Medicare Coverage Overview

Our Medicare Advantage Plan:
Virginia Premier Advantage Elite (HMO D-SNP)

This Dual Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan for individuals who are eligible for both Medicare and Medicaid. Our Advantage Elite plan benefits can be used along with Virginia Premier Medicaid. And, Advantage Elite offers more benefits than Original Medicare at no cost.

Advantage Elite Benefits
Monthly Premium
$0
Annual Deductible
$0
Annual Out-of-Pocket Maximum
$8,300
Doctors and Specialists
$0 copay
No referral is required to see a specialist.
Annual Exams
$0 copay
Extra Benefits
Dental Coverage – $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.
Vision Services – $0 copay
$0 copay for routine exam. Receive up to $300 allowance every 12 months for eyewear and/or contact lenses.
Hearing Services – $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.
Grocery Allowance – $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.

Fitness Program – $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.
Over-the-Counter (OTC) Product Allowance
$350 allowance every three months for approved OTC products. Unspent dollars do not carry over to the next quarter.
Transportation – $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.

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

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

Align Your Medicare D-SNP and Medicaid Plans

If you are eligible for both Medicare and Medicaid, you can choose Virginia Premier for both plans. See why you should align your Medicare D-SNP and Medicaid plans through Virginia Premier.

Questions?

Call a Licensed Plan Advisor

1-833-688-6701 (TTY: 711)

October 1 – March 31 | 7 days a week | 8 am – 8 pm

April 1 – September 30 | Monday – Friday | 8 am – 8 pm

Resources

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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.