Summary of Benefits
AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan) is a plan designed for people who have Medicare and MI Health Link Medicaid. Our health plan can help you get more from your coverage. And that means having a personal care team and a Care Coordinator to help you get the care you need.
Our large network of providers, hospitals, and pharmacies makes it easy for you to get care. Choose AmeriHealth Caritas VIP Care Plus and be treated like the VIP you are.
AmeriHealth Caritas VIP Care Plus provides:
- $0 copay for Plan-covered benefits.
- $0 copay for all prescription and over-the-counter (OTC) drugs on the formulary.
- Long-term services and supports waiver benefits to all members when medically necessary.
- Coverage for inpatient hospital care, as well as skilled nursing facility, and home health care services.
- A large network of providers, hospitals, and pharmacies.
Below is a brief summary of key benefits. You can also view:
- 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
- Mid-Year Member Handbook Notice PDF
- Spanish Member Handbook PDF
- Spanish Mid-Year Member Handbook Notice PDF
- A complete Annual Notice of Changes (ANOC) PDF
- The ANOC tells you about all plan changes in the next year.
- Annual Notice of Changes — Spanish (ANOC) PDF
For more information, contact AmeriHealth Caritas VIP Care Plus at 1-888-667-0318 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days a week.
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.|
$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.
$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.
$0 copay for unlimited round trip rides to a health-related location (scheduling rules apply).
$0 copay for home-delivered meals (authorization rules 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 for whom they are 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:
|Important message about what you pay for vaccines||
Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.
|Important message about what you pay for insulin||
You won't pay more than $35 for a one- month supply of each insulin product covered by our plan, no matter what cost sharing tier it is on. In most cases you will not pay more than $10.35 for a one-month supply of each insulin product.
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).