The ApexHealth team wants to make Medicare work for you. This means providing you with excellent health coverage tailored to your unique needs including more value, surprising and exciting benefits, and a whole new level of customer service. Scroll through these 2022 ApexHealth benefit highlights to discover what we mean when we say, “Welcome to a
new you kind of Medicare.” (And at any time, take a look at our plans!)
1. $0 deductible
A deductible means the amount of money you pay before your insurance begins to pay. Deductibles are part of the basic costs for people with Medicare. The amount you pay for a Medicare Advantage plan deductible varies by plan.
ApexHealth Medicare Advantage plans have a $0 deductible for both medical and prescription drug coverage. This means that your coverage kicks in right away!
2. Extra dental coverage
Original Medicare – Parts A and B – does not cover most dental care, including cleanings, fillings, tooth extractions, dentures and dental plates. It will pay for complicated or emergency dental procedures that you get while in the hospital. This means Medicare Advantage is the only way to get dental services covered under Medicare. Coverage and offerings vary by plan.
ApexHealth Medicare Advantage plans give you $1,500 or more for preventive and comprehensive dental services, like cleanings, x-rays, crowns, dentures, oral surgeries and more. Benefit amount varies by plan.
3. Glasses and contacts reimbursement
Original Medicare covers some vision care, but it does not cover routine vision care such as vision exams, eyeglasses (frames or lenses), or contact lenses. This means you’d have to pay for these costs out of pocket. Medicare Advantage plans cover the same services as Original Medicare and more – benefits may include routine eye exams, eyeglasses, contacts, and fittings for frames and contact lenses. Coverage and offerings vary by plan.
ApexHealth Medicare Advantage plans reimburse you $150 or more for glasses, contacts and routine optometrist visits. Benefit amount varies by plan.
4. Hearing aid coverage
You’re covered under Original Medicare for diagnostic hearing exams and balance exams if your doctor orders them to see if you need medical treatment (and your 20 percent coinsurance and Part B deductible apply). However, you’re not covered for hearing aids or exams for fitting hearing aids. Medicare Advantage plans cover what Original Medicare covers, plus more! Coverage and offerings vary by plan.
ApexHealth Medicare Advantage plans give you up to $1,350 in coverage for hearing aids with no deductible.
5. OTC drug allowance
Some medications and other health-related items that you might need may not require a prescription such as allergy pills, cold and flu products or first aid supplies. Unfortunately, Original Medicare and Medicare Part D do not pay for over the counter (OTC) drugs. But there is some good news! Some Medicare Advantage plans offer OTC allowances.
ApexHealth Medicare Advantage plans give you $30 or more every three months for over-the-counter drugs and supplies. Any unused allowance rolls over to the next three months but must be used by the end of the coverage year. Benefit amount varies by plan.
6. Free gym membership
Staying active is a great way to live life boldly. Original Medicare does not cover gym memberships or fitness programs, but these may be part of the extra coverage offered by Medicare Advantage plans.
ApexHealth Medicare Advantage plan members have access to free gym memberships at participating gyms, including Planet Fitness, YMCA and more.
7. Chiropractic/acupuncture/therapeutic massage
Generally, Original Medicare does not cover services ordered by a chiropractor including acupuncture, massage therapy or x-rays, unless certain conditions apply. One medically approved treatment covered by Medicare Part B is spinal manipulation (alignment), if medically necessary, and your 20 percent coinsurance and Part B deductible apply. Medicare Part B covers up to 12 acupuncture visits in 90 days for chronic low back pain, including an additional eight sessions if you show improvement. The Centers for Medicare & Medicaid Services (CMS) says if your doctor decides your chronic low back pain isn’t improving or is getting worse, then Medicare won’t cover your additional treatments. No more than 20 acupuncture treatments can be given yearly. Medicare Advantage plans offer the same benefits as Original Medicare, and they may offer more coverage, including supplemental benefits such as massage therapy. Keep in mind coverage and offerings vary by plan.
As part of our supplemental benefits coverage, ApexHealth Medicare Advantage plans offer additional chiropractic, acupuncture, and therapeutic massage treatments for as low as $30 per visit, for up to 20 total visits per year.
8. Routine podiatry visits
Foot care can refer to both treatment of serious conditions that affect the health of your feet or basic routine foot care. Routine foot care is not covered by Original Medicare unless it is considered medically necessary (e.g., if you have diabetes). Medicare Advantage plans can offer additional foot care coverage, including routine foot care. Coverage and offerings vary by plan.
ApexHealth Medicare Advantage plans offer routine podiatry visits as low as $20/visit, up to eight visits per year.
9. Prescription drug coverage
Both Original Medicare and Medigap do not include Part D prescription drug coverage. Prescription drug coverage is included with most Medicare Advantage plans, known as MAPD plans. Check out our formulary search tool to find out if ApexHealth covers your prescriptions.
Highlights of ApexHealth Part D benefits include $0 Tier 1 Preferred Generic prescription drug coverage, $0 Tier 6 Select Care prescription drug coverage, and $0 Viagra (generic) with a maximum of six (6) tablets per month.
Not long ago, HealthMine surveyed Medicare Advantage beneficiaries on how they felt their plan helps them manage their health. The responses were not too great; about 40% of those surveyed said that their health plans’ communications felt “impersonal or mass-oriented.” As a new Medicare company, ApexHealth knew we could do better when it comes to customer service.
ApexHealth members get support of your own personal ApexAssistant. As your personal Medicare expert, they’ll get to know you, your plan, your preferences and your needs.
ApexHealth members have access to a wide range of health care benefits and services tailored to their unique needs. See where we’re available, and give us a call at (844) 279-0508 (TTY: 711) if you have any questions. Our ApexAssistants will be happy to help you! Our hours of operation are Monday through Friday 8 a.m. – 8 p.m. (local time) from Apr. 1 through Sept. 30 and seven days a week 8 a.m. – 8 p.m. (local time) from Oct. 1 through Mar. 31.