Asuris offers four Medigap products (also known as Medicare supplements) available for eligible beneficiaries in Washington:

• Asuris Pledge Plan A
• Asuris Pledge Plan C
• Asuris Pledge Plan F

• Asuris Pledge Plan K

The products include benefits for services that Original Medicare does not cover such as deductibles and coinsurance.

• Provider Contact Center phone numbers
• Members can see any provider who is accepting Medicare patients

• Silver & Fit fitness program

The full member number must be submitted on claims. View sample member ID cards.

Use Availity Essentials for easy access to eligibility and claim status. You can also contact Provider Contact Center

These products are secondary to Medicare. Claims should be submitted to your local Medicare contractor first. When Medicare processes the claim, the information is transferred to Asuris directly. In most cases, there is no need to submit a separate claim to us. Learn about Medicare crossover claims.

Remittance advices include:

• Line-by-line breakdowns
• Specific error messages
• Boxes around the headers for each amount

• Codes billed by line item and then, if applicable, the bundled code(s)

Asuris Pledge members can seek services from our Participating or Preferred providers, or non-contracted providers.

We offer several Medicare Advantage PPO plans to eligible Medicare beneficiaries.

View our Medicare products and benefits.

Providers and their staff are responsible for training on Medicare fraud, waste, and abuse and ongoing compliance requirements. Training must be completed at time of hire and annually thereafter. Complete the training now.

Asuris TruAdvantage PPO members can seek services from our Asuris TruAdvantage PPO participating providers or from non-participating providers.

Learn more about provider requirements for this product in the Medicare Advantage Plans section of the Administrative Manual.

Verify the information about your practice and the networks you participate in using the Find a doctor tool at least every 30 days.

Asuris TruAdvantage plans are available for residents of Chelan and Spokane counties.

Our Medicare Advantage PPO plans include the following features:

• Referrals are not required.
• All Medicare Part A and B benefits with additional covered services
• Plans include all Medicare Part A and B benefits with additional covered services.
• Most professional services are covered at 100% after a copayment, or are paid in full for in-network providers.
• No deductible for services provided by an in-network PCP.
• No copayment or deductible is required for Medicare-covered preventive services.
• Routine vision benefits, including hardware, are available from Vision Service Plan®.
• Preventive dental benefits are built in. Some plans include comprehensive dental coverage or routine diagnostic coverage. Optional comprehensive dental coverage available on other plans. Learn more about our dental benefits at asurisdental.com.
• Plans include a hearing aid benefit.
• All plans include acupuncture, chiropractic, therapeutic massage and naturopathy benefits.
• Prescription medications are covered on plans with Part D.
  • Members can receive a 100-day supply of medications through mail order.
  • Insulin is covered for a maximum of $35 per month copay or $87.50-$105, depending on the plan for a three-month fill.

• Palliative care supports members who are living with serious illness and their caregivers.

  • Cost-sharing is waived for specific palliative care services.
  • Care planning and goals of care discussions are covered.
  • Additional member and caregiver support is available through care management.

Medicare Advantage members have access to these extra services and supplies. View the complete list on the Extra Benefits tab.

Medicare Advantage members have access to these extra services and supplies.

• Over-the-counter health and wellness products
  • Select plans include a quarterly allowance on a prepaid card for over-the-counter (OTC) health and wellness products.
  • Members can use their OTC card at participating retail locations, such as Walmart, CVS, Walgreens and more.
• Bathroom safety devices (available on select plans)
  • Members can purchase items to facilitate home safety.
  • Items include a shower/bathtub grab bar and bench, commode/toilet rails, elevated toilet seats, a transfer bench or chair or a tub stool.
  • The benefit is limited to specific items up to $100 per year, using HCPCS E0240-E0248. Installation and in-home assessments for safety items are not covered. .
• Personal emergency response system (PERS)
  • Members can receive a Lively Mobile Plus PERS device to help them stay safe and maintain independence at home and on the go for a $0 copay.
  • This PERS benefit and support is provided by Best Buy Health.
• Silver & Fit fitness program
  • Members have access to over 8,000 digital workout videos through SilverandFit.com or the mobile app.
  • Members also have access to over 16,5000 fitness centers or select YMCAs. In addition, members can access over 4,000 premium locations, including fitness centers, studios and unique fitness experiences for additional cost.
  • Coaches are available to help members meet their fitness, nutrition and lifestyle goals during scheduled phone sessions.
  • Members can pick one fitness kit per year (e.g., Pilates, strength, swim, yoga).

• Chronic condition meals delivered by Mom’s Meals

  • Members must be enrolled in case management.
  • We offer two meal delivery benefits through Mom’s Meals.
  • Each benefit offers: High-quality, refrigerated meals delivered to the member at home that last for 14 days in the fridge—ready for the member to heat, eat and enjoy in two minutes or less; health-specific menus designed to support the nutritional needs of your patient, including the following types of diets: diabetic, gluten-free, heart-friendly, renal-friendly, vegetarian, pureed, low sodium, cancer support or general wellness.
  • The post-discharge meal delivery benefit following an inpatient hospital, skilled nursing facility or inpatient rehabilitation stay is $0 copay per meal, two meals per day up to 28 days, for a total of 56 meals per discharge. The member can receive meals with each discharge during the plan year; there is no limit to the number of times the benefit can be accessed.

  • The chronic conditions meal delivery benefit for members with an eligible chronic condition (listed below) who are enrolled in care management is $0 copay per meal for two meals per day up to 56 days for a total of 112 meals per episode. There is no limit to the number of times the benefit can be accessed.

    Eligible conditions for chronic condition meals include:

    • Alcohol or other drug dependence
    • Cancer (excluding pre-cancer conditions or in-situ status)
    • Certain autoimmune disorders: polyarteritis nodosa, polymyalgia rheumatica, polymyositis, rheumatoid arthritis and systemic lupus erythematosus
    • Certain cardiovascular disorders: cardiac arrhythmias, coronary artery disease, peripheral vascular disease and chronic venous thromboembolic disorder
    • Certain chronic lung disorders: asthma, chronic bronchitis, emphysema, pulmonary fibrosis and pulmonary hypertension)
    • Certain hematological disorders: aplastic anemia, hemophilia, immune thrombocytopenic purpura, myelodysplastic syndrome, sickle-cell disease (excluding sickle-cell trait) and chronic venous thromboembolic disorder
    • Certain neurological disorders: amyotrophic lateral sclerosis (ALS), congestive heart failure, epilepsy, extensive paralysis (hemiplegia, quadriplegia, paraplegia, monoplegia), Huntington’s disease, multiple sclerosis, Parkinson’s disease, polyneuropathy, spinal stenosis and stroke-related neurologic deficit
    • Certain chronic and disabling mental health conditions: bipolar disorders, major depressive disorders, paranoid disorder, schizophrenia and schizoaffective disorder
    • Chronic heart failure
    • Dementia
    • Diabetes
    • End-stage liver disease
    • End-stage renal disease requiring dialysis
    • HIV/AIDS
    • Stroke
• Companionship provided by Papa Pals
  • We offer a virtual companionship benefit through Papa Pals to help solve issues that affect social determinants of health, such as loneliness, social isolation and food insecurity.
  • Papa Pals connects the member with a curated network of young adults for welfare check-ins, benefit plan guidance, technical assistance or assistance with grocery and prescription pickup/ delivery.
  • We cover up to 48 hours per year for $0 copay.
  • Papa Pals offers in-person and virtual visits.

Asuris offers Washington consumers two Medicare Part D prescription drug coverage plans:

• Asuris Medicare Script™ (stand-alone prescription drug coverage only).

• Asuris TruAdvantage + Rx (medical and prescription drug coverage)

Members can contact Customer Service at the number on the back of their member ID card for more information about these plans.

View medication pre-authorization and quantity limit requirements.