Plan benefits

There are no copays for covered services

• Primary care from doctors who specialize in HIV/AIDS
• Behavioral health care (mental and substance abuse services)
• Immunizations and wellness visits
• Specialist visits
• Urgent and emergency care
• Lab and X-ray services
• Pregnancy services
• Family planning
• Hospital care
• Physical therapy
• Speech and hearing services
• Smoking cessation services
• Home health care services
• Disease management services

Some services may require a referral or prior authorization before you can get them.

See your member handbook for a full list of benefits.

Vision services include:

• Eye exams
• Eyeglass frames and lenses, if medically necessary
• Contact lenses, if medically necessary

To find an eye doctor, call iCare Health Solutions at 855-418-1627 (TTY 711).

Your benefits include a wide range of prescription and over-the-counter drugs. We work with CarelonRx to provide these benefits. There are no copays when you fill your prescription at a plan pharmacy. Visit the Pharmacy page to find a pharmacy near you and check if your medicine is covered.

If you need transportation to your medical appointments, you or your provider can schedule a ride for you 8 a.m. to 5 p.m. Monday through Friday at no cost. At least three business days before your appointment, call:

• 844-628-0388 in Broward, Miami-Dade, and Monroe counties.
• 866-372-9794 in all other counties.

Please call back if anything changes.

Visit our transportation page for more information about scheduling a ride.

We offer extra benefits with no copays like:

• $25 a month per household to buy certain personal care items and over-the-counter (OTC) medicines
  • Choose from a list of approved OTC items ( English / Spanish ). Visit the online drugstore to place your order. You will get your items mailed to your home!
• Vision benefits:
  • One eyeglass frame per year
  • One eye exam per year
  • One six-month supply of contact lenses with prescription
• An extra 200 minutes at enrollment and 100 minutes for their birthday for members enrolled in the federal SafeLink program, which provides a free smartphone with free monthly minutes and text messaging
• Nonemergency transportation for non-medical reasons, up to four one-way rides per member per month
• Chiropractic services
• Massage therapy, when medically necessary
• Substance abuse services
• Home visits from a clinical social worker
• Nutritional counseling
• Home delivered meals after at least a three-day inpatient hospital stay
• Respiratory therapy and certain supplies
• Occupational, physical, and speech therapies
• Vaccines:
  • Hepatitis B
  • HPV
  • Influenza (flu)
  • Pneumonia
  • Meningococcal
  • Shingles
  • TDaP
• $25 for items to increase calm such as a stress ball, fidget spinner, seasonal affective disorder (SAD) lamp, mood journal, coloring book, or sleep mask for members with autism, sleep disorders, or anxiety
• Up to $100 for hypoallergenic bedding for members diagnosed with asthma or severe allergies
• Up to $200 for lessons to swim for the first 1,000 members who request the benefit each year
• Carpet cleaning services to reduce asthma triggers for members diagnosed with asthma or severe allergies
• Cellphone service. After signing up for the federal Lifeline Program, you can opt in to the Affordable Connectivity Program (ACP) to get the federal benefit, plus extra benefits from CHA.
• Home-delivered meals for pregnant members.
• Nonemergency transportation for nonmedical purposes. Six one-way rides up to 25 miles each per month for members 21 years and older. Maximum of 72 one-way rides per member per year.
• Flu/pandemic prevention kit containing 10 three-ply face masks, an oral digital thermometer, and hand sanitizer.
   

Limitations and restrictions apply. Benefits may change.

You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub. You can also call Member Services at 844-406-2398 (TTY 711) Monday through Friday from 8 a.m. to 7 p.m. Eastern time.

For a full list of extra benefits, review the member handbook.

Log in to get started today!

Earn reward dollars for completing activities to get and stay healthy in these programs:

• Smoking Cessation
  • English
  • Spanish
• Weight Management
  • English
  • Spanish

If you are a pregnant member:

• You can earn up to $40 for going to prenatal care visits before you deliver:
  • $20 incentive for going to a prenatal visit in the first trimester or within 42 days of enrollment into Clear Health Alliance
  • $20 incentive for attending at least six prenatal care visits
• You can earn $20 for going to your postpartum care visit:
  • $20 incentive for attending a postpartum visit 7-84 days after delivery
• Your baby can earn up to $40 for well child visits if they are enrolled in the Simply Healthcare Plans, Inc. Medicaid plan:
  • $20 incentive for baby’s checkup by 2 weeks of age
  • $20 incentive for going to at least six well-child checkups by 15 months of age

After you or your baby completes the above healthy activities, you will receive a mailer for a gift card. To redeem your gift card, please visit CHARewards.com or call 888-689-3420 Monday to Friday from 8 a.m. to 8 p.m. Eastern time.

What is telehealth?

Telehealth is a convenient and simple way to access a provider anytime, anywhere. Telehealth means having a visit with a provider using technology so you or your child can remain at home and still receive the medical care you need.

What resources do I need to access telehealth?

• Telehealth involves two-way, live communication between you and the provider. It can be done over the phone or by a video call, similar to how you would use Apple FaceTime™ or Facebook Messenger™ today.
• If you need assistance with getting a phone, contact Safelink at safelink.com or call 877-631-2550.

• You can receive care for nonurgent medical concerns such as:
  ◦Rash
  ◦Fever
  ◦Sore throat
  ◦Headache
  ◦Behavioral health visits
  ◦And more


• For life-threatening emergencies, please call 911.

Does my doctor provide telehealth?

• Many doctors are offering telehealth. Please contact your doctor’s office to find out how your doctor is providing telehealth and how you can make an appointment.

What do I do if I need behavioral health services or counseling?

Simply Healthcare Plans, Inc. partners with two providers that offer behavioral health services via telehealth for members across Florida. For more information, visit Brave Health at bebravehealth.com or Impower at impowerfl.org.

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Telehealth

We put tools and technologies in your hands to make it easier to access care and services. Your Care Plan is a tool for Clear Health Alliance Case Management members to help you:

• Stay connected with your care coordinator
• Get your care coordinator’s phone number and email address
• Send secure messages about diagnoses, goals, medicines, services and more
• View your goals and objectives
• Check due dates and statuses of goals and objectives