Routine eye exam & eyewear
NationsVision
A yearly routine eye exam, plus an allowance toward glasses or contact lenses.
- $0 for 1 routine eye exam per year
- Use the allowance for contacts, eyeglasses, lenses, frames, and upgrades
- You pay any costs above your allowance
Healthy Mississippi Premier Advantage (HMO-POS)
$300 eyewear allowance per year
In network only · 1 pair of glasses (lenses and frames) per year
Healthy Mississippi Preferred (PPO)
$250 eyewear allowance per year
1 pair of glasses per year · Out of network: 50% coinsurance, same shared allowance · For out-of-network eye exams and eyewear, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
$325 eyewear allowance per year
1 pair of glasses per year · Out of network: 40% coinsurance, same shared allowance · For out-of-network eye exams and eyewear, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
$325 eyewear allowance per year
1 pair of glasses per year · Out of network: 50% coinsurance, same shared allowance · For out-of-network eye exams and eyewear, submit your receipt to NationsBenefits for reimbursement
How to use it: See an eye doctor in the NationsVision network. To find one, search online at HealthyMS.NationsBenefits.com, use your NationsBenefits Pro Portal, or call NationsBenefits at 877-740-2369 (TTY 711).
Hearing exams & hearing aids
NationsHearing
A yearly routine hearing exam and fitting, plus coverage for prescription hearing aids.
- $0 for 1 routine hearing exam per year
- $0 for 1 hearing aid fitting/evaluation per year
- Up to 2 prescription hearing aids per year (OTC hearing aids are not covered)
Healthy Mississippi Premier Advantage (HMO-POS)
$0 copay, up to $1,950 per year
In network only · Allowance covers both ears combined
Healthy Mississippi Preferred (PPO)
$0 copay, up to $1,950 per year
Both ears combined · Out of network: 50% coinsurance, same shared allowance · For out-of-network hearing care, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
Tier 1: $399 copay per ear · Tier 2: $699 copay per ear
Up to 2 hearing aids per year · Out of network: 40% coinsurance · For out-of-network hearing care, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
$0 copay, up to $1,950 per year
Both ears combined · Out of network: 50% coinsurance, same shared allowance · For out-of-network hearing care, submit your receipt to NationsBenefits for reimbursement
How to use it: To find a provider, call NationsBenefits at 877-740-2369 (TTY 711) or visit HealthyMS.NationsBenefits.com.
OTC + SSBCI allowance
NationsOTC
An allowance for over-the-counter supplies such as bandages, toothpaste, and incontinence underwear. Members who qualify for SSBCI can use the same allowance for groceries, utilities, and rent or mortgage.
- One shared allowance covers OTC items and, if you qualify, SSBCI items
- SSBCI is only for members who qualify (see below)
Healthy Mississippi Premier Advantage (HMO-POS)
$205 every 3 months
In network only · Unused funds do not roll over · Quarters start January 1, April 1, July 1, and October 1
Healthy Mississippi Preferred (PPO)
$205 every 3 months
Unused funds do not roll over · OTC out of network: 50% coinsurance (not SSBCI) · For out-of-network OTC purchases, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
$400 every month
Does not cover OTC medications, such as pain relievers · Unused funds roll over until December 31, 2027 · OTC out of network: 40% coinsurance (not SSBCI) · For out-of-network OTC purchases, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
$300 every 3 months
Unused funds roll over until December 31, 2027 · OTC out of network: 50% coinsurance (not SSBCI) · For out-of-network OTC purchases, submit your receipt to NationsBenefits for reimbursement
How to use it: Your allowance is loaded onto your NationsBenefits debit card. Shop at participating retailers, order by phone, use the NationsBenefits app, or order online at HealthyMS.NationsBenefits.com or Walmart.com. Prices can vary, so it pays to compare.
Meals after a hospital stay
NationsBenefits
Freshly prepared (not frozen) meals after you leave the hospital, to help you recover and manage your health. Options include diabetic and kosher meals.
Healthy Mississippi Premier Advantage (HMO-POS)
14 meals after discharge
In network only · $0 copay
Healthy Mississippi Preferred (PPO)
14 meals after discharge
Out of network: 50% coinsurance
Healthy Mississippi Dual Advantage (PPO D-SNP)
14 meals after discharge
Out of network: 40% coinsurance
Healthy Mississippi Institutional (PPO I-SNP)
14 meals after discharge
Out of network: 50% coinsurance
How to use it: Nothing to do on your own. Our case managers set up your meals for you after discharge.
Rides to health care
NationsBenefits
Rides to plan-approved locations like doctors’ offices, hospitals, clinics, and pharmacies. Rides may be by car service (such as Uber or Lyft), wheelchair van, or other medical transport, depending on your needs.
- $0 copay per trip
- A missed ride still counts against your trips, one for each one-way trip you scheduled
- Not sure a trip qualifies? Call us to check
Healthy Mississippi Premier Advantage (HMO-POS)
48 one-way trips per year
In network only · Up to 100 miles per trip
Healthy Mississippi Preferred (PPO)
48 one-way trips per year
Up to 100 miles per trip · Out of network: 50% coinsurance · For out-of-network rides, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
48 one-way trips per year
Up to 75 miles per trip · Out of network: 40% coinsurance · For out-of-network rides, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
Not included in this plan
How to use it: Schedule at least 3 days ahead by calling NationsBenefits at 877-740-2369 (TTY 711). For a Friday appointment, call by Wednesday.
Health education & weight management
NationsBenefits
One-on-one health coaching. In 30-minute sessions, you and your coach talk through your health needs and set and track goals, including weight management.
Healthy Mississippi Premier Advantage (HMO-POS)
$0 copay per visit
In network only
Healthy Mississippi Preferred (PPO)
$0 copay per visit
Out of network: 50% coinsurance · For out-of-network health coaching, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
Part of a $150 yearly wellness allowance
Each coaching session uses $30 of the allowance · Shared with fitness · Does not roll over · Out of network: 40% coinsurance · For out-of-network health coaching, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
Not included in this plan
Fitness allowance
NationsBenefits
Money on your NationsBenefits debit card toward staying active, like gym memberships, gym classes, and recreation services. NationsBenefits can also mail fitness kits.
Healthy Mississippi Premier Advantage (HMO-POS)
$50 every month
In network only · Does not roll over; use it each month
Healthy Mississippi Preferred (PPO)
$50 every month
Does not roll over · Out of network: 50% coinsurance · For out-of-network fitness expenses, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
Part of a $150 yearly wellness allowance
Shared with health coaching · Does not roll over · Out of network: 40% coinsurance · For out-of-network fitness expenses, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
$50 every month
Does not roll over · Out of network: 50% coinsurance · For out-of-network fitness expenses, submit your receipt to NationsBenefits for reimbursement
Home & bathroom safety
NationsBenefits
For members at risk of falling: an allowance for grab bars (including mounts), medical shower benches, locking toilet seats, risers with arms, transfer benches, and handheld shower wands.
Healthy Mississippi Premier Advantage (HMO-POS)
$200 per year
In network only
Healthy Mississippi Preferred (PPO)
$200 per year
Shared allowance · Out of network: 50% coinsurance · For out-of-network safety devices, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Dual Advantage (PPO D-SNP)
$200 per year
Shared allowance · Out of network: 40% coinsurance · For out-of-network safety devices, submit your receipt to NationsBenefits for reimbursement
Healthy Mississippi Institutional (PPO I-SNP)
$150 per year
Shared allowance · Out of network: 50% coinsurance · For out-of-network safety devices, submit your receipt to NationsBenefits for reimbursement
How to use it: Shop the NationsBenefits bathroom safety catalog, or call 877-740-2369 (TTY 711) to ask about reimbursement.
About SSBCI: extra help for members with certain chronic conditions
SSBCI stands for Special Supplemental Benefits for the Chronically Ill. If you qualify, you can use your OTC allowance for groceries (healthy food and produce) and general supports for living, like utility bills and rent or mortgage, in addition to OTC items. It is the same shared allowance on your NationsBenefits card. SSBCI benefits are available in network only.
Who can qualify
You must meet all three of these:
- You have one or more medically complex chronic conditions that are life threatening or significantly limit your overall health or function
- You have a high risk of hospitalization or other poor health outcomes
- You need intensive care coordination
Qualifying chronic conditions include: chronic alcohol and other drug dependence; autoimmune disorders; cancer; cardiovascular disease; chronic heart failure; dementia; diabetes; end-stage liver disease; end-stage renal disease (ESRD); severe hematologic disorders; HIV/AIDS; chronic lung disorders; chronic and disabling mental health conditions; neurologic disorders; stroke; overweight, obesity, and metabolic syndrome; chronic gastrointestinal disease; post-organ transplantation; immunodeficiency and immunosuppressive disorders; conditions associated with cognitive impairment; conditions with functional challenges; chronic conditions that impair vision, hearing (deafness), taste, touch, and smell; and conditions that require continued therapy services to maintain or retain functioning.
How to qualify
- Most members don't need to do anything. We use medical claims and encounter data to find members with qualifying conditions, and eligible members are enrolled automatically.
- If we can't confirm your eligibility from our records, your provider can submit an SSBCI Attestation Form online, by mail, or by fax. Providers can find the form at www.healthy-ms.com in the provider section, under "SSBCI."
- Visit your provider early in the year to talk about your condition(s). This helps get a qualifying claim on file, and regular visits help you manage your health.
Questions? Call Member Services at 833-201-6413 (TTY 711), or call NationsBenefits at 877-740-2369 (TTY 711) or visit
HealthyMS.NationsBenefits.com.
The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify. The top five eligible chronic conditions include: Cardiovascular Disease, Chronic Kidney Disease, Diabetes, Chronic lung disorders, and Overweight, Obesity, and Metabolic Disorder. There are other chronic conditions eligible for this benefit. Please see your EOC for detailed information. To be eligible, members must have one or more qualifying chronic conditions, be at high risk of hospitalization or other adverse health outcomes and require intensive care coordination.
