Medicare D-SNP + Medicaid

Two health insurance plans, one trusted company: Virginia Premier

You can streamline your care and gain extra benefits when you have Virginia Premier manage your Medicare D-SNP and Medicaid plans. It’s easier having just one company to call for help with things like finding doctors and specialists in your area, scheduling rides, and connecting you to services to help with your medical and social needs.

Virginia Premier Advantage Elite (HMO D-SNP) is a Dual Eligible Special Needs Plan

  • $0 monthly plan premium
  • This Medicare Advantage plan is available to those with full Medicaid benefits who live in Virginia.

If you are eligible for both Medicaid and Original Medicare (Part A and Part B), you may be able to enroll in the Advantage Elite plan that provides extra benefits at no cost. You must also be enrolled in a Medicaid plan.

Virginia Premier Medicaid

Virginia Premier has a Medicaid plan, focused on managed care. Every member has a care team dedicated to providing personalized health care and support.

You can check your Medicaid eligibility and learn how to apply at coverva.org.

Choose Virginia Premier

Virginia Premier has been serving the health care needs of Virginians for over 25 years. We understand the opportunities and health care challenges of this community. We live and work throughout Virginia, too. That’s why we are bringing you quality health plans with personalized care and services.

Extra benefits overview: Virginia Premier Medicare and Medicaid plans

See the extra benefits you receive with Advantage Elite and Virginia Premier’s Medicaid plan below. For a complete list of covered services, view the Advantage Elite Summary of Benefits or our Medicaid Member Handbook.

For extra benefits covered by both Medicare D-SNP and Medicaid, the D-SNP benefit is used first. The Medicaid benefit covers what is not already covered by the D-SNP added benefit.

Extra Benefits

Advantage Elite (HMO D-SNP)-$0 copay with $4,000 max

  • Preventive: Oral exam, one cleaning, one fluoride treatment, one bitewing X-ray every 12 months, and one full-mouth X-ray every 60 months.
  • Comprehensive: Fillings, extractions and dentures up to $4,000 allowed annually.

Virginia Premier Medicaid

  • Coverage included by Virginia Medicaid.

Advantage Elite (HMO D-SNP)-$0 copay

  • $0 copay for routine exam. Receive up to $300 allowance every 12 months for eyewear and/or contact lenses.

Virginia Premier Medicaid

  • Up to $100 allowance towards contacts, frames, lenses, and one exam every 24 months (diabetics yearly). Members with diabetes receive one exam every 12 months.

Advantage Elite (HMO D-SNP)-$0 copay

  • $0 copay for routine hearing exam. $0 copay for one set of select hearing aids every 12 months to a max allowance of $2,000.

Virginia Premier Medicaid

  • Exams and hearing aid allowance up to $1,250 every 36 months.
Advantage Elite (HMO D-SNP)-$100 monthly allowance

Members may receive a monthly grocery allowance1 through NationsBenefits® to use toward thousands of healthy options using a prepaid flex card.

  • Once activated, your prepaid flex card can be used at retail locations that operate as grocery stores, including Food Lion, Harris Teeter, Kroger, Rite Aid, Walgreens, and Walmart.
  • You can also order grocery items from NationsBenefits by phone, online, or mail. Home delivery from NationsBenefits has no additional cost.
1Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit.

Advantage Elite (HMO D-SNP)-$0 copay

  • SilverSneakers®: Attend online classes and workshops, view on-demand workout videos, or visit one of many fitness locations nationwide. Available to Virginia Premier Advantage Elite members of all ages.

Virginia Premier Medicaid

  • In-home options available. Please contact your care coordinator.

Advantage Elite (HMO D-SNP)-$0 copay

  • $350 allowance every three months for approved OTC products. Unspent dollars do not carry over to the next quarter.

Virginia Premier Medicaid

  • Many generic OTC medications are covered. For more information on OTC drugs covered by Virginia Premier, please visit the Medicaid Formulary.

Advantage Elite (HMO D-SNP)-$0 copay

  • Medical: $0 copay for 48 one-way trips every 12 months for health-related services.
  • Non-medical1: $0 copay for 24 one-way trips every 12 months to approved locations such as grocery stores, church, or senior centers, churches, or community centers.

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

Virginia Premier Medicaid

  • Medical: Unlimited transportation services for medical trips including but not limited to routine PCP visits, urgent visits, and to/from the pharmacy.
  • Non-medical: Three free non-medical round trips every 3 months.

Find a complete list of extra benefits included in Advantage Elite.

Are you ready to enroll?

Enjoy the convenience of having both of your health insurance plans in one place with Virginia Premier. If you have Medicare and Medicaid from two different health plan carriers at the same time, it may be confusing to know who to ask for help. When Virginia Premier covers them both, you gain one main care coordinator to manage all your needs.

Would you like to enroll in Medicaid? You can check your Medicaid eligibility and learn how to apply at coverva.org.

How to switch your Medicare D-SNP to Virginia Premier

  • Once a quarter: January 1–March 31, April 1–June 30, July 1–September 30. Your coverage will be effective the first of the month following your election.
  • When you enroll October 15–December 7, your coverage will take effect the following January 1.

For details, talk to one of our Licensed Plan Advisors at 1-833-270-2104 (TTY: 711).

How to switch your Medicaid to Virginia Premier

  • New members: Within your first 90 days.
  • Annual Open Enrollment: All Medicaid members in Virginia have an open enrollment period based on their region. View regions and dates.
  • Any other time: With permission from the Virginia Department of Medical Assistance Services (DMAS).

For help switching to Virginia Premier Medicaid call the DMAS CCC Plus Helpline at 1-844-374-9159 (TTY: 1-800-817-6608) Monday through Friday, 8:30 a.m. to 6 p.m.

Resources

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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.

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

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