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:

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.

  • Bitewing X-rays, one time in a 12-month period.
  • A panoramic X-ray, one time every five years.
  • A full mouth or complete series of X-rays, one time every five years.

$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:

  • $0 copay for adult day programs.
  • $0 copay for assistive technology.
  • $0 copay for chore services.
  • $0 copay for environmental modifications.
  • $0 copay for expanded community living supports.
  • $0 copay for fiscal intermediary services.
  • $0 copay for home-delivered meals.
  • $0 copay for non-medical transportation.
  • $0 copay for preventive nursing services.
  • $0 copay for private duty nursing (PDN).
  • $0 copay for respite care services.
    Authorization rules apply.

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).

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Enrollment 2023