Using your extra benefits
Did you know plans offered by Sentara Medicare are all-in-one plans? That means dental, vision, hearing, and other extra benefits are built into our plans to give you more! Read the information below and learn how to use and access your Extra Benefits.
Refer to your Evidence of Coverage for extra benefits specific to your plan.
For illnesses or injuries that happen after hours or when your doctor’s office is closed, you can call the 24/7 Nurse Advice Line at 1-800-394-2237 (TTY: 711). You will talk with a professional nurse trained in emergency or acute care. They will be able to assess your medical situation, advise you as to where to seek care, and suggest self-care options until you can see your doctor.
Please note: The nurse will not have access to your medical records, cannot diagnose medical conditions, order lab work, write prescriptions, order home health services, or initiate hospital admissions.
During an Annual Physical Exam, your Primary Care Provider (PCP) reviews your current health history. The Annual Physical Exam benefit includes a comprehensive physical examination and evaluation of the status of chronic diseases. This is available at no cost to you and is a more in-depth look at your current health than an Annual Wellness Visit. Both types of appointments should always be scheduled and can be completed on the same visit – just let your provider know when you make the appointment.
Limit of one Annual Physical Exam per calendar year.
This exam may include diagnostic tests and additional cost share may apply if these tests are performed.
You may obtain up to two bathroom safety devices in a calendar year through NationsBenefits®. This benefit is separate from your Over-the-counter (OTC) benefit and does not take away from your OTC allowance.
Some of the eligible products include safety bars, shower mats, bath safety bench, handheld shower head, and more. You can order your bathroom safety devices online at SentaraMedicare.NationsBenefits.com, or by phone at 1-877-438-7521 (TTY: 711), 8 a.m.–8 p.m., 7 days per week. Your items will be delivered to your home at no additional cost.
Coverage of 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. You must use a provider in our network to use this benefit. You can search for a provider on our webpage at sentarahealthplans.com/findadoc.
Both preventive and comprehensive dental services are available with your Sentara Medicare plan. Plus, you will have access to a quality dental network through our partner, DentaQuest.
Preventive dental - covers cleanings, fluoride treatments, X-rays, and oral exams with a $0 copay.
Comprehensive dental allowance - covers fillings, extractions, and many additional enhanced services.
You have access to health education in the form of video, audio, written, and online materials. Visit our website at sentarahealthplans.com/medicare and type your area of interest into the search bar to find all the articles our website has on that topic. Health education is also available in-person and by phone through our staff of registered nurses, dietitians, and certified health education specialists. Appointments may be required. For more information, call Member Services at 1-800-927-6048 (TTY: 711), October 1 through March 31, 7 days a week, from 8 a.m. to 8 p.m. or April 1 through September 30, Monday.
Your hearing benefits gives you a $0 copay for a routine hearing exam every year. If hearing aids are needed, we provide free fittings and an allowance of up to $2,000 per year for a set of hearing aids. Your benefit also includes a 12-month warranty, one-time replacement coverage, and a one-year supply of hearing aid batteries.
There are two convenient options to access your hearing benefit.
- Call NationsHearing® to schedule a hearing test with a local provider. If you need hearing aids, use your allowance to order them and work with your NationsHearing provider for proper fit and tuning.
Call: 1-877-438-7521 (TTY: 711), 7 days per week, 8 a.m. to 8 p.m.
- Access Online hearing tests from your computer or mobile device and receive a digital record of your hearing test results. If you need hearing aids, use your allowance to order them from NationsHearing and connect with an online representative for remote tuning.
This in-home, non-medical benefit connects members with a network of friendly Pals to help with basic daily activities, including:
- board games
- grocery shopping
- light housework
- meal preparation
- tech help
- pet help
Pals are available to you for a maximum of 90 hours per year. To take advantage of this service call 1-855-481-7267 (TTY: 711), 8 a.m.–11 p.m., 7 days per week, 365 days per year to request your Papa Pal.
This benefit is available to eligible members after an inpatient hospital or skilled nursing facility stay.
Eligible members receive up to 56 ready-to-heat meals per discharge; 2 meals/day for 28 days including breakfast and lunch/dinner.
All meals have been designed by nutritionists to ensure members’ well-being and include dietary preferences such as: general wellness, low sodium, diabetic, vegetarian, pureed, and kosher.
Meals are prepared fresh and shipped in insulated boxes.
Prior authorization is required by a health plan care coordinator upon discharge.
If you have a qualifying chronic condition, you may receive a grocery allowance* through NationsBenefits® to use toward thousands of healthy options using a prepaid flex card.
Complete. Fill out the required Health Condition Questionnaire and self-attest to at least one of the eligible chronic conditions. You can complete the questionnaire and see the list of eligible conditions online in the NationsBenefits member portal at SentaraMedicare.NationsBenefits.com or by calling NationsBenefits Customer Service at 1-877-438-7521 (TTY: 711). The Health Conditions Questionnaire is different from the Health Risk Assessment (HRA) you were asked to complete at the time of your enrollment.
Shop Online. You don’t have to wait to receive your prepaid flex card in the mail to start using your allowance. You can order non-perishable grocery items in the NationsBenefits member portal as soon as your balance is loaded. Home delivery through NationsBenefits has no additional cost.
Shop in Stores. You can use your allowance at retail locations that operate as grocery stores including Food Lion, Harris Teeter, Kroger, and Walmart.
Once you have qualified for the grocery allowance, you will receive a prepaid flex card by mail within 14 days loaded with the applicable allowance amount. Activate the card by visiting SentaraMedicare.NationsBenefits.com/Activate or calling 1-877-205-8005 (TTY: 711), 24/7/365.
If you already have a prepaid flex card, the applicable grocery allowance will be loaded to your existing card within 72 hours of submitting the Health Condition Questionnaire and being approved.
The grocery allowance will reload on the first of the month and expires at the end of the month. Unused funds do not carry over to the next month. Your grocery allowance cannot be used to pay for non-grocery items such as alcohol, tobacco, or firearms, and it cannot be converted to cash.
Do you have questions about how to use or activate the card or have a balance inquiry? Visit your NationsBenefits member portal or call NationsBenefits Customer Service at 1-877-438-7521 (TTY: 711), 8 a.m.–8 p.m., 7 days per week.
Your Sentara Medicare plan can help keep more money in your pocket when you take advantage of your OTC quarterly allowance.
Purchase a wide selection of non-prescription drugs, supplies, and healthcare products through the plan’s catalog of items. You must spend your allowance each quarter. Leftover funds cannot be carried over to the next quarter.
Order online or by phone at 1-877-438-7521 (TTY: 711), 8 a.m.–8 p.m., 7 days a week.
PERS lets eligible members call for help in an emergency by pushing a button. The service is available 24/7. Eligible members must have a working landline and/or cellular phone coverage to take part in this benefit. Prior authorization is required.
Benefit availability, number of visits, and copays vary by plan.
To find a podiatrist in our network, visit our find-a-doctor webpage at sentarahealthplans.com/findadoc.
Sentara Medicare members are covered for a fitness benefit through SilverSneakers online and at participating locations*. Through this benefit members:
- have access to a nationwide network of participating locations
- 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:
- SilverSneakers LIVE classes
- SilverSneakers On-Demand videos
- SilverSneakers GO mobile app
For more information, contact SilverSneakers® at 1-888-423-4632 (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m.
*Participating locations ("PL") are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL. Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location. Get active with SilverSneakers® fitness programs.
Routine medical transportation
We provide one-way rides to and from health-related locations, such as doctor appointments and the pharmacy.
Non-medical transportation is available for members with chronic conditions to plan-approved locations such as churches, grocery stores, senior centers, and plan-sponsored events.
To schedule a ride
Call Sentara Medicare Member Services at 1-800-927-6048 (TTY: 711)
October 1 - March 31 | 7 days a week | 8 a.m. - 8 p.m.
April 1 - September 30 | Monday - Friday | 8 a.m. - 8 p.m.
Please call at least three business days in advance to arrange transportation.
Trips over 50 miles require authorization. Number of trips vary by plan.
Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit. This benefit is not available to Sentara Medicare Prime (HMO) or Sentara Medicare Savings (HMO) members.
Your $0 copay telehealth benefit allows you to schedule appointments with a local, in-network doctor board certified in internal medicine, family practice, emergency medicine, or a counselor or psychiatrist.
can be held over the phone or through video using your computer or smartphone. These doctors can diagnose, treat, and write prescriptions for routine medical conditions.
Appointments are available 24 hours per day, 7 days per week. For more information, visit our website at sentaramedicare.com/members/health-and-wellness/health-resources/mdlive.