Key Things to Know
Your Membership Fact Sheet Thanks for being a FirstMedicare Direct member. We’re happy you’re here and are excited to help you use your plan and all its perks made for you. Changes for 2022 Benefits and other aspects of a plan can change each year, even if you keep the same plan. Below are some benefit changes for the 2022 plan year. Other ways you can identify plan changes:
• Review
your Annual Notice of Change (ANOC) that is mailed to you every September or find it at FirstMedicare.com.
• Call
Member Services at the number on the back of your ID card. We can help you with any benefit change questions you might have.
Category
Change
Dental
Get covered preventive dental services, including two cleanings per year, two oral exams and one annual X-ray visit, for a $0 copay. Members will have access to services with an out of network provider in the new plan year.
Vision and Hardware Allowance
Get access to vision services beyond what Original Medicare covers, including a routine vision exam for $0 with an in-network provider. Plus, get a $130 allowance for eyewear.
Hearing
Through TruHearing®, you can get one routine hearing exam for a $45 copay and lowered rates on up to two TruHearing hearing aids per year when you see a TruHearing provider.
Worldwide Urgent Care
Reduced copays to $40 for POS Standard and $30 for POS Plus.
Outpatient Diagnostic Procedures, Labs, Tests
Now a $0 copay.
Outpatient X-rays
Now a $0 copay.
Additional Colorectal Screening
Now a $0 copay (wasn’t covered before).
Hally ® Mobile App and Member Website Get secure, instant access to your coverage by logging in to the Hally app or on hally.com. Manage your health plan and get the care you need anytime, anywhere. • See
all your account activities in one place.
• Access
your virtual ID card.
• Search
for doctors and other resources.
• Quickly • Get
connect with a doctor over virtual visits.
cost estimates.
• Check
claims status.
Visit the App Store or Google Play to download. App Store is a service mark of Apple Inc., registered in the U.S. and other countries. Google Play and the Google Play logo are trademarks of Google LLC.
Always go to the emergency department (ED) or call 911 if you experience: • Stroke
symptoms.
• Chest
pains.
• Head
or spinal injuries.
• Severely
broken bones.
These are examples, not a complete list. If you think your condition is a life-threatening emergency, call 911 or go to the nearest ED.
Making a Change Have you had changes to your health, medication usage or overall lifestyle and want to shop for a new plan that fits these changes? With FirstMedicare Direct, you have multiple plan options to choose from to support changes you may have experienced. Refer to the Key Benefits Guide included with this document for information about other plan options, premiums, and copayment or coinsurance amounts for commonly used benefits.
Your Care Options
Pharmacy
Your plan is made with plenty of options for different situations based on what your condition is, where you are and other factors.
All our plans come with pharmacy coverage. Remember, the formulary (or list of drugs we cover) can change yearly. You can review it at FirstMedicare.com.
With your FirstMedicare Direct plan you have access to 24/7 virtual coverage through the Nurse Advice Line and $0 virtual visits through FirstHealth On The Go.
Perks and Programs
For in-person coverage options you are able to access our extensive provider network, from which you can select a primary care provider (PCP) to oversee your care. If your illness or injury is not an emergency, set up an appointment with your PCP. Some injuries or illnesses require emergency care, but if your injury or illness doesn’t require immediate medical attention, calling your doctor or going to an urgent care clinic (sometimes called convenient care or a walk-in clinic) can save you time and money.
Your plan is made with plenty of perks and programs to help you with your health goals. Go online to FirstMedicare.com/Perks to view all the options available on your plan.
Member Services is here to help. If you have questions about these changes or your plan in general, call the Member Services number on the back of your ID card and have your member number ready. You’ll be prompted to make selections based on your type of question. Member Services can help with questions about eligibility, premiums, claims, prescriptions, authorizations, letters and more.
FirstCarolinaCare Insurance Company is a health plan with a Medicare contract. Enrollment in FirstCarolinaCare depends on contract renewal. MDMBFC22-WNCkeythingspdf-0721 • H6306_22_100142_M