Member Newsletter

Senior Care Options

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Why annual wellness visits are so important 

Going to an annual exam is one of the most important things you can do to manage your health. These once-a-year checkups give you and your healthcare provider a snapshot of your overall wellness. When you know where your health stands it is much easier to keep track of any changes. As a member of WellSense, your annual visits are covered at no cost to you. The best way to schedule your annual wellness visit is to contact your primary care provider (PCP). If you do not know who your PCP is or want to choose a new one, call Member Services at 855-833-8125.

Your PCP is the healthcare provider

you chose or who was assigned to you by WellSense to help you manage your non-emergency, day-to-day health needs. If you need to see a specialist or have a procedure done, your PCP can help you set up those appointments too.

Your wellness visit is also a great time to ask
your PCP any questions you might have about your health. They can teach you ways to stay healthy and manage your risk for conditions like high blood pressure or diabetes. 
If you need urgent or after-hours care
call our 24/7 Nurse Advice Line at 855-833-8125. Call 911 if you need emergency care for chest pain, bleeding that won’t stop, poisoning or drug overdose. For a mental health and/or substance abuse crisis, call our hotline, 24/7 at 888-217-3501.

See friends and family or run an errand with free social rides

Studies show that maintaining strong social relationships keeps you happier, healthier and living longer. That’s why your WellSense plan provides rides to see friends or family or even just to run errands, and they’re available at no cost to you. There’s no better time to start using your social rides than right now during the holiday season. 

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  • Your rides in 2022:  Two rides per month to any destination up to 10 miles away.
  • Your rides in 2023:  Eight rides per month up to 15 miles away.
  • Each ride you use is a one-way trip (going to an event and then back to your home would count as two rides.)
  • Extra stops are no problem, but you must use another ride from your monthly tally.

Get the most from your health plan with routine dental and eye appointments

It’s important to see your dentist regularly. Dental checkups are the best way to keep your teeth healthy. The American Dental Association says to visit your dentist every six months. WellSense is here to cover both of those visits each year at no cost to you.

Regular eye exams are also important. They can help find eye diseases early and preserve your vision. Eye diseases are common, but they can go unnoticed for a long time.

Annual, routine eye exams are covered once per year for in-network providers. Your WellSense Senior Care Options plan also provides you with an extra benefit of $325 per year for glasses, lenses, frames or contact lenses. Please call Member Services at 855-833-8125 for assistance locating a provider.

Dental
To find a dentist, visit DentaQuest.com
  1. Click on "Find a Provider"
  2. Click on "Medicare/Medicaid"
  3. Click on "Choose a location and plan"
  4. Enter your ZIP code
  5. Confirm your location by clicking on "Yes, this is correct"
  6. Select "WellSense Health Plan (formerly BMC HealthNet Plan SCO)" under the "Medicaid/Medicare" heading
  7. Click on "Confirm selection"

You can now use the various search functions to find the right dentist for you.

Find a Dentist

Stay safe from the flu and COVID-19 this winter

Winter is peak flu season, so you may be wondering how to stay healthy while more and more people return to “normal.” Though many of the public safety measures in response to COVID-19 have gone away, there are still things you can do to avoid getting sick.

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Flu vaccine

The best way to protect yourself during flu season is to get a yearly flu vaccine. Flu vaccines are safe and effective. They can help you avoid getting the flu. They also help you not get as sick if you do catch it. Seniors like you who are over 65 years old are at a higher risk of serious flu complications. You are at even greater risk if you have a chronic health condition. Because you are at a higher risk, getting your flu shot each year is an especially important way to protect your health

You can ask your usual healthcare provider about getting vaccinated against the flu at their office. You can also get flu vaccines at any pharmacy or clinic in your community that accepts your WellSense insurance.

COVID-19 vaccine and booster

For COVID-19, vaccines and boosters are also effective tools to help protect you from getting seriously ill. Staying up to date with the latest vaccines and boosters is the best way to protect yourself against new strains of COVID-19. Even people who have had the virus before can benefit from getting vaccinated.

COVID-19 vaccines and boosters are available at no cost to you no matter where you get them. You may be asked to provide insurance information, but you will not be charged. Even those without insurance can still receive a COVID-19 vaccine at no cost.

  • Preventive services
  • Fluoride treatments for members of all ages
  •  Dental sealants for members younger than 21
  • Pain relief and treatment of infections 
  • Fillings and crowns
  • Root canal treatment

What you can do about fraud, waste and abuse

When it comes to healthcare, we all like to think that everyone is doing their best to do the right thing. After all, people need to trust their care providers to look out for their health. That’s why WellSense wants you to know how you can help us keep everyone involved in your healthcare honest by reporting fraud, waste or abuse whenever you experience it.

In a healthcare setting, fraud is a kind of stealing where people lie about things for financial gain, like if you or WellSense ever get charged for services you never received. Waste is when medical services are deliberately overused, like if you are scheduled for extra appointments that aren’t needed. Abuse is when, typically by accident, someone causes services to be paid for that are not needed or not correct.

How to report suspected cases of fraud, waste or abuse

Reporting fraud, waste and abuse to WellSense can help us make sure all our members receive the right care at an affordable cost. If you suspect fraud, waste or abuse, please report it immediately to our confidential compliance hotline at 888-411-4959. Calls to this number are toll-free, and the hotline is available 24 hours a day, 365 days a year.