Retention.17_MDMBFC22-SHLkeythingspdf-0721-WEB

Key Things to Know

Your Membership Fact Sheet Hometown People, Hometown Coverage 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 can also access services from an out of network dentist in 2022.

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 copay to $10.

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 • Chest

symptoms. 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.

Pharmacy Your Care Options Your plan is made with plenty of options for different situations based on what your condition is, where you are and other factors.

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. 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.

Most of 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.

Perks and Programs 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.

Stop by our local office.

Walk-in hours: weekdays, 8:30 a.m. to 4:30 p.m.* 42 Memorial Dr., Pinehurst, NC 28374 Hours subject to change due to the ongoing COVID pandemic. Please call in advance.

FirstCarolinaCare Insurance Company is a health plan with a Medicare contract.

Enrollment in FirstCarolinaCare depends on contract renewal.

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