2025 Highmark Wholecare Medicare Assured Benefits

Highmark Wholecare is pleased to announce several exciting benefit enhancements for Medicare plan members beginning January 2025.

General Supports for Living

Members will receive a reusable Mastercard at the start of the plan year and will have the flexibility to purchase any of the eligible items listed below. The card is loaded with one combined allowance each month, and unused allowances will carry over from month to month. Any unused allowance will expire at the end of the calendar year. Plan restrictions apply.

Diamond Members - $263 per month can be used toward healthy groceries, eligible utilities, over-the-counter (OTC) medication and products, and home and bathroom safety items.

Ruby Members - $82 per month can be used toward healthy groceries, eligible utilities, over-the-counter (OTC) medication and products, and home and bathroom safety items.

Transportation

All members receive a yearly allowance of one-way transportation for plan-approved health related locations. Diamond members have the option to use a portion of their allowance toward plan-approved non-health related locations, such as trips to the grocery store.

$0 Rx Copays

$0 for covered drugs in all stages of the Part D drug benefit.

Dental

Members are covered for preventive dental services including a yearly plan allowance for comprehensive dental services.

Diamond - $8,000 comprehensive allowance per year, includes preventive services.

Ruby - $3,500 comprehensive allowance per year.

Vision (VSP Vision)

Members receive an annual routine eye exam and free glasses or contact lenses.

OR

Diamond - $600 allowance toward the purchase of non-vendor frames or contact lenses.

Ruby - $200 allowance toward the purchase of non-vendor frames or contact lenses.

Hearing

Members receive an annual routine hearing exam and one hearing aid per ear. Includes rechargeable aids.

Diamond Members - one hearing aid per ear every year.

Ruby Members - one hearing aid per ear every three years.

Mental Health Care

Members receive mental health services provided by a Medicare approved provider. Members have the right to self-refer to mental health and substance abuse treatment. This includes individual sessions, group sessions, and care through the telehealth setting.

Diamond - $0 copay for each Medicare-covered mental health visit.

Ruby - $25 copay for each Medicare-covered mental health visit.

Meals Post-Discharge

Members are eligible for meals up to 30 days after being discharged from inpatient stay at a hospital/rehab/skilled nursing facility.

Fitness

A subscription to a fitness and health platform that gives you extra options-including access to a nationwide network of gyms, fitness studios, and community centers.

24-Hour Nurse Line

A toll-free 24-hour nurse line is available at no cost to the member. Members can receive coaching and advice from our trained clinicians.

Personal Emergency Response System (PERS)

Members are eligible to receive one personal emergency response unit per member lifetime.

Please visit HighmarkWholecare.com for a full listing of our 2025 Medicare benefits.

VSP Vision is a separate company that administers the vision benefit(s) for Highmark Wholecare.