Benefits
You're a VIP. Discover the difference.
Our large network of providers, hospitals, and pharmacies makes it easy for you to get care. Choose AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan) and be treated like the VIP you are.
Summary of benefits
AmeriHealth Caritas VIP Care Plus provides:
- $0 copay for Plan-covered benefits.
- $0 copay for all prescription drugs in the formulary.
- Long-term services and supports waiver benefits if medically necessary.
- Coverage for inpatient hospital care, as well as skilled nursing facility 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 the complete documents below:
- Summary of benefits PDF
- Mid-Year Summary of Benefits Notice PDF
- Spanish Summary of Benefits PDF
- Spanish Mid-Year Summary of Benefits Notice PDF
- Member Handbook PDF May 30, 2023
For more information, call AmeriHealth Caritas VIP Care Plus Customer Care Advocates at 1-877-716-8694 (TTY/TDD 711), hours of operation are:
- 8 a.m. – 8 p.m. ET, Monday through Friday from April 1 – September 30
- 8 a.m. – 8 p.m. ET, seven days a week from October 1 – March 31
Find a provider in our network for the benefits listed below.
Premium | $0 monthly plan premium. |
---|---|
Doctor office visits | $0 copay for each primary care provider (PCP) visit. |
Dental services |
$0 copay for examinations and evaluations, one time every six months. $0 copay for cleaning, one time every six months. $0 copay for fluoride treatments, up to 6 applications per lifetime. $0 copay for X-rays.
$0 copay for fillings. $0 copay for tooth extractions. $0 copay for complete or partial dentures, one time every five years. |
Vision care |
$0 copay for routine eye examinations one time every two years. $0 copay for an initial pair of eye glasses. Replacement glasses are offered one time every year. $0 copay for contact lenses for people with certain conditions. $0 copay for basic and essential low-vision aids (such as telescopes, microscopes, and certain other low-vision aids). |
Over-the-counter (OTC) items |
Up to $75 per quarter may be spent for OTC items. Get more information from the OTC catalog (PDF). Money not spent in a quarter does not roll over into the next quarter. |
Transportation services |
$0 copay for unlimited round trip rides to a health-related location (scheduling rules apply). |
Home-delivered meals |
$0 copay for home-delivered meals (authorization rules may apply). |
Home health care |
$0 copay for home health visits (authorization rules apply). |
Home- and community-based waiver services (HCBS) |
HCBS benefits are offered to all plan enrollees when medically necessary. If you are not a waiver participant, you can receive HCBS waiver benefits through AmeriHealth Caritas VIP Care Plus if they are medically necessary for you. Waiver services include:
|
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 read the AmeriHealth Caritas VIP Care Plus Member Handbook (PDF).