Member Newsletter
Medicare Advantage
Great news: your over-the-counter card is worth more in 2023
Who doesn’t like extra money? WellSense knows every little bit can help. That’s why we’re increasing your over-the-counter (OTC) card benefits by $100 next year, from $125 every three months ($500 total) to $150 ($600 total).
Your money will be loaded onto your OTC card in January, April, July and October. It can be used at several retailers for everyday wellness supplies like select first aid supplies, dental care supplies, fiber supplements, vitamins and more.
A full list of eligible purchases and participating stores is available on your plan’s benefits page. So if you haven’t used it yet, be sure to use the final $125 for 2022 on your next visit to a participating retailer, and don’t forget to use your full $600 next year.
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.
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. Some people are at a higher risk of having serious flu complications than others.
Getting a flu shot is especially important for:
- Children under 2 years old
- Seniors over 65 years old
- Those with chronic health conditions
- Those who are pregnant
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.
Coming to your plan in 2023: SilverSneakers®
Starting Jan. 1, SilverSneakers will be available at no cost to all WellSense Medicare Advantage members to help them live their most active lives.
SilverSneakers offers a variety of fitness programs to fit many different needs, including online fitness classes, on-demand videos and in-person access to thousands of gyms across the country. While many of SilverSneakers’ services are aimed at older adults, most are appropriate for people of any age.
This new benefit replaces our current fitness benefits,
which require members to submit reimbursement forms for fees at fitness centers.
Dental
As a WellSense Medicare Advantage member, you have access to dental benefits designed to ensure you get the coverage you need to stay healthy. These include two dental exams and cleanings per year, dental x-rays and comprehensive coverage up to $750 per year. Comprehensive dental includes non-routine services, diagnostic services, restorative services, endodontics, periodontics, extractions and other services.
Vision
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. Your WellSense
plan covers one eye exam and $200 for eyewear
every two years.
Use the link below to find a vision provider in your area. You can request a printed list of providers near you by calling Member Services at 855-833-8128.
- 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.
We’re here to help
- Member Services: 855-833-8128
- Fraud Hotline: 888-411-4959
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