Humana Dual Fully Integrated (HMO D-SNP) en Illinois

Beneficios

Information about the coverage and benefits available to Humana FIDE SNP members is available in your Member Handbook, Summary of Benefits, and Annual Notice of Changes

Una pareja de la tercera edad sentada a la mesa leyendo un folleto y el teléfono

Servicios dentales

El plan cubre hasta $500 anuales de servicios dentales integrales y preventivos que no están cubiertos por Medicare. Usted debe pagar cualquier monto que supere el límite de la cobertura dental. Los montos no utilizados a fin de año caducarán.

Su beneficio puede utilizarse para la mayoría de los tratamientos dentales, como estos:

  • servicios dentales preventivos, como exámenes, limpiezas de rutina, etc.
  • Servicios dentales básicos, como empastes, extracciones, etc.
  • Servicios dentales complejos, como raspado periodontal, coronas, dentaduras postizas, tratamientos de conducto, puentes, etc.

Nota: La asignación no puede utilizarse para tratamientos con flúor, servicios cosméticos e implantes.

Certain dental services, including cleanings, fillings, and dentures, are available through the Illinois Medicaid Dental Program.

We pay for some dental services when the service is an integral part of specific treatment of a person's primary medical condition. Examples include reconstruction of the jaw after a fracture or injury, tooth extractions done in preparation for radiation treatment for cancer involving the jaw, or oral exams prior to organ transplantation.

Prior authorization may be required.

Programa de acondicionamiento físico

SilverSneakers® is a fitness program for seniors that is included at no additional charge with qualifying Medicare health plans. Members have access to participating fitness locations across the country that may include weights and machines plus group exercise classes led by trained instructors at select locations. Access online education on SilverSneakers.com, watch workout videos on SilverSneakers On-Demand™ or download the SilverSneakers GO™ fitness app for additional workout ideas.

Su afiliación no incluye servicios que generalmente tendrían un cargo adicional en los centros de acondicionamiento físico.

Asignación para opciones saludables

$255 monthly allowance automatically loaded on a limited-use prepaid debit card to use at participating retail locations to buy eligible products from these categories:

Over the Counter (OTC) Allowance

  • Resfrío, gripe y alergia
  • Dental and denture care
  • Salud digestiva
  • First aid and medical supplies
  • Bladder control and incontinence supplies
  • Over-the-counter hearing aids
  • Analgésicos
  • Cuidado de la piel
  • Complementos para dormir
  • Productos para dejar de fumar
  • Vitamins and dietary supplement, and more

You will receive a new Humana Spending Account Card to access this benefit. This card is what you use to spend this allowance. Active su tarjeta apenas la reciba.

  • The allowance is available to use at the beginning of every month.
  • Whatever you don’t spend rolls over to the next month and expires at the end of the plan year or upon disenrollment from this plan, whichever occurs first.
  • Our plan is not responsible for unauthorized use of allowances due to lost or stolen cards.
  • As with any debit card, please keep this card in a safe place, like your wallet.
  • Please keep this card even after the allowance is spent as future allowance amounts may be added to this card if you remain on the plan.
  • Limitations and restrictions may apply

Download the free MyHumana® mobile app, available on the App Store® o Google Play®, or visit MyHumana.com to find stores or check your balance. You can also see the back of your spending account card for more information.

Cuidado de la vista

The plan covers the following:

  • annual routine eye exams
    • eyeglasses (lenses and frames)
    • frames limited to one pair in a 24 month period
  • lenses limited to one pair in a 24 month period, but you may get more when medically necessary, with prior approval
  • custom-made artificial eye
  • low vision devices
  • contacts and special lenses when medically necessary, with prior approval

To be eligible for reimbursement, some services may be subject to prior approval and/or medical criteria.

We pay for outpatient doctor services for the diagnosis and treatment of diseases and injuries of the eye. For example, this includes annual eye exams for diabetic retinopathy for people with diabetes and treatment for age-related macular degeneration.

For people at high risk of glaucoma, the plan covers one glaucoma screening each year. People at high risk of glaucoma include:

  • people with a family history of glaucoma,
  • people with diabetes,
  • African-Americans who are age 50 and older, and
  • Hispanic Americans who are 65 or older.

For people with diabetes, we pay for screening for diabetic retinopathy once per year.

We pay for one pair of glasses or contact lenses after each cataract surgery when the doctor inserts an intraocular lens. If you have two separate cataract surgeries, you must get one pair of glasses after each surgery. You cannot get two pairs of glasses after the second surgery, even if you did not get a pair of glasses after the first surgery. In addition, we cover Mandatory Supplemental Vision Benefits which include a routine vision exam and an allowance for eyewear.

*Prior authorization may be required.

For a comprehensive list of your benefits, please refer to your Manual para afiliados.

Humana Dual Integrated en Illinois

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