Rewards and Incentives for Medicare Members

Reward type: Grocery

With an Advance Care Plan, you decide, in advance, in writing, what your healthcare choices are if you cannot speak for yourself. You can specifically direct the kind of treatment you do or do not want. You can find more details about Advance Care Plans and how to create one at sentarahealthplans.com/members/medicare/advance-care-plans.

You can earn a Healthy Reward for talking about your Advance Care Plan with your doctor or other health care provider. If you already have a plan, review it to ensure it still meets your needs.

To receive your Healthy Reward for having an Advance Care Plan, please fill out the form below:

Advance Care Plan Healthy Reward

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Grocery

If you complete your Annual Wellness Visit between January and June, you are eligible for a $100 reward. If you complete your Annual Wellness Visit between July and December, you are eligible for a $50 reward. Members can only earn one $100 reward or one $50 reward per member per plan year.

The Annual Wellness Visit¹ is an appointment with someone from your primary care provider’s team. This informational discussion with your provider establishes your current health today and identifies ways to keep you active and healthy in the future. The Annual Wellness Visit is a good way to help you stay in touch with your provider and ensure you get the help you need with preventive care planning for screenings or exams you may need over the next few years.

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), or Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Standard

Osteoporosis is one of the common causes for women to fall and/or sustain a fracture with a fall. With early detection, osteoporosis can be treated—which can help your recovery in the case of an injury. A bone density test measures how strong your bones are. The test will tell you if you have osteoporosis (or weak bones), and it can help you understand your risk of breaking a bone in the future. Women are at higher risk for osteoporosis than men, and the risk increases with age.

• If you are at risk for osteoporosis, talk with your doctor to see if they recommend completing a bone density scan. 

Eligibility: Female members ages 65+ enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), or Sentara Community Complete Select (HMO D-SNP)

 

Reward type: Standard

Regular mammograms can help detect breast cancer early, when it is easiest to treat. For most women, a mammogram is the best way to detect breast cancer. According to the Susan G. Komen Foundation, the five-year breast cancer survival rate for those diagnosed early (Stage 1) is 98-100%.

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (C-SNP), or Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Standard

According to the Centers for Disease Control and Prevention, regular screening is key to preventing colorectal cancer. For questions about which colorectal cancer screening is best for you, contact your doctor to learn your options. There are different types of screenings available, such as a colonoscopy or an at-home stool testing kit. For questions about which colorectal cancer screening is best for you, please contact your provider.

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), or Sentara Community Complete (HMO D-SNP)

 

Reward type: Standard

Managing your diabetes includes regular screenings to ensure you are staying as healthy as possible. Members with diabetes must complete the diabetic eye exam, diabetic HbA1c test, and diabetic kidney function test to earn this reward. 

• Diabetic HbA1c Test: The HbA1c test (hemoglobin A1C or HbA1c test) is a blood test that measures average blood sugar levels. The higher the level, the greater the chance for diabetes related complications down the road. Members with diabetes should make sure to get tested regularly to help manage diabetes.
• Diabetic Kidney Function Test: Diabetes can damage the kidneys. Early kidney disease does not usually show symptoms, making it important to get tested regularly. Kidney function testing is important to ensure the kidneys are functioning optimally.
• Diabetic Eye Exam: Diabetic retinopathy is a common diabetes complication, and it is a leading cause of blindness in adults in the United States. If you have diabetes, you should check your eye health each year, even if you do not wear eyeglasses. This will help you protect and preserve your vision.

Eligibility: Members with diabetes who are enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), or Sentara Community Complete (HMO D-SNP) or Sentara Community Complete Select (HMO D-SNP)

Reward type: Grocery

The HRA is a questionnaire that evaluates a member’s lifestyle and health status, as well as identifying possible risks factors. Your Care Coordinator will work with you to develop a plan to help you reach your health goals.

You can easily complete your HRA by calling the Sentara Medicare Outreach Team at 1-833-771-1427 (TTY: 711), October 1 – March 31, 7 days a week, 8 a.m. – 8 p.m. and April 1 – September 30, Monday – Friday, 8 a.m. – 8 p.m.

You will earn $50 for completing your first HRA within 90 days of joining Sentara Medicare. If you are not new to the plan, you will earn $25 for completing your annual HRA.

Eligibility: Members enrolled in Sentara Community Complete (HMO D-SNP), Sentara Community Complete Select (HMO D-SNP), or Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP)

Reward type: Standard

Meet with a licensed nurse practitioner in the convenience of your own home for a complete health assessment. During this visit, a licensed nurse practitioner will review your medications, complete a general wellness exam, discuss any preventive care services you may need, and go over your questions. The licensed nurse practitioner will also share a copy of your results with your doctor. 

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Grocery

You must meet certain criteria to be eligible for the Medication Therapy Management Program.

Eligibility is based on certain criteria, such as the number of medications taken, if you have certain chronic conditions, and the estimated annual cost of the medications. If eligible, Express Scripts (ESI) will contact you on behalf of Sentara Medicare to ask if you are interested in completing a Comprehensive Medication Review.

If you take eight or more medications for more than one chronic health condition and want to see if you are eligible for a Medication Therapy Management program, contact the ESI Pharmacy Help Desk at 1-855-723-7009(TTY: 711) Monday–Friday, 8 a.m.–6 p.m.

Eligibility: Eligible members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Standard

As a member, you get access to preventive care, plus many other extra benefits and services that can help you manage your overall health and well-being. But, accessing these benefits can get overwhelming.

You can learn more about your plan and earn a Healthy Reward by completing one of the following activities:

• Completing a "Welcome Call" or "Benefit Check-In Call" with a friendly Sentara Medicare Outreach team member. You can call the Outreach Team at 1-833-771-1427 (TTY: 711), October 1–March 31, 7 days a week, 8 a.m.–8 p.m., and April 1–September 30, Monday–Friday, 8 a.m.–8 p.m.
• Watching the Orientation to Your Plan video. Learn more here.

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO), Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP)

Reward type: Standard

Following an in-patient hospital admission, it’s important to have a follow-up with your personal doctor within 30 days after you get home. This visit allows your doctor to check on you and ensure you aren’t having any complications. This is a great time to ask your doctor questions about what caused your admission, and how to prevent it from happening again and keep you healthy.

Eligibility: All members enrolled in Sentara Medicare Value (HMO), Sentara Medicare Prime (HMO),Sentara Medicare Salute (HMO), Sentara Medicare Engage – Diabetes and Heart (HMO C-SNP), Sentara Community Complete (HMO D-SNP), or Sentara Community Complete Select (HMO D-SNP) with an in-patient hospital admission. A visit with a doctor or nurse must be completed within 30 days after discharge.

For most rewards, simply schedule an appointment with an in-network provider for the service. When you complete the screening or exam, a claim is submitted to us from your provider. Once Sentara Medicare receives the claim, your reward funds will be added to your prepaid flex card within 8 –10 weeks.

The benefit you get from participating in the Healthy Rewards program is more than just earning reward funds. Preventive care and staying on top of your health are important to healthy aging. The rewards activities selected can help you manage your overall wellness and help you develop a roadmap to achieve your health goals.

For questions about the rewards program, please call Sentara Medicare member services at 1-800-927-6048 (TTY: 711).