Additional benefits

We know taking care of your overall health is important to you. That is why we offer our members additional benefits that are not covered by Original Medicare. If you have any questions, call Member Services at 602-586-1730 or 1-877-436-5288 (TTY 711), 8:00 a.m. - 8:00 p.m., 7 days a week for more information.

Learn about these additional benefits for 2020:

Sometimes you need a little adjustment. Mercy Care Advantage covers the following Chiropractic care NOT covered by Medicare*: 

  • 12 supplemental routine visits every year at $0 copay

*Medicare-covered chiropractic visits are for manual manipulation of the spine to correct subluxation (a displacement or misalignment of a joint or body part).

Keeping your teeth healthy is a key part of good overall health. Mercy Care Advantage offers the following dental benefits, that are not covered by Original Medicare.

Our preventive dental benefits include the following services for $0 copay:

One (1) cleaning every six months
One (1) fluoride treatment every six months
One (1) oral exam every six months
One (1) X-ray per year
One (1) full mouth/Panorex X-ray every three years from the date of last Panorex X-ray

Also, included is comprehensive dental benefit coverage with a $4,000 annual benefit allowance. The comprehensive dental benefit allows Mercy Care Advantage members to receive the following services without a copay up to the $4,000 annual benefit allowance.

Extractions
Root canals
Gum treatments
Fillings

No prior authorization required.

Dental providers are contracted with DentaQuest. Members may select a dentist participating in the DentaQuest network by contacting Member Services.

If you need a bit of technology to help you talk with friends, listen to music and enjoy all of life’s sounds, Mercy Care Advantage members receive the following benefit NOT covered by Medicare:

Routine hearing exam (for up to 1 every calendar year): $0 copay
Hearing aids – up to $1,700 every two years at $0 copay

After each discharge from a hospital stay, you are eligible to receive a shipment of 14 frozen, packaged meals from Mom’s Meals. Meal variety supports chronic health conditions. The meal selection will be coordinated during the hospital discharge planning process.

Meals will be delivered to your residence within 24-72 business hours following Mom's Meals receipt of authorization form with meal selection. Signature is required at time of delivery. Mom's Meals will make a welcome call within 24-48 hours to schedule your meal delivery date.  They will make an additional call on the day of scheduled delivery to confirm your meals are on their way.  If FedEx is unable to deliver, they will make one more delivery attempt the following day.  For information about accessing this benefit, please call Member Services.

Sometimes you have health-related questions when the doctor’s office is not open. You do not have to wait for the doctor’s office to open to get your questions answered. You can call our Informed Nurse Health Line to talk to a registered nurse, Monday through Friday, 6:00 p.m. to 7:00 a.m., and Saturday and Sunday, 24 hours.

Call Mercy Care Advantage Member Services and select the option to speak to a nurse in after-hours messaging.

It’s easy to save money and stay healthy with Your Personal Health and Wellness Shop! 

As a Mercy Care Advantage member, you will have $60 dollars a month to purchase over-the-counter (OTC)* non-prescription drugs and personal health and wellness products. This additional benefit lets you order products from the comfort of your home.  Our partner, OTC Health Solutions, will ship your products ordered by phone or online at no cost to you!  OTC items are also available at select CVS Pharmacy retail locations.

Examples of OTC drugs and other health and wellness items available through the program are:

  • Blood pressure monitor
  • Cough/cold/allergy
  • Digestion/laxatives/antacids
  • First aid
  • Pain relief (aspirin, ibuprofen, and naproxen)
  • Skin care
  • Vitamins

Generics = bigger savings for you

You can get up to $60 dollars a month of quality, generic products. Generic products offer the same FDA-approved, safe and effective ingredients as brand name medications at lower costs. You can find a list of available items and the cost of each item in the 2020 OTC catalog.

How to get OTC products:

  • By Phone - Call OTC Health Solutions toll free at 1-833-331-1572 to place your order. You’ll need to provide your name and member ID when you call.
  • Online Ordering –Place your order using OTC Health Solutions online ordering system
  • New for 2020 - Products will be available at select CVS Pharmacy locations. View the list of CVS pharmacies where you can use your benefit. View information about using your benefit at a CVS Pharmacy.

When ordered by phone or online, you should expect to receive your package within 10-15 days from the date you place your order.

  • You may only select products once per month, whether you decide to order by phone, online or get products at a select CVS Pharmacy location.
  • Any amount you do not use will expire at the end of each month.
  • Each item is limited to 5 per order.  The only exception is Blood Pressure Monitors which are limited to one per calendar year.

Have questions? We can help!

Contact OTC Health Solutions toll free at 1-833-331-1572 for general questions, product information and order status.

You can call Mercy Care Advantage Member Services with questions about Your Personal Health and Wellness Shop benefit or concerns with OTC Health Solutions.

*Over-the-counter drugs are medicines that you can buy without a prescription. They are used for the treatment of minor health problems. They are safe and effective when you follow the directions on the label and as directed by your health care professional.  Products are for member use only, not for use by others (friends, family members, etc.).

Keep those feet healthy! Mercy Care Advantage offers the following podiatry care NOT covered by Medicare:

One (1) supplemental routine visit every three months at $0 copay

What is Telehealth? Telehealth is the use of technology to deliver health care, health information or health education at a distance. It enables a health care practitioner and a patient to interact via two-way video and audio transmissions at the same time. We have contracted and are partnering with MDLIVE to provide the telehealth benefit.

Members must register at mdlive.com/MCA and create an account to use this service. Appointments can be scheduled 24 hours a day, seven days a week via the MDLIVE website or by calling the MDLIVE customer service department at 1-888-918-1760, (TTY users call 1-800-770-5531). Once a member has set up an MDLIVE account, they can browse doctor profiles, view available appointment times and schedule an appointment with the doctor of their choice. Video consultations take place from 7:00 a.m. to 9:00 p.m., 7 days a week or by scheduled availability. The MDLIVE provider network can change at any time.

To receive a video consultation, you must have an Arizona address and be located within the state of Arizona at the time of the appointment. Arizona law only allows for telehealth services to be conducted via secure online video. Phone-only consultations are not permitted.

 

Our plan covers routine transportation services for the supplemental benefits covered by Mercy Care Advantage. Our plan will cover up to 26-one way trips or 13-round trips every calendar year.

You can only use this transportation service to access the following Mercy Care Advantage supplemental benefits:

  • Chiropractic
  • Dental
  • Hearing Aids
  • OTC items at select CVS pharmacies
  • Podiatry
  • Vision
  • Wellness programs

In order to provide you with better service, we encourage a 3-day advance notice for transportation requests whenever possible. If you call the same day of your appointment, we may not be able to arrange a ride for you in time for your appointment. You may have to reschedule your appointment or have a family member or friend provide transportation.

To keep your eyes in the best health, Mercy Care Advantage pays for the following vision services NOT covered by Medicare:

  • One (1) supplemental routine eye exam per year at $0 copay
  • Eyewear – $275 allowance for lenses, eyeglass frames, and contacts every two years

Mercy Care Advantage has arranged a unique wellness program through the Foundation for Senior Living. The program offers:

  • Exercise classes for all fitness levels
  • A “Quit Coach” to help you quit smoking (smoking cessation)
  • Nutrition education with a registered dietician
  • Diabetes prevention and education with a Diabetic Educator

The wellness program is offered at multiple locations throughout our service area. Please call the numbers below to register for one or more of our programs in your county:

  • Maricopa County: 602-285-0505, ext. 321 or ext. 177
  • For all other Arizona counties: 1-866-375-9779, ext. 321 or ext. 177

Monday – Thursday: 8:00 a.m. – 8:00 p.m., Friday: 8:00 a.m. – 5:00 p.m.

This information is not a complete description of benefits. The formulary, pharmacy network and/or provider network may change at any time.  You will receive notice when necessary. You must receive all routine care from plan providers. This is general health information and is not meant to replace care or advice you get from your doctor. Always ask your doctor or other health care provider for information about your own health care needs.

Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Mercy Care Advantage. The availability of any particular provider cannot be guaranteed, and the provider network is subject to change. You will receive notice when necessary.

 

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Last Updated: 12/10/2019