Pennsylvania Health & Wellness
Remove Pennsylvania Health & Wellness from comparison1-844-626-6813
(TTY: 1-844-349-8916)
www.PAHealthWellness.com
To see a list of services covered by all plans, go to Physical and behavioral health benefits and Long-term services and supports.
People with Medicare pay the co-pays below except prescription drug co-pays. People with both Medicare and Medicaid get most prescriptions through Medicare Part D. They pay Part D co-pays, not the prescription co-pays listed here.
Ambulance - Per trip $0
Dental care - $0
Inpatient hospital
Per day - $0
Maximum with limits - $0
Medical centers
Ambulatory surgical center - $0
Federal Qualified Health Center or Regional Health Center - $0
Independent medical/surgical center - $0
Short procedure unit - $0
Medical equipment
Purchase - $0
Rental - $0
Medical visits
Certified nurse practitioner - $0
Chiropractor - $0
Doctor - $0
Optometrist - $0
Podiatrist - $0
Outpatient hospital
Per visit – Outpatient surgical, except maternity - $0
Per visit – Non-surgical or diagnostic - $0
Prescriptions
Generic - $0
Brand name - $3
X-rays - Per service $0
- Beyond Medicaid coverage of dental services, extra dental cleanings, visits and oral hygiene kit for participants who are Nursing Facility Clinically Eligible (NFCE)
- Beyond Medicaid covered vision services, $100 yearly allowance for glasses or contacts for participants who are NFCE
- Free Smartphone with 1000 free talk minutes, 1 GB of data and unlimited texts for participants who qualify
- After hospital stay: 14 days of home delivered meals
- After hospital stay: 14 days of respite care
- Caregiver access and supports
- Health library
- Healthy Rewards Program purchasing card to get health items at authorized retailers. Learn more on the My Health Pays™ web page
- Support services for members waiting for LTSS eligibility determination
- 90-day prescription refill for those not on Medicare
- 1 week of home delivered meals for each member leaving nursing facility, regardless of waiver benefit coverage
* There are no co-pays for persons living in a nursing, personal care or domiciliary home. Pregnant women, new mothers and terminally ill participants getting hospice care have no co-pays. Some services, items and drugs have no co-pays. For co-pay updates, go to ow.ly/WGQM30hern9.