A complaint (grievance) does not involve a coverage decision. (function() { To report a side effect with any JUVDERM product, please call Allergan at 1-800-433-8871. We may decide completely or only partly against you. To be eligible for a temporary supply, you must meet one of changes listed in Requirement 1 and one of the situations described in Requirement 2 below: We will cover a temporary supply of your drug during the first 90 days of the calendar year (current members) or during the first 90 days of your membership (new members). According to the Kaiser Family Foundation, more than 24 million people got Medicare benefits through Advantage plans in 2020. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. Members may enroll in a Medicare Advantage plan only during specific times of the year. Any information we provide is limited to those plans we do offer in your area. This cancer occurs more commonly in patients with textured breast implants than smooth implants, although rates are not well defined. Login. See our new privacy terms at Click to Call 1-877-354-4611 TTY 711.Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). Products in the JUVDERM Collection are available only by a licensed physician or properly licensed practitioner. By clicking the links above, you may be directed away from VivaHealth.com 2023 Viva Health, Inc. All Rights Reserved. You may contact Medicare to file your complaint by clicking here and by following the instructions on the form. Please be aware that you can change plans only at certain times during the year. The premiums listed do not include any Part B premium that you may have to pay. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of 91 days of medication. People can choose from a range of HMO options. You have the right to ask us for an "exception," which is a type of coverage determination if you believe you need a drug that is not on our list of covered drugs (formulary), or you believe you should not have to meet prior authorization or other utilization management requirements, or you believe you should get a non-preferred drug at the lower preferred drug copayment. (n.d.). Premium amount depends on county of residence. 2021 Medicare Advantage Plan Benefits explained in plain text. 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. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. They include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Are there any reasons why I should not receive any JUVDERM formulation? BOTOX Cosmetic may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX Cosmetic. One of the risks with these products is unintentional injection into a blood vessel. Monday - Friday, 8am - 8pm (Oct 1 - Mar 31: 8am - 8pm, 7 days a week). Actual Part B premium reduction could be lower. Having more than 8 years of diverse experiences, especially in NURSE PRACTITIONER, Michelle Sweetser affiliates with Franklin Memorial Hospital, cooperates with many other doctors and specialists in medical group Healthreach Community Health Centers. You have the right to contact Medicare and file a complaint about your coverage decision. This plan offers a network of providers across Alabama, including doctors, clinics, and pharmacies. These notices give you a summary of your claims and costs. Individuals depicted are not Silver&Fit members. 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. View explanations of benefits for medical claims and understand what service was provided, what charges were made, covered and not covered, and how to appeal a decision. Medicare Advantage plans: What do they cover? We must end your membership in our plan if any of the following happen: We cannot ask you to leave our plan for any reason related to your health. The benefit information provided is a brief summary, not a complete description of benefits. *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. To speak with you about your general health. In addition to the CMR, all MTM eligible members will also receive a Targeted Medication Review (TMR). 5 Star plans get extra bonus money that is used to give you better benefits and savings. BOTOX Cosmetic may cause serious side effects that can be life threatening. If your drug is not on the Drug List or is restricted, here are things you can do: Under certain circumstances, the plan can offer a temporary supply of a drug to you when your drug is not on the Drug List or when it is restricted in some way. gcse.async = true; Other marks are the property of their respective owners. Medicare Advantage Plus Prescription Drug, Autauga, Baldwin, Blount, Bullock, Calhoun, Chambers, Blount, Chambers, Chilton, Dale, Geneva, Henry, Autauga, Baldwin, Blount, Calhoun, Chambers, Cherokee, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Best Medicare Part D Prescription Drug Plan Companies 2023, whether Medicare Advantage is right for you, What to Consider When Shopping for Medicare Coverage, Find Continuing Care Retirement Communites. $2,250 every year to spend at the dentist, $200 every year to spend on glasses or contact lenses, 24 one-way rides to your doctor or dentist. Some Advantage plans may also include prescription drug coverage (Medicare Part D). 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. You can also review your monthly Part D Explanation of Benefits (EOB) to see which of the drugs you are currently taking are coming off the Viva Medicare formulary. 5 Stars is the highest possible rating. To ask for a temporary supply, call Member Services at the number on the bottom of this page. You can learn more about Silver&Fit here or search for All women featured on this website are paid spokeswomen IMPORTANT: This page has been updated with plan and premium data for 2023. From October 1st to March 31st, seven days a week, 8 am - 8 pm. As with any injection, this may result in increased bruising or bleeding at the injection site, Patients who experience skin injury near the site of injection may be at a higher risk for adverse events, Women with active infection anywhere in their body, Women with existing cancer or precancer of their breast who have not received adequate treatment for those conditions, Women who are currently pregnant or nursing, Autoimmune diseases (eg, lupus and scleroderma), A weakened immune system (eg, taking medications to decrease the bodys immune response), Planned chemotherapy or radiation therapy following breast implant placement, Conditions or medications that interfere with wound healing and blood clotting, Clinical diagnosis of depression or other mental health disorders, including body dysmorphic disorder and eating disorders, Those with a diagnosis of depression or other mental health disorders should wait for resolution or stabilization of these conditions prior to undergoing breast implantation surgery, There is a Boxed Warning for breast implants. This page features plan details for 2023 VIVA Medicare Extra Care (HMO D-SNP) The doctor acts as the first point of contact, coordinating the individuals healthcare and providing referrals to specialists where necessary. Breast implants are not considered lifetime devices. (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.). Save Money! There are a few factors that can increase or decrease this premium. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Deductibles, copays and coinsurance may apply. Results may vary. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. 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. I Forgot My Password. Enrollment in Viva Medicare depends on contract renewal. 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. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of 30 days of medication. These notices give you a summary of your claims and costs. 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. Founded in 1995, they have more than 100,000 members and a network of more than 70 hospitals across Alabama. 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. Upon completion of the CMR, you will be mailed a Medication Action Plan that provides steps you should take to help you get the best results from your medications, and a Personal Medication List that will help you keep track of your medications and how to use them the right way. Using a provider from outside the network may carry a higher cost unless it is a medical emergency. (We cannot make you leave our plan for this reason unless we get permission from Medicare first.