Supplemental Benefits

$0 copay

Our plan provides a prepaid Visa® debit card that helps reduce your out-of-pocket expenses for dental, vision, and hearing services.
With an annual maximum limit of  $1,000, you can allocate your benefit dollars as needed across these services. Any unused benefit dollars expire at the end of the year. It’s important to note that this benefit is not a substitute for supplemental dental, vision, or hearing benefits, but rather a way to offset certain expenses. To ensure coverage, please receive supplemental dental, vision, and hearing services from a participating provider within the plan.

The Silver&Fit^® Program Fitness Benefit

BCBSAZ Health Choice Pathway knows how important fitness is to our members. During this unprecedented health crisis, we want to support you with additional resources to keep you on track. With the Silver&Fit fitness benefit, we’ve got Something for Everyone^®, and is available right on the Silver&Fit website at SilverandFit.com.

The Silver&Fit Exercise & Healthy Aging Program provides you with the following services:

• You will receive a fitness center membership.
• Available fitness center types include full centers, basic coed centers, YMCAs, gender-specific centers, and exercise centers.
• Fitness advisors at Silver&Fit contracted centers will introduce you to the fitness center and assist you with enrolling.

Fitness Center Program. Silver&Fit gives you access to more than 16,500 fitness center locations across the country with all basic gym features. Many fitness centers may also offer group classes for older adults.

Get Started Program: By answering a few questions on the Silver&Fit website about your fitness goals, you will receive a customized exercise plan including instructions on how to get started and suggested online workout videos.

Home Fitness Kit. If you like to work out at home, you are eligible to receive one home fitness kit per benefit year from a variety of fitness categories.

Also, please remember these other helpful Silver&Fit resources:

• Mobile App with Fitness On-Demand Exercise Videos
• Fitness Activity Tracking
• Healthy Aging Coaching

For more information, or to register, please call Silver&Fit Customer Service at 1-877-427-4788, TTY: 711, Monday – Friday, 8 a.m. to 9 p.m. EST.

Silver&Fit Program Flier
English
(Updated - 01/01/2022 07:27 AM) | Spanish
(Updated - 01/01/2022 07:28 AM)

The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH).  All programs and services are not available in all areas.  Silver&Fit, Something for Everyone, and the Silver&Fit logo are trademarks of ASH and used with permission herein.  Limitations and restrictions may apply.  Other names and logos may be trademarks of their respective owners.  Kits are subject to change.  Participating facilities and fitness chains may vary by location and are subject to change.

With SilverSneakers^®, is more than a traditional fitness program. It’s an opportunity to improve your health, gain confidence and connect with your community.

At the gym:

• Many locations all around the country.¹
• You can sign up at multiple locations, whenever you want.
• There are classes for all skill levels and abilities.²

At home:

• SilverSneakers LIVE online classes and workshops led by specially trained instructors, happening every day.
• SilverSneakers On-Demand videos that you can watch anytime.
• Use the SilverSneakers GO mobile app for personalized resources, changing workout plans and more.

In your community:

• Get active outside of traditional gyms at recreation centers, parks and other neighborhood locations.
• Enjoy access to online GetSetUp³ classes on topics like cooking and nutrition, technology and brain games.

After January 1, 2024, make a free online account at SilverSneakers.com to see your Member ID and all the things you can use in the program without paying extra.

For additional questions, go to SilverSneakers.com or call 1-888-423-4632, TTY: 711, Monday through Friday, 8 a.m. to 8 p.m. ET.

Footnotes:

1. 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.
2. Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location.
3. GetSetUp is a third-party service provider and is not owned or operated by Tivity Health, Inc. (“Tivity”) or its affiliates. Users must have internet service to access GetSetUp service. Internet service charges are responsibility of user. Charges may apply for access to certain GetSetUp classes or functionality.

SilverSneakers and the SilverSneakers shoe logotype are registered trademarks of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved.

You have a $900 annual maximum combined allowance each year between In-Home Support Services, Home and Bathroom Safety Devices and Modifications, Support for Caregivers of Enrollees (Respite Care), and Home Repairs.

$0 copay for In-Home Support Services – Prior authorization may be required
Members have access to in-home support services, including cleaning, household chores, meal preparation, errands, light yard work, and assistance with other instrumental activities of daily living.

$0 copay for Home and Bathroom Safety Devices and Modifications.
This benefit will include temporary home modifications including ramps and adding grab bars and safety rails in the shower.

$0 copay for Support for Caregivers of Enrollees (Respite Care).

$0 copay for Home Repairs.
This benefit will include widening of hallways or doorways, permanent mobility ramps, easy use doorknobs and faucets. To qualify for this benefit, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have one or more of the following qualifying chronic conditions:

• Chronic heart failure (CHF)
• Chronic lung disorders
• Diabetes
• Post-Acute Sequelae of SARS CoV-2 infection (PASC)/Long COVID

You receive a $380 allowance every 3 months towards over-the-counter health items such as toothpaste, bandages, antacid, sunscreen, cold medicine, pain relievers, and much more!

Any unused benefit amount will roll over from the previous quarter however, it will expire in the following quarter if unused. The rollover dollars will be applied before the current period benefit amount. Members will never have more than twice their benefit to spend in any one quarter. Please note, any unused benefit amount from quarter 4 (October, November, December) will not carry over to the next plan year.

See 2024 Over-the-Counter (OTC) Healthy Food and Produce Card for coverage information

$0 copay for $600 every 3 months combined allowance for OTC products and Healthy Food and Produce. With this benefit, you’ll get a credit loaded to your Visa Debit Card each quarter to pay for covered groceries and OTC items.

Covered items include:

• Healthy foods like fruits, vegetables, meat, seafood, dairy products,
  water, and more.
• Brand-name and generic OTC products, like vitamins, pain relievers,
  toothpaste, cough drops, and more.

Maximum plan benefit coverage amount carries forward to the next quarter if it is unused, however, it will expire in the following quarter if unused. The rollover dollars will be applied before the current period benefit amount. A member will never have more than twice their benefit to spend in any one quarter. Any unused benefit amount from quarter 4 (October, November, December) will not carry over to the next plan year.

2024 OTC Catalog 
English
(Updated - 10/05/2023 03:54 PM) 
Spanish
(Updated - 10/05/2023 03:55 PM)

$0 copay 

Personal emergency response system (PERS), also known as medical alert systems, provide continuous in-home and mobile monitoring to aging and at-risk populations.

PERS allows members to call for assistance 24/7, whether at home or on the go.

• Members are immediately connected with professionally trained
  operators who quickly assess the nature of a call and coordinate
  appropriate assistance.
• A member experiencing a medical emergency presses a button to
  speak with an operator who immediately coordinates emergency
  dispatch.

$0 copay for 12 treatments every year

This benefit is in addition to the Medicare-covered Acupuncture. Benefit includes coverage for supplemental coverage for evaluation and management, acupuncture and acupressure, modalities, and therapeutic procedures for treatment of pain syndromes, musculoskeletal conditions, and nausea not covered by Medicare. Acupuncture services are delivered by participating American Specialty Health (ASH) providers.

$0 copay for 12 visits every year

This benefit is in addition to the Medicare-covered Chiropractic services. Supplemental coverage for evaluation and management, X-ray examination, chiropractic manipulative therapy, modalities, therapeutic procedures, and physical rehabilitation for musculoskeletal conditions of the spine & extremities. Chiropractic services are provided by a Doctor of Chiropractic – DC (“Chiropractor”). Chiropractic services are delivered by participating American Specialty Health (ASH) providers.

$0 copay for 6 visits every year

Includes Supplemental Benefit Coverage for preventive clinical services for the skin of the foot and toenail care, including removal of corns and calluses, nail trimming, and preventive foot hygiene. Routine Foot Care services are provided by a Doctor of Podiatric Medicine – DPM (“Podiatrist”). Podiatry services are delivered by participating American Specialty Health (ASH) providers.

If eligible, our plan offers a prepaid Visa® debit card with a limit of $30 or $100 dollars per month to help cover the cost of healthy food items. For a complete list of items, please refer to the Evidence of Coverage (EOC), Chapter 4, Section 2.1.

Not covered under SSBCI – See 2024 Over-the-Counter (OTC) Healthy Food and Produce Card for coverage information

If eligible, our plan offers a prepaid Visa® debit card with a combined annual limit of $1,000 to help reduce your out-of-pocket expenses for dental, vision, and hearing services. Your benefit dollars may be spent between dental, vision, and hearing as you see fit. Any unused benefit dollars will expire at the end of the year. This benefit is not a replacement for dental, vision, or hearing benefits and is designed to help offset certain expenses. See Evidence of Coverage, Chapter 4, Section 2.1, Benefit chart for additional information regarding this benefit and information regarding supplemental dental, vision, or hearing benefit limitations and maxes.

Not covered under SSBCI – See 2024 Dental, Vision, and Hearing Flex Card section for 2024 coverage

If eligible, our plan offers a prepaid Visa® debit card with a limit of up to $1,000 per year to help cover the cost of lodging after an eligible inpatient stay and certain utilities (electric, gas, sanitary, water, and/or telephone service).

Any unused Flex Card benefit dollars will expire at the end of the year. This benefit is for your use only, may not be sold or transferred, and has no cash value.

If eligible, our plan offers a prepaid Visa® debit card with a limit of up to $1,000 per year to help cover the cost of lodging after an eligible inpatient stay and certain utilities (electric, gas, sanitary, water, and/or telephone service).

To qualify, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have qualifying chronic conditions: Complications from prediabetes
or diabetes and/or recent hospitalization for diabetes or a medical condition worsened by pre-diabetes or
diabetes.

Any unused Flex Card benefit dollars will expire at the end of the year. The funds are intended for temporary accommodation following a qualifying inpatient hospital stay, rather than being allocated for rental or mortgage assistance. This benefit is for your use only, may not be sold or transferred, and has no cash value.

$0 copay for 6 visits every year

Supplemental coverage for therapeutic massage, including assessment, massage, or soft tissue work for treatment of myofascial conditions, musculoskeletal injuries, and pain syndromes. Therapeutic Massage services are provided by licensed providers of massage including licensed massage therapists – LMT, and can also be provided by physical therapists. Therapeutic massage services are delivered by participating American Specialty
Health (ASH) providers.