Humana Dual Fully Integrated in Illinois: Benefits

Plan covers up to $500 allowance every year for non-Medicare covered preventive and comprehensive dental services. You are responsible for any amount above the dental coverage limit. Any amount unused at the end of the year will expire.

Your benefit can be used for most dental treatments such as:

• Preventive dental services, such as exams, routine cleanings, etc.
• Basic dental services, such as fillings, extractions, etc.
• Major dental services, such as periodontal scaling, crowns, dentures, root canals and bridges, etc.

Note: The allowance cannot be used on fluoride, cosmetic services and implants.

Certain dental services, including cleanings, fillings, and dentures, are available through the Illinois Medicaid Dental Program.

We pay for some dental services when the service is an integral part of specific treatment of a person’s primary medical condition. Examples include reconstruction of the jaw after a fracture or injury, tooth extractions done in preparation for radiation treatment for cancer involving the jaw, or oral exams prior to organ transplantation.

Prior authorization may be required.

SilverSneakers^® is a fitness program for seniors that is included at no additional charge with qualifying Medicare health plans. Members have access to participating fitness locations across the country that may include weights and machines plus group exercise classes led by trained instructors at select locations. Access online education on SilverSneakers.com opens in new window , watch workout videos on SilverSneakers On-Demand™ or download the SilverSneakers GO™ fitness app for additional workout ideas.

Any fitness center services that usually have an extra fee are not included in your membership.

A $260 monthly allowance automatically loaded on a limited-use prepaid debit card to use at participating retail locations to buy eligible products from these categories:

• Cold, flu and allergy
• Dental and denture care
• Digestive health
• First aid and medical supplies
• Bladder control and incontinence supplies
• OTC hearing aids
• Pain relief
• Skin care
• Sleep aids
• Smoking cessation products
• Vitamins and dietary supplement
• And more.

You will receive a new Humana Spending Account Card to access this benefit. This card is what you use to spend this allowance. Please activate your card as soon as you receive it.

• The allowance is available to use at the beginning of every month.
• Whatever you don’t spend rolls over to the next month and expires at the end of the plan year or upon disenrollment from this plan, whichever occurs first.
• Our plan is not responsible for unauthorized use of allowances due to lost or stolen cards.
• As with any debit card, please keep this card in a safe place, like your wallet.
• Please keep this card even after the allowance is spent as future allowance amounts may be added to this card if you remain on the plan.
• Limitations and restrictions may apply.

Download the free MyHumana^® mobile app, available on the App Store^® opens in new window  or Google Play™ opens in new window , or visit MyHumana.com opens in new window to find stores or check your balance. You can also see the back of your spending account card for more information.

The plan covers the following:

• Annual routine eye exams
• Eyeglasses (lenses and frames)
  • Frames limited to 1 pair in a 24 month period, and
  • Lenses limited to 1 pair in a 24 month period, but you may get more when medically necessary, with prior approval
• Custom-made artificial eye
• Low vision devices
• Contacts and special lenses when medically necessary, with prior approval

To be eligible for reimbursement, some services may be subject to prior approval and/or medical criteria.

We pay for outpatient provider services for the diagnosis and treatment of eye diseases and injuries. For example, this includes annual eye exams for diabetic retinopathy for people with diabetes and treatment for age-related macular degeneration.

For people at high risk of glaucoma, the plan covers 1 glaucoma screening each year. People at high risk of glaucoma include:

• People with a family history of glaucoma,
• People with diabetes,
• African-Americans who are age 50 and older, and
• Hispanic Americans who are age 65 or older.

For people with diabetes, we pay for screening for diabetic retinopathy once per year.

We pay for 1 pair of glasses or contact lenses after each cataract surgery when the doctor inserts an intraocular lens. If you have 2 separate cataract surgeries, you must get 1 pair of glasses after each surgery. You cannot get two pairs of glasses after the second surgery, even if you did not get a pair of glasses after the first surgery. In addition, we cover Mandatory Supplemental Vision Benefits which include a routine vision exam and an allowance for eyewear.

Prior authorization may be required.