LifeWorks Advantage

LifeWorks Advantage (HMO SNP) members get more than what is covered by Original Medicare, with a dedicated nurse practitioner leading a personalized care plan. LifeWorks Advantage is a Special Needs Plan that covers all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D).

If you or your loved one is eligible, LifeWorks Advantage may be the extra help you need to maintain and enhance your health and well-being. Some of the benefits include specialized chronic disease care coordination, preventative screenings, and routine vision coverage.

Membership advantages include:

  • Coordinated care and more personal attention.
  • Part D prescription drug coverage.
  • Routine vision, hearing, and foot care, plus preventive services and screenings.
  • Regular visits from your nurse practitioner to your residing nursing center to help avoid unnecessary and often unwanted trips to the hospital.
  • Nurse practitioners can complete tests and treatments in the nursing center that are normally done in the hospital.
  • One point of contact for communication with you, your family, your doctors, and the nursing center staff.

Benefit Highlights

2018 Benefit Highlights

How much is the monthly premium?

$30.00 per month. In addition, you must keep paying your Medicare Part B premium.

How much is the deductible?

$183 per year for in-network services.
$405 deductible per year for Part D prescription drugs.

Is there any limit on how much I will pay for my covered services?

Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care. Your yearly limit(s) in this plan:

  • $6,700 for services you receive from in-network providers.

If you reach the limit on out-of-pocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs.

Is there a limit on how much the plan will pay?

Our plan has a coverage limit every year for certain in-network benefits. Contact us for the services that apply.

Benefits Coverage
Primary Care Physician (PCP) Visit $0 Copay – You Pay Nothing
Foot Care $0 Copay for 6 routine podiatry visits every year
Hearing $0 Copay for routine hearing exam and hearing aid fitting
Plan pays up to $2,000 for hearing aids every two years
Vision $0 Copay for routine eye exam and glaucoma
Plan pays up to $300 for eyewear every year
Preventive Care $0 Copay for annual preventive screenings and routine physicals
Skilled Nursing No prior hospital stay is required for a skilled nursing stay

2019 Benefit Highlights

How much is the monthly premium?

$30.60 per month. In addition, you must keep paying your Medicare Part B premium.

How much is the deductible?

$183 per year for in-network services. This may change for 2019.
$415 deductible per year for Part D prescription drugs. This may change for 2019.

Is there any limit on how much I will pay for my covered services?

Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care. Your yearly limit(s) in this plan:

  • $6,300 for services you receive from in-network providers.

If you reach the limit on out-of-pocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year. Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs.

Is there a limit on how much the plan will pay?

Our plan has a coverage limit every year for certain in-network benefits. Contact us for the services that apply.

 Benefits Coverage
Primary Care Physician (PCP) Visit $0 Copay – You Pay Nothing
Routine Foot Care $0 Copay for 6 routine podiatry visits every year
Hearing $0 Copay for routine hearing exam and hearing aid fitting
Plan pays up to $2,000 for hearing aids every two years
Vision $0 Copay for routine eye exam and glaucoma test
Plan pays up to $300 for eyewear every year
Preventive Care $0 Copay for annual preventive screenings and routine physicals
Skilled Nursing No prior hospital stay is required for a skilled nursing stay

Full benefits, plan premiums, and cost sharing information for this plan may be found within the Summary of Benefits , found on the Member Resources page. LifeWorks Advantage will help make your Medicare benefits work better for you.

LifeWorks Advantage Management

LifeWorks Advantage (HMO SNP) is locally-managed by Medical Facilities of America (MFA). MFA is the regional leader in providing quality skilled nursing and rehabilitation care throughout Virginia and North Carolina. The company has been a trusted part of the community for more than 40 years, and it is proud to be a dedicated champion of health and wellness throughout the region. The “flagship product” is the LifeWorks Rehab program, which is available exclusively at MFA LifeWorks Rehab and Skilled Nursing Centers. With over 40 centers currently in operation (and more planned in the future), no other skilled nursing and rehabilitation facilities have greater regional coverage. Like a trusted neighbor, MFA is here for you and your family when you need us most, to get you back on your feet and back home as quickly as possible.

Want more information about LifeWorks Advantage?

Call us at 1-844-854-6883 or TTY 711. Our trained member service representatives are available from 8:00 a.m. to 8:00 p.m., or fill out this contact request form to have us call you.

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