Supplemental Benefits

These extra benefits are available at no additional cost to BCBSAZ Health Choice Pathway (HMO D-SNP) members!

Questions about these extra benefits? We’re here to help. Call Member Services at 1-800-656-8991, TTY 711, 8 a.m. to 8 p.m., 7 days a week.

Check your Evidence of Coverage to see exactly what is covered.

Supplemental Benefits flier
2024 English | Español
2025 English | Español

  • 2025 Plan Year

    $0 copay for $125 every month combined allowance for OTC products and Healthy Food and Produce.

    The allowance will be loaded to your Mastercard® Flex Card each month to pay for covered groceries and/or OTC items.

    Covered items include:

    • Healthy foods such as fruits, vegetables, meat, seafood, dairy products, water, and more.
    • Brand-name and generic OTC products, such as vitamins, pain relievers, toothpaste, cough drops, and more.

    To place an order, view the card balance, view all OTC items, search for eligible products, and find participating store locations, visit bcbs-az.thehelperbeesportal.com or call 1-888-454-1423, TTY:711, Monday – Friday, 8 a.m. – 8 p.m. local AZ time.

    Any remaining allowance at the end of the month will expire and does not roll over to the next month. Any unused allowance will not carry over to the next plan year. All other trademarks referenced are the property of their respective companies.

    2025 OTC Catalog
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    Español - Coming Soon

    2024 Plan Year

    $0 copay for $600 every 3 months combined allowance for OTC products and Healthy Food and Produce. With this benefit, you’ll get a credit loaded to your Visa Debit Card each quarter to pay for covered groceries and OTC items.

    Covered items include:

    • Healthy foods like fruits, vegetables, meat, seafood, dairy products, water, and more.
    • Brand-name and generic OTC products, like vitamins, pain relievers, toothpaste, cough drops, and more.

    Maximum plan benefit coverage amount carries forward to the next quarter if it is unused, however, it will expire in the following quarter if unused. The rollover dollars will be applied before the current period benefit amount. A member will never have more than twice their benefit to spend in any one quarter. Any unused benefit amount from quarter 4 (October, November, December) will not carry over to the next plan year.

    You can continue ordering OTC items through the OTC CVS catalog and CVS retail locations. Additionally, you have the option to purchase OTC items from participating retailers online at CVS.com, walgreens.com, Albertsons.com, Walmart.com, Instacart, Mom’s meal & Farmbox. You must link from mybenefitscenter.com to access all online participating retailers.

    Placing Orders with CVS: Call CVS at 1- 844-457-8938. Begin the call by stating you’re calling regarding the Incomm Flex card benefit and specify the plan name: BCBSAZ Health Choice Pathway. Have your flex card number ready, as you’ll be prompted to enter it using the dial pad to finalize your order.

    Checking your Balance: To get your balance, call 1-833-684-8472 or visit mybenefitscenter.com. To review all purse balances, kindly listen to all prompts attentively. Balances from the different benefits will be presented in descending order, starting from the highest.

    Card Replacements: A new card may be ordered by calling Member Services at 1-800-656-8991, TTY: 711, 8 a.m. to 8 p.m., 7 days a week. You will receive a new card in 7-14 business days.

    Participating Retailers: The flex card will only work at approved locations. Additionally, you can go to mybenefitscenter.com or download the OTC Network App to check participating locations.

    Eligible Items: To search products that are covered, call 1-833-684-8472. You may also download the OTC Network App available on the app store.

    Instructions:

    1. Log in to the OTC app on a mobile device.
    2. Select the scan product button at the bottom of any screen.
    3. Choose the retailer.
    4. Select “Scan Code with Camera”.
    5. Scan the barcode of the product.

      Results:
      1. Eligible
      2. Not Eligible

    *Note: Members should check their available balances before purchasing. This can be done through the app as well when members receive the eligible/not eligible prompt to check balance. The eligible purse will display along with the available balance.

    2024 OTC Catalog
    English
    Spanish

  • 2025 Plan Year

    $0 copay

    $3,500 maximum benefit  dental services.

    Comprehensive services including:

    • Restorative services (i.e. crowns, fillings, bridge to replace one tooth)
    • Endodontics services
    • Periodontics services
    • Oral and maxillofacial surgery, including extractions services
    • Dentures
      • Covered once every five years
      • Adjustments up to four per year

    No maximum amount for preventive and diagnostic dental services.

    Preventive and diagnostic services including:

    • One Fluoride Treatment every year
    • Two Oral Exams every year
    • Two Prophylaxis (Cleanings) every year, once every 6 months
    • Two Dental X-rays every year, which consists of:
      • One of either bite-wing X-rays or single X-rays or
      • One complete full mouth X-ray (FMX) or panoramic X-ray. Complete/panoramic only allowed once every 36 months

    2024 Plan Year

    You receive a $4,000 allowance every year towards comprehensive dental services like dentures, bridges, crowns, fillings, extractions, and endodontics. Other covered services include: no maximum amount for preventative services, 2 oral exams every year; 2 x-rays every year; 2 cleanings every year; 1 fluoride treatment every year. For help finding a dental provider, contact Member Services..

  • 2025 Plan Year

    Not Covered

    2024 Plan Year

    $0 copay

    Our plan provides a prepaid Visa® debit card that helps reduce your out-of-pocket expenses for dental, vision, and hearing services. With an annual maximum limit of $1,000, you can allocate your benefit dollars as needed across these services. Any unused benefit dollars expire at the end of the year. It’s important to note that this benefit is not a substitute for supplemental dental, vision, or hearing benefits, but rather a way to offset certain expenses. To ensure coverage, please receive supplemental dental, vision, and hearing services from a participating provider within the plan.

  • 2025 Plan Year

    You have a $1,000 annual maximum combined allowance each year between In-Home Support Services, Home and Bathroom Safety Devices and Modifications, Support for Caregivers of Enrollees (Respite Care), and Home Repairs.

    $0 copay for In-Home Support Services
    Members have access to in-home support services, including cleaning, household chores, meal preparation, errands, light yard work, and assistance with other instrumental activities of daily living. Prior authorization may be required.

    $0 copay for Home and Bathroom Safety Devices and Modifications
    This benefit will include temporary home modifications including ramps and adding grab bars and safety rails in the shower.

    $0 copay for Support for Caregivers of Enrollees (Respite Care)

    Caregiver respite encompasses a temporary reprieve for primary caregivers, offering them a crucial break from their caregiving responsibilities.

    $0 copay for Home Repairs
    This benefit will include widening of hallways or doorways, permanent mobility ramps, easy use doorknobs and faucets. To qualify for this benefit, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have one or more of the following qualifying chronic conditions:

    • Chronic heart failure (CHF)
    • Chronic lung disorders
    • Diabetes
    • Post-Acute Sequelae of SARS CoV-2 infection (PASC)/Long COVID

    Not all members qualify, as other coverage criteria may also apply.

    For more details on these services and additional assistance, please visit bcbs-az.thehelperbeesportal.com or call 1-888-454-1423, TTY: 711, Monday – Friday, 8 a.m. – 8 p.m. local AZ time.

     

    2024 Plan Year

    You have a $900 annual maximum combined allowance each year between In-Home Support Services, Home and Bathroom Safety Devices and Modifications, Support for Caregivers of Enrollees (Respite Care), and Home Repairs.

    $0 copay for In-Home Support Services – Prior authorization may be required Members have access to in-home support services, including cleaning, household chores, meal preparation, errands, light yard work, and assistance with other instrumental activities of daily living..

    $0 copay for Home and Bathroom Safety Devices and Modifications.
    This benefit will include temporary home modifications including ramps and adding grab bars and safety rails in the shower.

    $0 copay for Support for Caregivers of Enrollees (Respite Care).

    $0 copay for Home Repairs.
    This benefit will include widening of hallways or doorways, permanent mobility ramps, easy use doorknobs and faucets. To qualify for this benefit, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have one or more of the following qualifying chronic conditions:

    • Chronic heart failure (CHF)
    • Chronic lung disorders
    • Diabetes
    • Post-Acute Sequelae of SARS CoV-2 infection (PASC)/Long COVID
  • 2025 Plan Year

    $0 copay for physical fitness, memory fitness, activity tracker.

    Fitness Center Membership and home kits.

    Member can choose one of the following items for the At-Home Kits which includes the Quick Start Guide. The Quick Start guide is a printout with some suggested exercises and more information about SilverSneakers.

    • Pedometer to track daily steps
    • SilverSneakers ball
    • Resistance band
    • Yoga strap
    • Inspire 3 Fitbit

    SilverSneakers® can help you live a healthier, more active life through fitness and social connection. You are covered for a fitness benefit through SilverSneakers at participating locations,1 where you can take classes 2and use exercise equipment and other amenities, at no additional cost to you. Enroll in as many locations as you like, at any time. You also have access to instructors who lead specially designed group exercise online classes, seven days a week with SilverSneakers LIVE.

    Activate your free online account at SilverSneakers.com to view your SilverSneakers Member ID number and explore everything SilverSneakers has to offer. For additional questions, go to SilverSneakers.com or call 1-888-423-4632 (TTY: 711) Monday through Friday, 8 a.m. to 8 p.m. ET. Always talk with your doctor before starting an exercise program.

    1Participating locations (“PL”) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL.
    2Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location.
    SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved.

     

    2024 Plan Year

    With SilverSneakers®, is more than a traditional fitness program. It’s an opportunity to improve your health, gain confidence and connect with your community.

    At the gym:

    • Many locations all around the country.1
    • You can sign up at multiple locations, whenever you want.
    • There are classes for all skill levels and abilities.2

    At home:

    • SilverSneakers LIVE online classes and workshops led by specially trained instructors, happening every day.
    • SilverSneakers On-Demand videos that you can watch anytime.
    • Use the SilverSneakers GO mobile app for personalized resources, changing workout plans and more.
    In your community:
    • Get active outside of traditional gyms at recreation centers, parks and other neighborhood locations.
    • Enjoy access to online GetSetUp3 classes on topics like cooking and nutrition, technology and brain games.

    Make a free online account at SilverSneakers.com to see your Member ID and all the things you can use in the program without paying extra.

    SilverSneakers Program Flier
    English | Spanish

    For additional questions, go to SilverSneakers.com or call 1-888-423-4632, TTY: 711, Monday through Friday, 8 a.m. to 8 p.m. ET.

    1. Participating locations (“PL”) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL.
    2. Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer members additional classes. Classes vary by location.
    3. GetSetUp is a third-party service provider and is not owned or operated by Tivity Health, Inc. (“Tivity”) or its affiliates. Users must have internet service to access GetSetUp service. Internet service charges are responsibility of user. Charges may apply for access to certain GetSetUp classes or functionality.

    SilverSneakers and the SilverSneakers shoe logotype are registered trademarks of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved.

  • 2025 Plan Year

    You receive a $1,500 allowance every year for hearing aids, for both ears combined.

    $0 copay for 1 evaluation/fitting every year, and 1 routine hearing exam every year. For help finding a hearing provider, contact Member Services.

    2024 Plan Year

    You receive a $2,500 allowance every year for hearing aids, for both ears combined. $0 copay for 1 evaluation/fitting every year, and 1 routine hearing exam every year. For help finding a hearing provider, contact Member Services.

  • 2025 Plan Year

    $0 copay

    Personal emergency response system (PERS), also known as medical alert systems, provide continuous in-home and mobile monitoring to aging and at-risk populations.

    PERS allows members to call for assistance 24/7, whether at home or on the go.

    • Members are immediately connected with professionally trained operators who quickly assess the nature of a call and coordinate appropriate assistance.
    • A member experiencing a medical emergency presses a button to speak with an operator who immediately coordinates emergency dispatch.
    • Coverage for one personal emergency response device.

    To get started, call 1-800-979-9238, TTY: 711, 8 a.m. to 5 p.m., Monday through Friday or visit bcbsaz.connectamerica.com.

     

    2024 Plan Year

    $0 copay

    Personal emergency response system (PERS), also known as medical alert systems, provide continuous in-home and mobile monitoring to aging and at-risk populations.

    PERS allows members to call for assistance 24/7, whether at home or on the go.

    • Members are immediately connected with professionally trained operators who quickly assess the nature of a call and coordinate appropriate assistance.
    • A member experiencing a medical emergency presses a button to speak with an operator who immediately coordinates emergency dispatch.

    To get started, call 1-800-979-9238, TTY: 711, 8 a.m. to 5 p.m., Monday through Friday or visit bcbsaz.connectamerica.com.

  • $0 copay for 12 treatments every year

    This benefit is in addition to the Medicare-covered Acupuncture. Benefit includes coverage for supplemental coverage for evaluation and management, acupuncture and acupressure, modalities, and therapeutic procedures for treatment of pain syndromes, musculoskeletal conditions, and nausea not covered by Medicare. Acupuncture services are delivered by participating American Specialty Health (ASH) providers. To find a contracted ASH provider, please call 1-800-678-9133, TTY: 711, Monday – Friday, 5 a.m. to 8 p.m.; Saturday 12 p.m. to 8 p.m. Pacific Time, or visit ashlink.com/ash/BCBSAZHCP.

  • $0 copay for 12 visits every year

    This benefit is in addition to the Medicare-covered Chiropractic services. Supplemental coverage for evaluation and management, X-ray examination, chiropractic manipulative therapy, modalities, therapeutic procedures, and physical rehabilitation for musculoskeletal conditions of the spine & extremities. Chiropractic services are provided by a Doctor of Chiropractic – DC (“Chiropractor”). Chiropractic services are delivered by participating American Specialty Health (ASH) providers. To find a contracted ASH provider, please call 1-800-678-9133, TTY: 711, Monday – Friday, 5 a.m. to 8 p.m.; Saturday 12 p.m. to 8 p.m. Pacific Time, or visit ashlink.com/ash/BCBSAZHCP.

  • $0 copay for 6 visits every year

    Includes Supplemental Benefit Coverage for preventive clinical services for the skin of the foot and toenail care, including removal of corns and calluses, nail trimming, and preventive foot hygiene. Routine Foot Care services are provided by a Doctor of Podiatric Medicine – DPM (“Podiatrist”). Podiatry services are delivered by participating American Specialty Health (ASH) providers. To find a contracted ASH provider, please call 1-800-678-9133, TTY: 711, Monday – Friday, 5 a.m. to 8 p.m.; Saturday 12 p.m. to 8 p.m. Pacific Time, or visit ashlink.com/ash/BCBSAZHCP.

  • 2025 Plan Year

    Lodging and Utilities Flex Card

    $0 copay

    If eligible, our plan offers a prepaid Mastercard® debit card with a limit of up to $1,000 per year to help cover the cost of lodging and certain utilities (electric, gas, sanitary, water, and/or telephone service).

    To qualify, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have qualifying chronic conditions: Complications from prediabetes or diabetes and/or recent hospitalization for diabetes or a medical condition worsened by pre-diabetes or diabetes. Not all members qualify, as other coverage criteria may also apply.

    Any unused Flex Card benefit dollars will expire at the end of the year. The funds are intended for temporary accommodation following a qualifying inpatient hospital stay, rather than being allocated for rental or mortgage assistance. This benefit is for your use only, may not be sold or transferred, and has no cash value. All other trademarks referenced are the property of their respective companies.

    2024 Plan Year

    Lodging and Utilities Flex Card

    If eligible, our plan offers a prepaid Visa® debit card with a limit of up to $1,000 per year to help cover the cost of lodging after an eligible inpatient stay and certain utilities (electric, gas, sanitary, water, and/or telephone service).

    To qualify, you must be actively engaged with BCBSAZ Health Choice Pathway care management and have qualifying chronic conditions: Complications from prediabetes or diabetes and/or recent hospitalization for diabetes or a medical condition worsened by pre-diabetes or diabetes.

    Any unused Flex Card benefit dollars will expire at the end of the year. The funds are intended for temporary accommodation following a qualifying inpatient hospital stay, rather than being allocated for rental or mortgage assistance. This benefit is for your use only, may not be sold or transferred, and has no cash value.

  • $0 copay for 6 visits every year

    Supplemental coverage for therapeutic massage, including assessment, massage, or soft tissue work for treatment of myofascial conditions, musculoskeletal injuries, and pain syndromes. Therapeutic Massage services are provided by licensed providers of massage including licensed massage therapists – LMT, and can also be provided by physical therapists. Therapeutic massage services are delivered by participating American Specialty

    Health (ASH) providers. To find a contracted ASH provider, please call 1-800-678-9133, TTY: 711, Monday – Friday, 5 a.m. to 8 p.m.; Saturday 12 p.m. to 8 p.m. Pacific Time, or visit ashlink.com/ash/BCBSAZHCP.

  • 2025 Plan Year

    $0 copay

    You receive up to 24 additional one-way transportation trips every calendar year. If you need transportation to and from plan-approved locations, including medical appointments, call 1-888-418-0903, TTY: 711, 24 hours a day, 7 days a week.

    Please call 72 hours before your appointment to schedule transportation. If you have an urgent medical need, please call to arrange transportation. For emergency medical needs, please call 911.

    2024 Plan Year

    You receive up to 48 additional one-way transportation trips every calendar year. If you need transportation to and from plan-approved locations, including medical appointments, call 1-888-418-0903, TTY: 711, 24 hours a day, 7 days a week. Please call 72 hours before your appointment to schedule transportation. If you have an urgent medical need, please call to arrange transportation. For emergency medical needs, please call 911.

  • Telehealth Flyer
    English | Spanish

    Quick access to a Provider when you need care

    You can talk to a primary care provider, specialist, or urgent care from the comfort of your own home 24 hours a day, 7 days a week. Not all medical conditions can be treated through virtual visits. Download the BlueCare Anywhere app today or visit bluecareanywhereaz.com to get started.

  • 2025 Plan Year

    You receive a $350 allowance towards your choice of contacts and/or eyeglasses (lenses and frames).

    $0 copay for 1 routine eye exam every year. For help finding a vision provider, contact Member Services.

    2024 Plan Year

    You receive a $450 allowance towards your choice of contacts and/or eyeglasses (lenses and frames) every year and $0 copay for 1 routine eye exam every year. For help finding a vision provider, contact Member Services.

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© BCBSAZ Health Choice Pathway

BCBSAZ Health Choice Pathway (HMO D-SNP) is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in BCBSAZ Health Choice Pathway (HMO D-SNP) depends on contract renewal. BCBSAZ Health Choice Pathway is a subsidiary of Blue Cross® Blue Shield® of Arizona.

Member Services can be reached at 1-800-656-8991, TTY 711, 8 a.m. to 8 p.m., 7 days a week. Member Services also has free language interpreter services available for non-English speakers.

Every year, Medicare evaluates plans based on a 5-star rating system.

H5587_D40881PY25_M Last Updated: 10/1/24