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First Choice VIP Care Plus (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for First Choice VIP Care Plus (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on First Choice VIP Care Plus (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
First Choice VIP Care Plus (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Independence Health Group, Inc. available for enrollment in 2025 to people living in SC - 42 of 46 counties. The overall rating for this plan is not yet available for 2025.
It's important to know that First Choice VIP Care Plus (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
First Choice VIP Care Plus (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about First Choice VIP Care Plus (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For First Choice VIP Care Plus (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for First Choice VIP Care Plus (Medicare-Medicaid Plan)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The First Choice VIP Care Plus (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. This plan has a $0 deductible. During the initial coverage phase, you will pay the costs for drugs in each tier until your total drug costs reach $2,000. After your yearly out-of-pocket drug costs reach $2,000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The First Choice VIP Care Plus plan offers comprehensive coverage with a focus on outpatient services and essential care. Many services, including primary care, emergency services, and ambulance services, have no copay. The plan also includes benefits for hearing, vision, and dental services, with coverage for routine exams, eyewear, and some dental procedures. Additionally, the plan provides coverage for home health services, medical equipment, and various other services like over-the-counter items and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits are covered for the First Choice VIP Care Plus (Medicare-Medicaid Plan), but additional days for inpatient hospital acute and psychiatric, as well as non-Medicare covered stays and upgrades, are not covered. Prior authorization is required.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, and outpatient blood services, but individual and group sessions for outpatient substance abuse are not covered. Outpatient blood services have a three-pint deductible waived.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. There is no information about the cost of this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the First Choice VIP Care Plus (Medicare-Medicaid Plan), with no copay or coinsurance for all ambulance services, but ground and air ambulance services are not covered. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by First Choice VIP Care Plus (Medicare-Medicaid Plan), with no copay and no coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care benefits include Primary Care Physician Services, Physician Specialist Services, Occupational Therapy Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits, all with no copay and no coinsurance, but with authorization required for Occupational Therapy, Physical Therapy, and Speech-Language Pathology services. Chiropractic Services and Mental Health Specialty Services are partially covered, with Routine Chiropractic Care, Individual Sessions for Mental Health Specialty Services, and Group Sessions for Mental Health Specialty Services not covered. Podiatry Services and Individual and Group Sessions for Psychiatric Services are not covered.
Preventive Services See details
Preventive services are covered, but annual physical exams, personal emergency response systems (PERS), medical nutrition therapy (MNT), re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefit, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, home and bathroom safety devices and modifications, and counseling services are not covered. Some services like health education, in-home safety assessment, post-discharge in-home medication reconciliation, fitness benefit, enhanced disease management, telemonitoring services, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visit are covered.
Hearing Services See details
Hearing services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with no copay for exams, and no deductible. Routine hearing exams are covered once per year, and fitting/evaluation for hearing aids are covered three times every three years. Prescription hearing aids are covered up to a maximum of $1500 every three years, though prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision services include coverage for routine eye exams with 1 exam covered every year, and eyewear with a combined maximum benefit of $150 every two years. Contact lenses and eyeglasses (lenses and frames) are covered, with one pair allowed every two years. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental Services are partially covered under the First Choice VIP Care Plus (Medicare-Medicaid Plan) plan, but the plan does not cover Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics. Medicare Dental Services are covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs are covered under this plan. Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered under this plan.
Medical Equipment See details
Medical Equipment benefits are covered by the First Choice VIP Care Plus plan. Durable Medical Equipment, Prosthetics/Medical Supplies (Non-Medicare benefit) are covered with no copay and no coinsurance, but prior authorization is required. Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered with no copay, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. Prior authorization is required.
Home Health Services See details
Home Health Services are covered, with no copay or coinsurance, but authorization is required. Personal Care Services, Other 1 for Home Health Services, and Other 2 for Home Health Services are covered. Additional Hours of Care is not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but this plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the First Choice VIP Care Plus plan, with prior authorization and a doctor referral required. Non-Medicare-covered stays for SNF are covered, and the plan offers enhanced benefits with additional days beyond Medicare coverage.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with a maximum benefit of $100 every three months, as well as Behavioral Health Services, Palliative Care, Outpatient Mental Health Services, Infusion Centers, Residential Personal Care Services, Nursing Home Transition Services (1 session per year), Respite Care, Adult Day Health Services & Nursing Services, Environmental Modifications (up to $7,500 per lifetime), Telemedicine, Companion Services, Adult Day Health Transportation, Two (2) Additional Prescription Drugs, Personal Emergency Response System, Meal Benefit (2 meals per day), and Oral Nutritional Supplements (up to 96 per month). Acupuncture, Meal Benefit, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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