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Information for

  • 2019
  • 2020

Supplemental Benefits

At Eon Health we provide you with additional benefits not covered under Original Medicare. Some of these Supplemental Benefits include enhanced dental, hearing and vision coverage.

Dental Services

Take care of your teeth, gums and mouth for overall health. All of Eon Health’s Medicare plans provide preventive and comprehensive dental coverage.

Covered services:

In-network

  • $0 preventive dental services
    • Cleaning twice a year
    • Dental x-rays twice a year
    • Oral exam twice a year
    • 1 dental bitewing x-ray twice a year
    • 1 panoramic x-ray every five years
  • Up to $800 of covered comprehensive dental services (Eon Deluxe, Eon Silver, Eon Select)
    • Fillings
    • Simple extractions
    • Denture repair
  • $0 partial or complete dentures every five years (Eon Deluxe, Eon Silver, Eon Select)

Out-of-network

Eon Gold (PPO SNP), Eon Choice (PPO)

  • You pay 40% coinsurance for Medicare-covered and comprehensive dental services.

Vision Services

Good eyesight plays an important role in overall health and happiness. Eon Health provides additional vision benefits.

Covered services:

In-network

  • $0 copay for routine eye exam up to 1 every year
  • $0 copay contact lenses up to 1 every year
  • $0 copay eyeglasses (frames and lenses) up to 1 every year
  • $0 copay eyeglasses or contact lenses after cataract surgery
  • Eon Deluxe (HMO SNP): Up to $225 covered every year for contact lenses and eyeglasses (frames and lenses)
  • Eon Silver (HMO SNP), Eon Select (HMO), Eon Gold (PPO SNP): Up to $175 covered every year for contact lenses and eyeglasses (frames and lenses)
  • Eon Choice (PPO): Up to $135 covered every year for contact lenses and eyeglasses (frames and lenses)

Out-of-Network

Eon Gold (PPO SNP), Eon Choice (PPO)

  • You pay a 50% coinsurance for a routine eye exam up to 1 every year
  • You pay a 50% coinsurance for contact lenses up to 1 every year
  • You pay a 50% coinsurance for eyeglasses (frames and lenses) for up to 1 every year
  • You pay a 50% coinsurance for eyeglasses or contact lenses after cataract surgery

Hearing Services

Eon Health provides additional hearing benefits.

Covered services:

In-network

  • $0 copay routine hearing exam up to 1 every year (Eon Deluxe)
  • $25 copay routine hearing exam up to 1 every year (Eon Silver, Eon Select, Eon Choice, Eon Gold)
  • $0 copay hearing aid fitting and evaluation up to 1 every 3 years
  • Up to $750 coverage for hearing aids every 3 years

Out-network

(Eon Gold (PPO SNP)), Eon Choice (PPO)

  • You pay a 50% coinsurance for a routine hearing exam up to 1 every year
  • You pay a 50% coinsurance for a hearing aid fitting and evaluation up to 1 every 3 years
  • You pay a 50% coinsurance for hearing aids

Fitness

With any Eon Health Medicare plan, you enjoy a covered SilverSneakers™ fitness benefit. Covered services include:

  • Membership to SilverSneakers™ approved fitness facility per month
  • Orientation to the fitness center and instructions about how to use equipment and services
  • And/or, one Step Kits per year for those members with limited access to a network fitness center

Over-The-Counter (OTC) Benefits

Over-the-counter (OTC) medicines are drugs you can buy without a prescription. Some OTC medicines relieve aches, pains and itches. Some prevent or cure diseases, like tooth decay and athlete’s foot. Others help manage recurring problems, like migraines. Eon Health understands your need to sometimes use these OTC items, so we provide you with additional OTC benefits.

Covered services:

In-network

  • Eon Deluxe (HMO SNP): $45 monthly allowance on covered OTC items
  • Eon Silver (HMO SNP), Eon Select (HMO), Eon Gold (PPO SNP) & Eon Choice (PPO): $20 monthly allowance on covered OTC items

For an explanation of out-of-network OTC coverage, please refer to your Over the Counter Booklet.

For easy ordering, refer to the Mail Order Form.

Transportation

Covered Services include:

  • Eon Deluxe: $0 copay for up to 30 one-way trips to plan-approved locations.

Telehealth

Profile

  • On-demand, text-based diagnosis and treatment
  • No appointments, no travel, no waiting rooms
  • Expert care from board-certified doctors
  • Available anytime, day or night

Privacy

Health records are kept totally private and protected. You determine who can see the information in your record.

DO I TALK TO “REAL DOCTORS”?

  • Yes, Eon members only talk to actual doctors who are board certified and licensed in the U.S.
  • 98point6 doctors have training and are credentialed.

WHAT ARE SOME OF THE MEDICAL CONDITIONS 98POINT6 WILL TREAT?

  • Common medical conditions such as respiratory infections, cold and flu symptoms, allergies and many other non-emergency conditions.

CAN I REQUEST A PARTICULAR DOCTOR?

  • This service is designed to support your relationship with your existing primary care physician (PCP); It is not intended to replace your doctor.

CAN I GET A PRESCRIPTION?

  • 98point6 does not guarantee prescriptions. The 98point6 doctor will determine if a prescription is needed based on best treatment. 98point6 doctors will not prescribe controlled substances or any drugs which may be harmful because of their potential for abuse.

CAN I SPEAK TO A 98POINT6 DOCTOR OUTSIDE OF THE U.S.?

  • 98point6 doctors are NOT available outside of the United States.

For More Information click here

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Eon Health has a contract with Medicare to offer HMO and PPO Plans. Eon Health also has a contract with the Georgia Medicaid program and a contract with the South Carolina Medicaid program. Enrollment in Eon Health depends on contract renewal. Eon Deluxe (HMO SNP): This plan is available to anyone who has both Medicare and received assistance from the State. Eon Silver (HMO SNP) and Eon Gold (PPO SNP): These plans are available to anyone with Medicare who has been diagnosed with Cardiovascular Disorder, Chronic Heart Failure or Diabetes. Eon Health has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2022 based on a review of Eon Health’s Model of Care. This information is not a complete description of benefits. Contact the plan for more information. Limitations, Copayments, and restrictions may apply. Benefits, formulary, pharmacy/provider network, premium and cost sharing may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Premiums, co-pays/co-insurance may vary based on the level of Extra Help you receive. Please contact the plan for further details. Medicare beneficiaries may also enroll in Eon Health through the CMS Medicare Online Enrollment Center located at www.medicare.gov. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary Eon Gold (PPO SNP) and Eon Choice (PPO),: Out of network/non-contracted providers are under no obligation to treat Eon Health members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask for a pre-service organization determination before you receive the service. Please call our customer service or see your Evidence of Coverage for more information, including cost-sharing that applies to out-of-network services.