PHP, Florida

Robert Heglar
AHF Provider

Medical Benefits and Costs

Next year, PHP (HMO SNP) is changing coverage for the medical services listed below. The information below describes these changes. For more details about the coverage and costs for these services, see Chapter 4, Medical Benefits Chart (what is covered and what you pay), in your 2019 Evidence of Coverage.

Benefit

2018 (this year)

2019 (next year)

Dental Services

Limited dental services (this does not include services in connection with care, treatment, filling removal or replacement of teeth): You pay $0 copay.

Preventive dental services:

  • Cleaning (for up to 2 every year): You pay $0 copay.
  • Dental x-ray(s) (for up to 1 every year): You pay $0 copay.
  • Fluoride treatment (for up to 2 every year): You pay $0 copay.
  • Oral exam: You pay $0 copay.

Comprehensive dental services such as the following: You pay $0 copay.

  • Non-routine services
  • Diagnostic services
  • Restorative services
  • Endodontics/
    periodontics/
    extractions
  • Prosthodontics, other oral/maxillofacial surgery, other services

Comprehensive dental services are limited to $1,050 every year.

Limited dental services (this does not include services in connection with care, treatment, filling removal or replacement of teeth): You pay $0 copay.

Preventive dental services:

  • Cleaning (for up to 2 every year): You pay $0 copay.
  • Dental x-ray(s) (for up to 1 every year): You pay $0 copay.
  • Fluoride treatment (for up to 2 every year): You pay $0 copay.
  • Oral exam: You pay $0 copay.

Comprehensive dental services such as the following: You pay $0 copay.

  • Non-routine services
  • Diagnostic services
  • Restorative services
  • Endodontics/
    periodontics/
    extractions
  • Prosthodontics, other oral/maxillofacial surgery, other services

Comprehensive dental services are limited to $800 every year.

Therapeutic Massage Therapeutic massage is not covered.

You pay nothing for up to 2 therapeutic massages per month.


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H3132_4006 2019 101518