Every year, Medicare evaluates plans based on a 5-star rating system. Use of this website constitutes acceptance of the Terms of Service and Privacy Policy. Current members that experience unplanned transitions as a result of a change in treatment settings (e.g., such as moving from a hospital to a long term care facility, to home or to a skilled nursing facility or those leaving a skilled nursing facility) can request a formulary exception to continue their current non-formulary drug. What to Consider When Shopping for Medicare, VIVA Medicare Extra Care H0154-019 (HMO D-SNP), $0 or $235 per day for days 1 through 6 / $0 per day for days 7 through 90, $0 or $95 copay per visit (always covered), $0 or $0-40 copay per visit (always covered), $0 per day for days 1 through 20 / $0 or $196 per day for days 21 through 55 / $0 per day for days 56 through 100, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Best Medicare Part D Prescription Drug Plan Companies 2023, Medicare Advantage Plus Prescription Drug Plans in Alabama, Medicare Advantage Plus Prescription Drug Plans in 35739 (Madison County), VIVA Medicare Medicare Advantage Plus Prescription Drug Plans in Alabama, Find Continuing Care Retirement Communites. VIVA HEALTH / VIVA MEDICARE - Apps on Google Play also provides the following benefits. Your doctor may choose to treat side effects persisting over 30 days with antibiotics, steroids, or hyaluronidase (an enzyme that breaks down hyaluronic acid). Please confirm you have only entered a valid email address. After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00. We avoid using tertiary references. To find out information about the Medicare Ombudsman, click hereMedicare Ombudsman. The information mainly comes from Centers for Medicare & Medicaid Services (CMS) published data, and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, user generated contents or related graphics or advertisings contained on the website for any purposes. Not affiliated with or endorsed by any government agency. Can diet and exercise reverse prediabetes? For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), Some patients report complete resolution of symptoms when the implants are removed without replacement. The national Viva Medicare networks equal or exceed the requirements of the . Its important to us that you have the best experience possible with Viva Medicare and your doctors. We are required to complete a Health Risk Assessment (HRA) on all new members and yearly for many members. We do not offer every plan available in your area. Can diet help improve depression symptoms? The national Viva Medicare networks equal or exceed the requirements of the Centers for Medicare & Medicaid Services (CMS) for pharmacy access. Results may vary. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. 1-800-294-7780 (TTY: 711). Paid user. . If you use/used prescription products for eye pressure problems, use LATISSE under doctor care. Part B Premium give-back is not available with all plans. VIVA Medicare Extra Care (HMO D-SNP) - 2023 VIVA Medicare - FactsOnMedicare IMPORTANT SAFETY INFORMATION The VIVA Medicare Extra Value (HMO D-SNP) has a monthly premium of $32.70. (n.d.). To report a side effect with any JUVDERM product, please call Allergan at 1-800-433-8871. We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan: When individuals qualify for Medicare, they can enroll in either original Medicare (Part A and Part B) or a Medicare Advantage plan. Viva Medicare must also explain how you can make a complaint about our decision to end your membership. Other marks are the property of their respective owners. The most commonly reported side effects with JUVDERM injectable gels included redness, swelling, pain, tenderness, firmness, lumps/bumps, bruising, discoloration, and itching. To give information about Health Screenings and services based on your age and/or health. See your county's plan options: Henry. Regular office hours are from 8 am - 8 pm, Monday through Friday. Medicare Advantage plans, also known as Medicare Part C, must provide equal coverage to original Medicare, including: Unlike original Medicare, Medicare Advantage plans cap out-of-pocket expenses. The pharmacy claims of all members who qualify for MTM will be reviewed every three months to identify any new or persistent drug therapy problems, such as the presence of potential safety problems and/or gaps in care involving adherence to chronic medications and omissions in care. Birmingham, AL 35203 offers the following coverage and cost-sharing. Plain text explanation available for any plan in any state. free weights, and more at your local gym. Prescription only. Viva Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. Learn more about the options here. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; A complaint (grievance) does not involve a coverage decision. After you pay your $490.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. These surveys help us make your experiences with Viva Medicare and your doctors even better. Hours are Monday-Friday, 8 am - 8 pm. Read EOBs View an electronic copy of your explanation of benefits for medical claims under your plan. Viva Health Medicare Insurance Plans. To find out information about the Medicare Ombudsman, click hereMedicare Ombudsman. Medicare has neither reviewed nor endorsed the information on our site. JUVDERM VOLLURE XC, JUVDERM Ultra Plus XC, and JUVDERM Ultra XC injectable gels are for injection into the facial tissue for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Ready to sign up for VIVA Medicare Extra Care (HMO D-SNP) If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. To appoint a representative, complete the appropriate form below and mail (417 20th Street North, Suite 1100, Birmingham, AL 35203) or fax (205-558-7414) it to Member Services. Who can get breast implants? If you do not stay continuously enrolled in Medicare Part A and Part B. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. LATISSE may cause eyelid skin darkening which may be reversible. You must be in one of the situations described below: angiotensin-converting enzyme (ACE) inhibitors, We will tell you the reason we are calling you, We will provide you with a call back number, If you are hospitalized on the day your membership ends, your hospital stay will usually be covered by. Please click on the picture below to use your benefit, Food/Produce Benefit (Extra Value/Extra Care plans only), Please use one of the Internet browsers below, Hours of operation: 4 Clement Way, Belgrade, ME 04917-4370. Enroll on the phone or online! Enrollment in Viva Medicare depends on contract renewal. Viva Medicare Advantage: Location, coverage, costs, and more Get $2,250 every year to spend at the dentist. Get help from a licensed insurance agent. Copays are listed in the front of your formulary. Do not receive BOTOX Cosmetic if you: are allergic to any of the ingredients in BOTOX Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc (rimabotulinumtoxinB), Dysport (abobotulinumtoxinA), or Xeomin (incobotulinumtoxinA); have a skin infection at the planned injection site. Viva Healths Medicare Advantage plans match the coverage that original Medicare provides and offer additional benefits, including dental care, wellness benefits, access to a 24-hour nurse line, Viva Health cafes, and the VCare Program for people with specialized care management needs. These notices give you a summary of your claims and costs. The Viva Member Portal is your 24/7 secure member website for managing your account, accessing prior claims, requesting a replacement member card, and more. View a list of your summarized medical and prescription claims. For example, if we deny your request for payment for a Part D drug that you have already received, we may say that we will pay nothing or only part of the amount you requested. The Star Ratings referenced are for contract years 2022-2023. Viva Medicare's coverage determination and exception request form is below. H0154_mcdoc581r19a_M_CMS 2020 VIVA Medicare Extra Value (HMO D-SNP) - H0154-012- in AL Plan Benefits Explained 2020 Medicare Advantage Plan Benefits explained in plain text. Providing 2021 Medicare Plan Star Rating Details and detailed information on the Medicare Part D prescription drug and Medicare Advantage plans for every state, including Medicare Part D plan features and costs. BOTOX Cosmetic may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX Cosmetic. The Star Ratings referenced are for contract years 2022-2023. All plan-related information on this site is from CMS.gov and Medicare.gov. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX Cosmetic: BOTOX Cosmetic dosing units are not the same as, or comparable to, any other botulinum toxin product. If you do not pay the plan premium for 60 days (if you have a plan premium). MA-Compare: Review Changes in each 2020 Medicare Advantage Plan for 2021, Find a 2021 Medicare Part D Plan (PDP-Finder: Rx Only), Find a 2021 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2021 Medicare Plan Formulary (Drug List), Q1Rx 2021 Medicare Part D or Medicare Advantage Plan Finder by Drug, Guided Help Finding a 2021 Medicare Prescription Drug Plan, Search for 2021 Medicare Plans by Plan ID, Search for 2021 Medicare Plans by Formulary ID, 2021 Medicare Prescription Drug Plan (PDP) Benefit Details, Pre-2020 Medicare.gov Plan Finder Tutorial, Click here to see plans for the current plan year, or contact your local SHIP for assistance, See cost-sharing for all pharmacies and tiers, $0.00 for people who qualify for both Medicare and Medicaid. Viva Health are a Medicare-approved private insurance company. May cause brown darkening of the colored part of the eye which is likely permanent. Login. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.). You can file a complaint (grievance) if you have any type of problem with Viva Medicare or one of our network providers. Members continue to pay the Part B premium to Medicare. Formularies (lists of covered drugs) offer members access to both generic and brand name drugs. Viva Medicare Enrollment in Viva Medicare depends on contract renewal. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. *Members enrolled in Viva Medicare Extra Value and Viva Medicare Extra Care that receive Extra Help (limited income subsidy) will pay $0 for insulin covered by our plan. JUVDERM Injectable Gel Fillers Important Information. Use this form to request payment for a Part D drug paid for out-of-pocket. What are possible side effects? All women featured on this website are paid spokeswomen You have the right to contact Medicare and file a complaint about your coverage decision. For more information on Viva Medicare MTM Program, please contact our member services department at 1-800-633-1542 or 205-918-2067, TTY users call 711. The benefit information provided is a brief summary, not a complete description of benefits. APPROVED USES The formulary includes prescription drugs in every therapeutic class and category. People can also get free, impartial advice from the State Health Insurance Assistance Program (SHIP). Learn more about the pros and cons of Medicare Advantage plans here. Rather, Policies been exploited in the process by determine if a service can be medicine necessary and fair either investigational. Plan members also have access to Viva Health Cafes, where they can get answers to their Medicare questions. You can reach Member Services at 205-918-2067 in Birmingham or 1-800-633-1542 toll free. That is $392.40 for 12 months. Other marks are the property of their respective owners. Map and Directions. Enrollment in any plan depends on contract renewal. If you have symptoms of or uncertain ultrasound results for breast implant rupture, an MRI is recommended. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, Inc Is the ketogenic diet right for autoimmune conditions? 31) are from 8 am - 8 pm, 7 days a week. The Centers for Medicare & Medicaid Services (CMS) awarded Viva Medicare 4 stars based on quality scores and member experiences. Viva Health was founded in 1995 and is currently the preferred health care provider in Alabama for more than 200 companies and 90,000 members. Availability varies by carrier and location. You may contact Medicare to file your complaint by clicking here and by following the instructions on the form. Providing 2022 Medicare Plan Star Rating Details and detailed information on the Medicare Part D prescription drug and Medicare Advantage plans for every state, including Medicare Part D plan features and costs. Please contact Medicare.gov or 1-800- MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Medicare Part D will provide a full subsidy with low co-payments to Medicare beneficiaries with incomes up to 135% of the Federal Poverty Level (FPL) and limited resources. Contact the plan for details. var gcse = document.createElement('script'); A person enrolled in an HMO plan must use an approved network of healthcare providers and choose a primary care physician from the network. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. However, they also provide routine vision benefits and diagnostic, preventive, and comprehensive dental coverage. Using BOTOX Cosmetic with certain other medicines may cause serious side effects. Other health plan deductibles: In-network: No, Drug plan deductible: $444.00 annual deductible, Diagnostic tests and procedures: $0 or $0-50 copay (authorization required), Lab services: $0 copay (authorization required), Outpatient x-rays: $0 or $10 copay (authorization required), Emergency: $0 or $90 copay per visit (always covered), Urgent care: $0 or $0-40 copay per visit (always covered), $0 or $245 per day for days 1 through 6, $0 or $0-175 copay per visit (authorization required), Occupational therapy visit: $0 copay (authorization required), Physical therapy and speech and language therapy visit: $0 copay (authorization required), Inpatient hospital - psychiatric: $0 or $245 per day for days 1 through 6, Outpatient group therapy visit with a psychiatrist: $0 copay (authorization required), Outpatient individual therapy visit with a psychiatrist: $0 copay (authorization required), Outpatient group therapy visit: $0 copay (authorization required), Outpatient individual therapy visit: $0 copay (authorization required), Diabetes supplies: $0 copay per item (authorization required), Fluoride treatment: $0 copay (limits apply), Dental x-ray(s): $0 copay (limits apply), Non-routine services: $0 copay (limits apply, authorization required), Diagnostic services: $0 copay (limits apply, authorization required), Restorative services: $0 copay (limits apply, authorization required), Endodontics: $0 copay (limits apply, authorization required), Periodontics: $0 copay (limits apply, authorization required), Extractions: $0 copay (limits apply, authorization required), Prosthodontics, other oral/maxillofacial surgery, other services: $0 copay (limits apply, authorization required), Routine eye exam: $0 copay (limits apply), Contact lenses: $0 copay (limits apply), Eyeglasses (frames and lenses): $0 copay (limits apply), Eyeglass frames: $0 copay (limits apply), Eyeglass lenses: $0 copay (limits apply), Chemotherapy: 0% or 20% coinsurance (authorization required), Other Part B drugs: 0% or 20% coinsurance (authorization required). See our new privacy terms at (207) 495-3323. Limitations, copayments, and restrictions may apply. Individuals depicted are not Silver&Fit members. You must continue to pay your Part B premium. Visit a friendly Viva Health cafe. How this plan performs for drug pricing, patient safety, member experience and more. Members can find information regarding any mid-year non-maintenance formulary changes to the printed formulary, as well as Prior Authorization and Step Therapy criteria, by looking below or calling Member Services. LATISSE (bimatoprost ophthalmic solution) 0.03% Important Information. What precautions should my doctor advise me about? Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Each October, all current members who are on a plan that includes Part D coverage are notified that the formulary for the next calendar year is available on our website. This means that you will need to get approval from us before you fill these prescriptions or we may not cover the drug. From October 1st to March 31st, seven days a week, 8 am - 8 pm. These complications, which have been reported for facial injections, can include vision abnormalities, blindness, stroke, temporary scabs, or permanent scarring of the skin. PPO plans also use a network of providers, but members can choose out-of-network providers with higher out-of-pocket expenses. The plan covers all emergency services, including out-of-network ones. 5 Stars is the highest possible rating. The government agency that runs Medicare, called the Centers for Medicare & Medicaid Services, or CMS, and the National Committee for Quality Assurance, or NCQA, require that two surveys be sent each spring to some members in every Medicare Advantage plan. SNPs provide benefits to people who have certain chronic health conditions, such as HIV or cancer, live in a long-term care facility, or qualify for both Medicare and Medicaid benefits. While you are a member of our plan, you must continue to get your Medicare covered services through Viva Medicare. A nurse works with the individual to help them follow their prescribed care plan, with the goal of becoming more active and independent. LATISSE (bimatoprost ophthalmic solution) 0.03% Important Information. Attention: Medicare Member Appeals and Grievances Coordinator Viva Medicare Extra Value (HMO SNP) and Extra Care (HMO SNP) are special plans just for people on Medicare and Medicaid. ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. (n.d.). Approved Use. 24 hours per day, 7 days per week, The survey helps CMS compare health plans and see which ones are doing a great job of helping members improve their health and which ones are not. gcse.src = (document.location.protocol == 'https:' ? You can view the Centers for Medicare & Medicaid Services webpage here about the evidence you may submit to show your eligibility for the low-income subsidy (also known as Best Available Evidence). If you lie about or withhold information about other insurance you have that provides prescription drug coverage (if you have prescription drug coverage with our plan). Accepted 10/01/2021. This page features plan details for 2023 VIVA Medicare Extra Care (HMO D-SNP) Please check the plans formulary for specific drugs covered. For JUVDERM VOLBELLA XC, dryness was also reported. During this time, you can keep your current coverage with Viva Medicare or make changes to your coverage for the upcoming year. Medicare has neither approved nor endorsed any information on this site. The premiums listed do not include any Part B premium that you may have to pay. Viva Medicare is the only plan in Alabama to earn a 5-Star rating two years in a row! By clicking the links above, you may be directed away from VivaHealth.com 2023 Viva Health, Inc. All Rights Reserved. 2023 AbbVie. 1-800-294-7780 (TTY: 711). Medicare Advantage: Monthly costs and more, outpatient visits with doctors and specialists, inpatient stays in hospitals, clinics, or skilled nursing facilities, zero cost medical and diabetes testing and diabetic supplies, low cost generic drugs and a home delivery option for prescriptions, Silver&Fit program, which is a fitness program for older adults. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Viva Health is an affiliate of the UAB Health System, offering access to 70 hospitals worldwide, including those in Montgomery, Birmingham, Huntsville, and more. The doctor acts as the first point of contact, coordinating the individuals healthcare and providing referrals to specialists where necessary. Michelle Sweetser - Nurse Practitioner, Belgrade ME - HealthCare4PPL To report a side effect, please call Allergan at 1-800-433-8871. Are there any reasons why I should not receive any JUVDERM formulation? For JUVDERM VOLBELLA XC, most resolved within 30 days or less. Not all plans offer all of these benefits. The following VIVA Medicare plans offer Medicare Advantage Prescription Drug plan coverage to Alabama residents. (n.d.). Free Medicare Part D Newsletter, Use the Online Caculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC 10 Plans Sort by: Plans Medicare Advantage Plus Prescription Drug Medicare Advantage Prescription Drug (Part D) Location Not all plans shown here will be available to you; enter your ZIP Code. Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. SuperAger and Alzheimer's brains share similar pathologies, so what sets SuperAgers apart? Medicare is a state-provided insurance policy. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service The Centers for Medicare & Medicaid Services (CMS) sometimes changes the coverage rules that apply to an item or service under Medicare. You can also request a coverage determination by writing to: You can request an expedited coverage determination by calling Member Services at 205-918-2067 in Birmingham or 1-800-633-1542 toll-free. If a person is enrolled in original Medicare, they must get a stand-alone Part D plan from a private insurance company. Please refer to your Evidence of Coverage for information about how to make a complaint.
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