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:

For more information, contact AmeriHealth Caritas VIP Care Plus at 1-888-667-0318 (TTY 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
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 six 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

* New 2024 dental benefits *

$0 copay for sealants, once every three years, if criteria are met

$0 copay for indirect restorations (crowns), covered once every 5 years per tooth, if criteria are met

$0 copay for root canal therapy/re-treatment of previous root canal

$0 copay for comprehensive periodontal evaluation

$0 copay for scaling in presence of inflammation

$0 copay for periodontal scaling and root planning

$0 copay for other periodontal maintenance

We pay for some dental services when the service is an integral part of specific treatment of a beneficiary's primary medical condition. Some examples include reconstruction of the jaw following fracture or injury, tooth extractions done in preparation for radiation treatment for cancer involving the jaw, or oral exams preceding kidney transplantation.

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 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:

  • $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.
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.

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).