Your 2026 Member Action Plan
Follow this step-by-step Action Plan to get the most out of your health plan. It outlines key services to schedule, tips to access care quickly, how to get extra support and valuable benefits you won’t want to miss.
Step 1 – Consider your doctor
New members
Select or review your primary care provider. Find in-network options in our provider search tool.
All members
Browse our directory for primary care, specialists, hospitals, labs and other facilities. You can switch your primary care provider at any time.
Need to find a facility for care?
You have top facilities near you! Locate quality care options, including Johns Hopkins facilities and Inova medical centers, with our online search tool.
Step 2 – Schedule Preventive Care
Annual Wellness Visit
Your yearly well-visits are a chance for your primary care provider to get to know you, identify preventive health screenings you may be due to have, and create a care plan for the year.
Annual Eye Exam
Advantage MD members pay $0 for in-network annual eye exams and glaucoma screenings. Take advantage of your annual $0 routine eye exam from a Superior Vision provider, which includes refractions and written lens prescriptions. Be sure to check your specific coverage. Schedule 12 months after your last visit.
Dental Cleaning
You get one or two $0 dental cleanings per year. Some plans have comprehensive dental services included, with a yearly allowance. Comprehensive coverage can be purchased by members in other plans for $23/month, but it must be done by the end of January. Check your plan here.
Step 3 – Transfer your prescriptions
Your pharmacy benefits are managed through CVS Caremark. Find an in-network pharmacy near you using our online search.
New members
If you use an out-of-network pharmacy, be sure to transfer your prescriptions once your coverage becomes effective. Learn how to verify medication coverage, refill prescriptions, monitor orders and more with CVS Caremark pharmacy.
Your prescription drug coverage
Taking all medications as prescribed and staying on top of refills is important for your health.
Step 4 – Sign up for telehealth
When you need instant care anywhere for minor but urgent health concerns, use our 24/7 telehealth platform to have a convenient video chat with a health professional using your phone or computer — no appointment needed!
24/7 Nurse Chat Line
Have a health concern but you can’t reach your doctor’s office? Call our Nurse Chat line at no additional cost. A registered nurse is on call 24/7 to answer your questions about an illness, injury or symptom. Call 888-202-8828 (TTY: 711) to speak with a nurse now.
Step 5 – Focus on mental health
Our behavioral health care team can assist you with care coordination for substance use challenges, struggles with depression, anxiety or other mental health conditions. We offer compassionate guidance and useful resources to support your mental well-being journey.
UpLift
Taking the first step to better mental health is not always easy. UpLift is a virtual behavioral health network that can help make that first step easier. Search for care tailored to your needs and schedule timely appointments — often as soon as one day and no later than two weeks.
Step 6 – Schedule additional health care
Whether it’s dental, vision or hearing, your plan provides coverage for services to address your whole health. Be sure to get any follow-up care recommended by your primary care provider and see specialists when needed. Remember to stay in-network for the lowest costs.
Step 7 – Use your member portal
Your personal member portal — Enjoy health care at your speed 24/7 and start taking charge of health care decisions. Create an account and log on anytime to view Explanation of Benefits, manage personal information, check the status of a claim, choose a primary care doctor and much more.
Step 8 – Fast track your fitness
Silver&Fit™
Whether you prefer the social energy of a fitness center or the convenience of working out at home, the Silver&Fit program can keep your fitness goals on track. Designed specifically for older adults, Silver&Fit gives eligible members the option to work out at any participating fitness center near them and choose from a variety of home fitness kits to stay in shape at home.
Step 9 – Use your extra benefits
Many of our plans come with extra benefits to help you save money and get the care you need.
These include:
- Over-the-counter allowance — Receive an allowance every three months to help pay for common over-the-counter items.
- Transportation — Schedule a ride to and from your health care appointments.
- Flex Card1 (D-SNP plan only) — Receive $75 every month to help pay for healthy food and utilities.
- Rewards program — Earn a reward for getting preventive care. Some preventive care services are so important, we offer an incentive to complete them. We’ll let you know if you are due for one of these services and how you could earn reward dollars on a Benefits Mastercard® Prepaid Card.
- In-home health assessment — Enjoy no-cost visits with a licensed clinician from the comfort of home through Signify Health. We’ll contact eligible members.
- Health education classes — Attend an online class to help manage a condition, learn how to stay active and adopt healthy habits.
When you need extra support
Your health and well-being deserve the right doctors, comprehensive support and seamless coordination of care. Our care management team gives you and your family one-on-one support when and where you need it.
A care manager can help when:
- You want to achieve your health goals
- You are being discharged from a hospital stay
- You have a chronic health condition like diabetes, hypertension or COPD
- You want help with advance care planning
Take the next step! Call our Care Management team at 800-557-6916 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m., or email us.
When you need to talk to us
From getting medication approvals, to answering questions about your plan, to helping you get the care you need, our experienced representatives handle complex cases and are ready to discuss any issues or questions you may have.
Call us:
PPO Members:
HMO Members:
Hours are 8 a.m. to 8 p.m., 7 days a week, Oct. 1 through March 31, and 8 a.m. to 8 p.m., Monday through Friday, April 1 through Sept. 30. Weekends and holidays, you may need to leave a message.
1 The benefits mentioned are a part of special supplemental program for the chronically ill and include the following conditions: autoimmune disorders, cardiovascular disorders, chronic heart failure, diabetes, chronic lung disorders. Other conditions apply but are not listed in this disclaimer. Not all members qualify. Coverage of the item or service depends on the chronically ill classification as defined in 42 CFR §422.102(f)(1)(i)(A) and on Johns Hopkins Advantage MD’s SSBCI coverage criteria required by 42 CFR §422.102(f)(4).
