan-approved locations.

You also have 24 one-way trips to non-medical locations such as grocery stores, senior centers, gyms, support groups, churches, and Virginia Premier events.

Virginia Premier partners with Verida for transportation services. To schedule a ride, call  1-855-880-3480 (TTY: 711), at least three days in advance, Monday through Friday, 6:00 am to 6:00 pm, or go online.

1Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit.

With the push of a button, your Personal Emergency Response System will connect you with help. Eligible members can receive a PERS in-home monitoring device that can get you to help quickly, 24 hours a day. This benefit requires a working landline or mobile phone coverage. Prior authorization is required.

Your benefit offers one Annual Physical Exam every 12 months for a $0 copay. An Annual Physical Exam includes a comprehensive physical examination and evaluation of chronic diseases. It does not include lab tests, non-radiological diagnostic tests, or radiological diagnostic tests. Additional cost-share may apply to any lab or diagnostic testing performed during your visit.

Home delivery is a convenient and cost-effective way for you to order up to a 90-day supply of your long-term medication.

Convenient: Your long-term medications will be delivered to your home, office, or another location of your choosing.

Cost Effective: Standard shipping is free and you can save money when you order a 90-day supply of your medications for home delivery.

How to use Home Delivery

You can ask your doctor to write a prescription for a 90-day supply of your long-term medication. Once you have your prescription, fill out an order form below.

You can also log into the member portal online.

Click here to access and download the mail order form.

After an inpatient hospital or skilled nursing facility stay, you may qualify to have ready-to-heat meals delivered to your home. You can receive up to 56 meals over a 28-day period following discharge. This requires prior authorization working with your care coordinator.

Virtual Visits make it easy to talk with a provider from the privacy of your home. Using your computer or smartphone, you can talk to a licensed doctor, counselor, or psychiatrist. These healthcare providers can diagnose, treat, and write prescriptions for routine medical conditions. Appointments are available 24 hours a day, 7 days a week, 365 days a year. There is no cost to you for a Virtual Visit.

Visit a podiatrist for preventive treatments such as removal of corns, warts, calluses, and nail care. You can visit the podiatrist up to eight times per year with a $0 copay.

See a chiropractor, up to six times per year, for therapeutic manipulation and adjustments. There is no cost to you for these visits. The benefit does not cover X-rays.

Resources

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I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services.

With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. This includes full compliance with the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’), the HITECH Act, and the Virginia Health Records Privacy Act, and applicable regulations to these laws.

I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members.

I agree to notify Virginia Premier System immediately in the event that my network access has been compromised in any way and in the event of unauthorized use or disclosure of any information obtained from the Virginia Premier System network.

Need to register for a new account? Click here.

In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. If you would like access to a specific group NPI/API instead, please enter it in the field provided. 

For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account.

You will receive an email within 3-5 business days with your username and temporary password.

Please call Technical Support for help with Virginia Premier’s Provider Portal at 1-877-814-9909 or email connect@healthtrio.com. 

Virginia Premier is offering EFT services through PaySpan.

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If you have questions or need help please, contact our Provider Services department at vphpnetdev@sentara.com or by calling 804-968-1529.