Assistance for Asthmatics

Receive mattress covers and pillowcases that help eliminate dust mites for people with asthma.

Copayments

Our members pay nothing for preventive care or annual checkups covered by our plan.

Diabetic Support

If you have diabetes, we'll help make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best.

Our diabetes program also includes self-care training and classes focused on:

• Planning healthy meals.
• Managing stress.
• Living a healthy lifestyle.

Disease Management

If you have chronic or high-risk illnesses, our disease management services are designed to support you.

We have special programs for:

• Congestive heart failure
• Asthma.
• Chronic obstructive pulmonary disease (COPD).
• Coronary artery disease.
• Cancer.

Durable Medical Equipment

Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:

• Breast pumps.
• Orthotics.
• Wheelchairs or walkers.

Health Education

Take free classes to help improve your health or to address a condition.

Our plan includes classes on diabetes, nutrition and more. You can even get a ride, if needed, to and from the class at no cost to you.

Healthy Rewards

An ounce of prevention can be worth a pound of cure. It can also be worth great rewards.

Earn great gifts for you or your child by doing things like:

• Completing well-child exams.
• Getting lab tests.
• Recording the family's health activities.

Hearing Care

Trouble hearing can affect a person's everyday life in many ways. Our plan includes services and support to help protect your hearing.

We cover:

• Exams, therapy and tests.
• Hearing aids and batteries for children up to age 19.

Hospitalization

Some members have a small copay.

Our plan covers:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

And after leaving the hospital, a member is not alone. We make sure the follow-up care is available to continue healing at home.

In-Home Care

After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. You may even need an in-home medical visit to check on how well you are healing. With approval, our plan covers:

• An in-home medical visit.
• Medical equipment like hospital beds, walkers or wheelchairs.
• Disposable medical supplies.
• Help with personal care.

Interpreters

Your doctor and you need to understand each other. Speaking English as a second language can make this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Kidney Disease Care

Kidney disease is a serious medical condition. After the kidneys stop working, regular treatments (called renal dialysis) or an organ transplant are necessary. Dialysis uses a machine to clean the blood, just like healthy kidneys do.

Our plan includes:

• Dialysis.
• Medications.
• Health education and support.
• Organ transplant if needed.

Lab and X-rays

Knowing what’s wrong and finding it early can make all the difference.  Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We’ll help you get the information needed to improve your health or be at your best.

Language Help

You can get information in another language. Just ask. Then anything we write to you will only be in that language. This is provided at no cost to you.

Member Advocates

We're looking out for you. Member advocates can help solve problems, provide training and education, and work on issues that concern members. Our member advocates can be reached at 1-844-752-9434 and are available M-F 8 a.m. - 8 p.m. ET.

They can:

• Provide information about your plan.
• Teach you to get the care you need.
• Help with doctor issues or complaints.

Member Services

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call at 1-844-752-9434, M-F 8 a.m. - 8 p.m ET. We’ll answer your questions simply and completely.

We can also help you find:

• Home care providers.
• Dentists and vision providers.
• Specialists.

Mental Health

Mental health is as important as physical health. That's why we have coverage for both.

This includes:

• Behavioral therapy.
• Substance use treatment.
• Medications.

Mobile Lab

Now your child can get any kind of blood test needed at home.

Our mobile lab brings the lab to your home. In addition to convenience, the mobile lab offers:

• Accurate test results.
• Comfortable setting for members.

No Copays

There are no copayments for:

• Preventive care.
• Annual checkups.

There is never a copayment for prescription drugs, medical, or vision care.

While your family’s health care is low-cost or free, the care quality is high. You get:

• Visits to doctors in our network.
• Treatments at hospitals and clinics.
• Prescription drugs and over-the-counter medicines.

NurseLine℠

Medical questions and situations can come at inconvenient times. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week at 1-800-842-3014.

Our nurses will: 

• Listen to the symptoms.
• Help with self-care.
• Advise you about getting care at a doctor visit or an urgent care center.
• Help you know when to go to the emergency room.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

• Provide medical care.
• Answer any questions and concerns.

Outpatient Services

Knowing what's wrong and finding it early can make all the difference for your child.

Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We'll help you get the information needed to help improve your child's health or be at his or her best.

Personal Care

Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:

• Dressing.
• Bathing.
• Feeding. 

Physical, Speech or Occupational Therapy

Physical, occupational and speech therapy can help you recover from a serious injury or illness, or simply reach his or her full potential. 

Therapies include:

• Occupational therapy.
• Physical therapy.
• Speech therapy.
• In-home therapy.

Prenatal Visits

A pregnancy is a journey with the help of friends, family and a pregnancy doctor, or OB-GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

• Make sure both mom and baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Quitting Tobacco

Most people know the bad health effects of smoking. And they know they need to quit. We support our members while they quit, with coaches and supplies. The only thing they won’t get from us is a lecture. Call Member services for information on our phone-based program to help you quit tobacco.

Rehabilitation Care

After a serious illness, surgery or injury you may need extra nursing and therapy. If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are: Included are:

• Nursing home services.
• 24-hour nursing care.
• Help with activities of daily living.
• Physical, occupational and speech therapy.

Shots and Vaccines

Routine shots help protect you from illness. So, our plan covers:

• Recommended shots and vaccines.
• Influenza shots. 

Social Services

Your Community Department of Social Services (DSS) offers additional information and resources for:

• Energy and Food assistance
• Child care or Child support
• Protective Services
• Other resources

Visit the main Virginia website to see all what is offered, how to apply, and how to find your local agency. Visit www.dss.virginia.gov or call the main state number at 804-726-7000 for more information.

Sports Physical

We encourage kids to take part in healthy activities like team or individual sports. We cover a sports physical each year for all school-aged members.

Urgent Care

You may have an injury or sudden illness that is not life-threatening but needs immediate attention. So our plan covers care at:

• Urgent care centers.
• Medical aid units.
• Other walk-in clinics.

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

• Screening for obesity.
• Support for healthy diet and exercise choices.
• Weight Watchers Vouchers

Well Visits

Well visits with your doctor are important for good health. These visits can catch health problems early, so they can be treated.

Preventive services include:

• Checkups for adults and children.
• Well-baby care.
• Care for women expecting a baby.
• Routine shots and tests.
• Mammograms and women's health services.

There are no copayments for preventive care.