Presbyterian Medicare Advantage Member Information

Presbyterian Medicare Advantage Members

 

Presbyterian Medicare Advantage Membership has its privileges!

All members enrolled in Presbyterian Medicare Advantage are automatically members of the BenefitSource Value Added Services program at no additional cost.  The open enrollment season for Medicare Advantage is specified by Medicare, normally in the month of October.

Please review the 2018 PHP Medicare Advantage Value Added Guidebook for a complete description of the services described below.

The services included in this Value Added program are:

Dental Care

  • Automatic enrollment in our Sandia Dental Plan.  This plan is a network based referral plan that provides for savings from 20% to 60% for comprehensive dental care.  Savings are greater for diagnostic and preventive dental such as cleanings and x-rays.  There are also substantial savings for more extensive dental procedures such as restorations, oral surgery, periodontics, and prosthodontics.  Please review the Sandia Plan Fee Schedule  to see the complete list of dental procedures.  Members must use the Sandia Plan Participating Providers to receive these benefits.
  • Option to purchase a PPO Dental  Plan,  our Elite Dental Plan.  This plan offers freedom of choice to use any dentist.  Benefits are richer when obtaining care from our participating PPO dental offices, however.  This plan is available for the low monthly premium of $35.35 per person, or $424.20 annually per person for those enrolling in October of each year.  For a comprehensive list of these savings review the Elite Plan Fee Schedule and the Elite Dental Plan Description and Application.

Vision Care and Audiology Services

  • Medicare Advantage members should refer to their medical Summary of Benefits for Vision Care services related to exams, cataract surgery, or for refractive correction.  However, the BenefitSource Value Added program enables members to enjoy additional savings for corrective eye wear such as eye glasses, frames, special lenses or contact lenses.    For a list of participating vision providers go to www.visioncaredirect.com.
  • Participating audiology centers provide a variety of hearing hardware and appliances for discounts from 25% to 50% including hearing aids and hearing aid batteries.  And there are fixed copayments for complete hearing evaluations.
  • Vision, Hearing and Home Safety Technology is available to help members hear, see, and maintain independence, with items such as amplifiers and help alerts.

Complementary and Alternative Medicine (CAM)

  • Acupuncture:  This involves the use of small, thin, sterile needles that are inserted into “reflex point” to relieve pain, sleep disorders, stress, and digestive problems
  • Chiropractic Care:  This is manipulation of various body parts for pain management and improvement in the nervous, skeletal and muscular systems.  There may be partial coverage for type of care under your medical plan, so those benefits should be exhausted first.   Please review the Chiropractic Service Fee Schedule for a complete list of fees for this care.
  • Massage Therapy:  This is soft tissue manipulation that is helpful for pain management and relief.
  • Naprapathic Medicine:  This is manual medicine nutritional counseling and therapy for pain management caused by connective tissue disorders.

Assisted Living Services

  • Meals on Wheels:  this is a home delivery of meals for those who are home bound or otherwise unable to obtain proper nutritional meals on their own.  This program enables those members to retain independence, improve health and stay at home
  • Non-Medical Home Health Care:  This service enables seniors to remain at home for as long as possible.  Most of these services are not reimbursed by Medicare, but are designed to help seniors with daily, non-medical activities such as bathing, transferring, transportation, light cleaning and meal preparation.

Fitness and Weight Management

  • New Mexico Sports and Wellness has five facilities throughout Albuquerque that are fully equipped with cardiovascular equipment, weight lifting/strength training equipment and multiple classes for fitness and well-being.
  • Yoga:  this is a therapy which helps increase strength and flexibility while helping detoxify the body.
  • Fitshop:  this helps members achieve fitness goals by providing individualized nutrition plans designed to accommodate individual schedules and goals.
  • Jenny Craig Weight Management:  this is a comprehensive weight management program where members learn how to eat foods they want, develop a healthy and enjoyable eating style, increase energy levels through simple activity and bring more balance into their lives.

 

 

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