Extra benefits: Better when you maximize your Medicare and Medicaid coverage

Members with a qualifying chronic condition may receive an Essential Benefits Allowance on a prepaid flex card¹,² to use for groceries, over-the-counter (OTC) products, and qualified utilities. 

The Sentara Essentials Flex Card is automatically loaded at the beginning of each month. Unused amounts expire at the end of each month. 

Groceries

Members can use their Essential Benefits Allowance toward thousands of healthy food options like fresh meats, seafood, fruits, vegetables, dairy products, pantry staples, and more.
Members can use the allowance to purchase groceries at retail locations that operate as grocery stores including Food Lion, Harris Teeter, Kroger, and Walmart or order non-perishable grocery items through a member portal.

Over-the-counter products

Members can use their Essential Benefits Allowance to purchase non-prescription OTC drugs and health-related items like vitamins, sunscreen, pain relievers, cough and cold medicine, bandages, and more at retail locations and through a member portal.

Utilities

Members can use their Essential Benefits Allowance to pay for qualifying utilities each month. Members will use the benefit by going through their utility provider.
The Sentara Essentials Flex Card is automatically loaded at the beginning of each month. Unused amounts expire at the end of each month.

Members have comprehensive and preventive coverage with access to a quality dental network. 

• Preventive dental gives you a $0 copay for two exams, cleanings, and fluoride treatments every 12 months, 1-4 bitewing X-rays every 12 months, and 1 full-mouth X-ray every 36 months.
• Members can apply the comprehensive dental allowance to services such as fillings, dentures, endodontics, and extractions.

The hearing benefit gives members a $0 copay for a routine hearing exam every year. If hearing aids are needed, members get free fittings and an allowance for a set of hearing aids.

Sentara Medicare members are covered for a fitness benefit through SilverSneakers online and at participating locations³. Through this benefit, members have access to:

• A nationwide network of participating gym and community locations with group fitness classes at select locations - enroll in as many as you’d like
• SilverSneakers LIVE online classes and workshops led by specially trained instructors, offered 7 days a week, morning, afternoon and evening
• SilverSneakers On-Demand 200+ online workout videos available 24/7
• SilverSneakers GO mobile app with adjustable workout plans and more

Non-medical transportation

Members with qualifying chronic conditions receive non-medical transportation for trips to grocery stores, community events, senior centers, places of worship, etc.¹,⁴

Routine medical transportation

Transportation to plan-approved, health-related locations, such as doctor appointments.

Members who qualify receive home-delivered meals after an inpatient hospital or skilled nursing facility stay.

• The ready-to-heat breakfast and lunch/dinner meals are prepared fresh and shipped in insulated boxes.
• Low sodium, diabetic, vegetarian, pureed, kosher, and general wellness options are available.
• Members are shipped up to 56 meals (two meals per day for 28 days).

This in-home, non-medical benefit connects members with a network of friendly helpers. They can help with basic daily activities, including:

• Grocery shopping
• Meal preparation
• Light housework
• Errands
• Gardening
• Tech help 

Helpers are available to members for a maximum of 40 hours per year.

Members may order up to two bathroom safety devices each year through NationsBenefits online or by phone. 

• Some eligible products include safety bars, shower mats, bath safety benches, handheld shower heads, and more.
• This benefit is separate from the over-the-counter (OTC) benefit and does not take away from your quarterly OTC products allowance.

This benefit covers chiropractic services to help correct a subluxation (when one or more of the bones of the spine move out of position) using manipulation of the spine.

• Members must use a network provider. The provider list can be found under “Find a Doctor” on sentaramedicare.com/DSNP. 

Members can have a $0 copay health appointment over the phone or through video using a computer or smartphone at any time.

• Local, in-network doctors board-certified in internal medicine, family practice, emergency medicine, or a counselor or psychiatrist are available.
• The doctors can diagnose, treat, and write prescriptions for routine medical conditions.
• Appointments are available 24/7/365.

Members have access to our 24/7 Nurse Advice Line when minor illnesses and injuries occur after their doctor’s office has closed. We can help with things like:  

• Eye swelling or infection 
• Mild fever 
• Rash 
• Vomiting 

A professional nurse will answer the call, assess your medical situation, advise you where to seek care, and, if possible, suggest self-care options until you can see your doctor in person. 

Personal emergency response system (PERS) lets eligible members call for help in an emergency by pushing a button. 

• The service is available 24/7. Prior authorization is required for the PERS benefit.

All members have access to health education opportunities.

• Sentara Medicare registered nurses, dietitians, and certified health education specialists help members learn about healthy living.
• Health education opportunities include written materials, video, audio, in-person, telephonic, or online resources.
• Appointments may be required.

Members with a qualifying chronic condition may receive a monthly grocery allowance on a prepaid flex card.¹ We partner with NationsBenefits® to give you thousands of healthy options.

Using your grocery allowance:

• Shop approved groceries at participating stores such as Food Lion, Kroger, and Walmart.

• Order online from the NationsBenefits member portal or by phone. They will deliver your items at no additional cost.

Members will have to re-attest to their chronic condition and be verified each year. The grocery allowance cannot be used to pay for non-grocery items such as alcohol, tobacco, or firearms, and it cannot be converted to cash. 

The over-the-counter (OTC) products allowance gives members access to hundreds of health and wellness items and first-aid supplies.

• Your OTC allowance is loaded to your NationsBenefits account on the first day of each quarter. 
• Examples of OTC products through NationsBenefits include, but are not limited to: antacids, cold, flu, and allergy relief medicines, compression hosiery, denture care supplies, and toothpaste.

Members have comprehensive and preventive coverage with access to a quality dental network. 

• Preventive dental gives you a $0 copay for two exams, cleanings, bitewing X-rays, and fluoride treatments every 12 months, and 1 full-mouth X-ray every 36 months.
• Members can apply the comprehensive dental allowance to services such as fillings, dentures, endodontics, and extractions.

The hearing benefit gives members a $0 copay for a routine hearing exam every year. If hearing aids are needed, members get free fittings and an allowance for a set of hearing aids. 

• The benefit also includes a 12-month warranty, one-time replacement coverage, and up to a one-year supply of hearing aid batteries.

Sentara Medicare members have a fitness benefit through SilverSneakers online and at participating locations nationwide². Through this benefit, members:

• Can take classes and use exercise equipment and other amenities.
• Can enroll in as many locations as they like, at any time.
• Are connected with a support network and online resources through:

o SilverSneakers LIVE classes
o SilverSneakers on-demand videos
o SilverSneakers GO mobile app

Non-medical transportation

Members with qualifying chronic conditions receive non-medical transportation for trips to grocery stores, community events, senior centers, places of worship, etc.^1,3

Routine medical transportation

Transportation to plan-approved, health-related locations, such as doctor appointments.

Sentara Medicare members who qualify receive home-delivered meals after an inpatient hospital or skilled nursing facility stay.

• The ready-to-heat breakfast and lunch/dinner meals are prepared fresh and shipped in insulated boxes.
• Low sodium, diabetic, vegetarian, pureed, kosher, and general wellness options are available.
• Members are shipped up to 56 meals (two meals per day for 28 days).

This in-home, non-medical benefit connects members with a network of friendly helpers. They can help with basic daily activities, including:

• Grocery shopping
• Meal preparation
• Light housework
• Errands
• Gardening
• Tech help

Helpers are available to members for a maximum of 40 hours per year.

Members may order up to two bathroom safety devices each year through NationsBenefits online or by phone.

• Some eligible products include safety bars, shower mats, bath safety benches, handheld shower heads, and more.
• This benefit is separate from the over-the-counter (OTC) benefit and does not take away from your quarterly OTC products allowance.

This benefit covers chiropractic services to help correct a subluxation (when one or more of the bones of the spine move out of position) using manipulation of the spine.

• Members must use a network provider. The provider list can be found under “Find a Doctor” on sentaramedicare.com.

Members can have a $0 copay health appointment over the phone or through video using a computer or smartphone at any time.

• Local, in-network doctors board-certified in internal medicine, family practice, emergency medicine, or a counselor or psychiatrist are available.
• The doctors can diagnose, treat, and write prescriptions for routine medical conditions.
• Appointments are available 24/7/365.

Members have access to our 24/7 Nurse Advice Line when minor illnesses and injuries occur after their doctor’s office has closed. We can help with things like: 

• Eye swelling or infection 
• Mild fever 
• Rash 
• Vomiting 

A professional nurse will answer the call, assess your medical situation, advise you where to seek care, and, if possible, suggest self-care options until you can see your doctor in person. 

Personal emergency response system (PERS) lets eligible members call for help in an emergency by pushing a button. 

• The service is available 24/7. Prior authorization is required for the PERS benefit.

All members have access to health education opportunities.

• Sentara Medicare registered nurses, dietitians, and certified health education specialists help members learn about healthy living.
• Health education opportunities include written materials, video, audio, in-person, telephonic, or online resources.
• Appointments may be required.