GUIDE. to your Medicare Benefits. Effective January 1- December 31, Look inside for more information on:
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1 GUIDE to your Medicare Benefits Effective January 1- December 31, 2018 Look inside for more information on: $0 monthly premium $2,000 dental coverage $75 a quarter for OTC items More brand name drugs No referrals for specialist visits And much more! H5969_404105_18
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4 $2,000 Comprehensive Preventive and Restorative Dental Coverage KEEP YOUR SMILE BRIGHT! AlohaCare offers comprehensive preventive and restorative dental coverage for our members. Your Medicaid plan only covers emergency dental services, but as a member of our Medicare plan, you ll be covered for a wide range of dental services that will keep you smiling! Oral Exams Routine Cleaning X-rays Root Canals Extractions Dentures You will be covered for up to $2,000 per plan year for preventive and restorative dental services.
5 $75 a quarter for Over-the-Counter (OTC) Items SAVE MONEY ON EVERYDAY ITEMS! AlohaCare offers our members a pre-paid debit card to pay for OTC eligible items at the pharmacy. You will get a quarterly benefit (every 3 months) of $75 to spend. You can use this card to purchase the following: Adult Cough, Cold and Flu Medicine Allergy and Sinus medications Bandages (band-aids) Diabetes Care Accessories First Aid Kits and Supplies Toothbrushes and Toothpaste Vitamins, Multi-Vitamins and Minerals And much more! This debit card will be sent to you upon your enrollment into AlohaCare Advantage Plus. It will be automatically replenished every three months. Unused money will not transfer over to the next three months. OTC delivery services may be available when medically necessary and prior authorized.
6 We Give You More Aloha! We treat you with aloha! All members have access to a care manager to help them get the care they need. Your care manager is dedicated to helping you find and receive services and coordinate your care. It s easy to get care! AlohaCare members can see a specialist without a referral. This means getting care is faster than ever. Work with your PCP to get specialty care. We are in your neighborhood! AlohaCare is providing care in your community! If you can t come to us, we come to you. We have staff statewide to meet you in-person - in your home, your doctor s office or where it s convenient for you - to give you personalized assistance.
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8 We are here to help you! Call or visit us on Oahu, Maui, Kauai and Hawaii Island. Hawaii Island AlohaCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. AlohaCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. AlohaCare provides free aids and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact AlohaCare s Compliance Officer. If you believe that AlohaCare has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: AlohaCare Attn: Compliance Officer 1357 Kapiolani Blvd., Ste Honolulu, HI Phone: Toll-free: TTY/TDD: Fax: Compliance@alohacare.org You can file a grievance in person or by mail, fax, or . If you need help filing a grievance, AlohaCare s Compliance Officer is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C , (TDD) Complaint forms are available at AlohaCare Advantage Plus is an HMO SNP with a Medicare contract and a contract with the Hawaii Medicaid program. Enrollment in AlohaCare Advantage Plus depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copays, and restrictions may apply. Benefits, premiums and/ or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
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