Key Things to Know
Your Membership Fact Sheet Medicare Advantage made for you. Thanks for being a Health Alliance™ 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 2025 Benefits and other aspects of a plan can change each year, even if you keep the same plan. This document highlights new perks and programs and some of the key benefits of your plan and how they are changing. It is not a full listing of all benefit changes. Each year we focus on bringing you perks and programs that provide you value and help you improve or maintain a healthy lifestyle.
Sometimes this means changing these to ensure we are creating plans and benefits that provide the most value. Assist America®, the Companion Benefit and whiskerDocs® are being discontinued and will end on 12/31/24: Very few of our members utilized these programs. As a reminder, all our plans include worldwide emergency care.
Outlined below are some of the key changes coming to your plan in 2025. Category
Change
Premium
Starting in 2025, HMO 20 Rx members will have a $148 premium, POS Basic Rx members will have a $73 premium and POS 10 Rx members will have a $188 premium.
Out-of-Pocket Maximum
In 2025, POS Basic Rx members will have an in-network out-of-pocket maximum of $5,500 and Guide HMO Rx members will have an out-of-pocket maximum of $4,300.
Specialist Visit
In 2025, Guide HMO Rx members will have a $40 specialist visit copay.
Be Fit
Starting in 2025 you can use the benefit to purchase wearable activity trackers. Also, due to Medicare rules, the Be Fit benefit will no longer cover league fees, local and national park passes, and race entry fees.
Outpatient Surgery/ Ambulatory Surgical Center Services
Dental
The copayment for this benefit will be split into minor procedures and major procedures. The copayment for minor procedures, including services like skin lesion removal, skin tag removal, small wound repairs, etc., will be lower than that of major procedures. Please see your plan materials for full coverage details. For members on the POS Choice Rx plan, your coverage is moving from coinsurance to a copayment for these services. POS Choice Rx members, or those interested in this plan, for 2025 you will have coverage for dental servies up to $3,000 a year. New for 2025, one round of meals for 90 days per year for those with uncontrolled diabetes and the ability to participate in Virta Health.
Diabetic Services
Virta Health is a virtual program which can help you safely and sustainably reverse type 2 diabetes without the risks, costs or side effects of medications or surgery. Virta is a research-backed treatment that includes support from healthcare providers, coaches and digital health tools. *Participation in the program is not a guarantee that the member’s diabetes will be reversed and that it requires active participation/adherence by the member. *All perks aren’t available on all plans or to the general public.
Go online to HealthAlliance.org/Perks to view all the options available on your plan.