Summary of Benefits
First Choice VIP Care Plus is a plan designed for people who have Medicare and Healthy Connections Medicaid. Our health plan can help you get more from your coverage. And that means having a personal care team and Care Coordinator to help you get the care you need.
Our large network of providers, hospitals, and pharmacies makes it easy for you to get care. Choose First Choice VIP Care Plus and be treated like the VIP you are.
First Choice VIP Care Plus provides:
- $0 copay for Medicare-covered benefits.
- $0 copay for all prescription drugs on the formulary.
- Routine Vision Services.
- Up to one routine eye exam every year.
- Up to one pair of eyeglasses (lenses and frames) every 2 years OR up to $150 of contact lenses every two years.
- $150 plan coverage limit for eye wear every two years.
- Long-term services and supports waiver benefits if medically necessary.
- Coverage for inpatient hospital care, skilled nursing facility services, and home health care services.
- A large network of providers, hospitals, specialists and pharmacies.
Below is a brief summary of key benefits. You can also view:
- Complete Summary of Benefits (PDF — April 1, 2020)
- Spanish Summary of Benefits (PDF — April 1, 2020)
- Member Handbook (PDF — April 1, 2020)
- Spanish Member Handbook (PDF — April 1, 2020)
- A complete Annual Notice of Changes — ANOC (PDF)
- The Annual Notice of Changes (ANOC) tells you about all plan changes for 2020.
- Spanish Annual Notice of Changes — ANOC (PDF)
Contact First Choice VIP Care Plus Member Services for more information at 1-888-978-0862 (TTY/TDD 711), 8 a.m. - 8 p.m., 7 days a week.
Find a provider in our network for the benefits listed below.
|Premium||$0 monthly plan premium.|
|Provider office visits||$0 copay for each Medicare-covered primary care provider (PCP) visit.|
$0 copay for each Medicare-covered specialist visit
|Inpatient hospital visits||
$0 copay for Medicare-covered visits
|Environmental modifications||$0 copay for minor changes to your home, up to a $7500 lifetime limit. Includes pest control and physical changes to the home that are necessary to ensure your health, welfare, and safety (only available to waiver members, and authorization rules may apply).|
$0 copay for home-delivered meals
|Home health care||$0 copay for Medicare-covered home health visits.
$0 copay for each Medicare-covered individual therapy visit.
$0 copay for each Medicare-covered group therapy visit.
|Outpatient mental health care||$0 copay for each Medicare-covered individual therapy visit with a psychiatrist.
$0 copay for each Medicare-covered group therapy visit with a psychiatrist.
$0 copay for each Medicare-covered partial hospitalization program services.
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or refer to the First Choice VIP Care Plus Member Handbook (PDF).