experiencehealthnc.com Open in urlscan Pro
74.117.229.171  Public Scan

Submitted URL: http://experiencehealthnc.com/
Effective URL: https://experiencehealthnc.com/
Submission: On October 30 via api from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST https://experiencehealthnc.com/!/forms/prospects

<form method="POST" action="https://experiencehealthnc.com/!/forms/prospects"
  x-data="{&quot;first_name&quot;:null,&quot;last_name&quot;:null,&quot;email&quot;:null,&quot;email_service_provider&quot;:null,&quot;delivery_option&quot;:&quot;download&quot;,&quot;address_1&quot;:null,&quot;address_2&quot;:null,&quot;city&quot;:null,&quot;state&quot;:&quot;NC&quot;,&quot;zip_code&quot;:null,&quot;form_name&quot;:null,&quot;asset&quot;:null,&quot;submission_type&quot;:&quot;prospect&quot;,&quot;opt_in_2020_aep&quot;:null,&quot;opt_in_webinar_call&quot;:null,&quot;seminar_date&quot;:null,&quot;opt_in_aep_stream&quot;:null,&quot;opt_in_n2m_stream&quot;:null,&quot;seminar_id&quot;:null,&quot;zoom_webinar_id&quot;:null,&quot;campaignmonitor_list_id&quot;:null,&quot;activecampaign_list_id&quot;:null,&quot;utm_source&quot;:null,&quot;utm_medium&quot;:null,&quot;utm_campaign&quot;:null,&quot;utm_content&quot;:null,&quot;utm_term&quot;:null}"
  autocomplete="on"><input type="hidden" name="_token" value="GjmHmLf7X3EsYBFIUb5s2VACNvkr6V0tRAmFttap">
  <div class="tw-grid tw-grid-cols-1 tw-gap-4 md:tw-grid-cols-8 tw-text-blue">
    <input class="formname" name="form_name" type="hidden" value="prospect_asset_request_hero">
    <input class="asset" name="asset" type="hidden" value="info-kit">
    <input class="email_service_provider" name="email_service_provider" type="hidden" value="campaignmonitor">
    <input class="submission_type" name="submission_type" type="hidden" value="prospect" data-abide-ignore="">
    <input class="utm_campaign" x-model="utm_campaign" name="utm_campaign" type="hidden" value="" data-abide-ignore="">
    <input class="utm_content" x-model="utm_content" name="utm_content" type="hidden" value="" data-abide-ignore="">
    <input class="utm_source" x-model="utm_source" name="utm_source" type="hidden" value="" data-abide-ignore="">
    <input class="utm_medium" x-model="utm_medium" name="utm_medium" type="hidden" value="" data-abide-ignore="">
    <input class="utm_term" x-model="utm_term" name="utm_term" type="hidden" value="" data-abide-ignore="">
    <input class="delivery" name="delivery_option" type="hidden" value="email">
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="first_name">First Name</label>
      <input type="text" class="form-input" placeholder="Joe" x-model="first_name" name="first_name" value="" pattern="[A-Za-z '-]+" title="Please enter your given name." required="">
    </div>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="last_name">Last Name</label>
      <input type="text" class="form-input" placeholder="Daniels" x-model="last_name" name="last_name" value="" pattern="[A-Za-z '-]+" title="Please enter your family name." required="">
    </div>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
        <label class="tw-text-sm tw-font-bold" for="address_1">Street Address</label>
        <input type="text" class="form-input" placeholder="1 E. Edenton St." x-model="address_1" name="address_1" pattern="[A-Za-z0-9 '-:/]+" autocomplete="address-line1" title="Please enter a valid street address." required="">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
        <label class="tw-text-sm tw-font-bold" for="address_2">Apt. / Unit / Building</label>
        <input type="text" x-model="address_2" name="address_2" pattern="[A-Za-z0-9 '-:/]+" title="Please enter a valid detailed address." autocomplete="address-line2">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-4">
        <label class="tw-text-sm tw-font-bold" for="city">City</label>
        <input type="text" placeholder="Raleigh" x-model="city" name="city" pattern="[A-Za-z '-]+" title="Please enter a valid city." required="">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-2">
        <label class="tw-text-sm tw-font-bold" for="state">State</label>
        <select class="dynamic-valid-state" x-model="state" name="state" required="">
          <option value="AL">AL</option>
          <option value="AK">AK</option>
          <option value="AZ">AZ</option>
          <option value="AR">AR</option>
          <option value="CA">CA</option>
          <option value="CO">CO</option>
          <option value="CT">CT</option>
          <option value="DE">DE</option>
          <option value="District of Columbia">District of Columbia</option>
          <option value="FL">FL</option>
          <option value="GA">GA</option>
          <option value="HI">HI</option>
          <option value="ID">ID</option>
          <option value="IL">IL</option>
          <option value="IN">IN</option>
          <option value="IA">IA</option>
          <option value="KS">KS</option>
          <option value="KY">KY</option>
          <option value="LA">LA</option>
          <option value="ME">ME</option>
          <option value="MD">MD</option>
          <option value="MA">MA</option>
          <option value="MI">MI</option>
          <option value="MN">MN</option>
          <option value="MS">MS</option>
          <option value="MO">MO</option>
          <option value="MT">MT</option>
          <option value="NE">NE</option>
          <option value="NV">NV</option>
          <option value="NH">NH</option>
          <option value="NJ">NJ</option>
          <option value="NM">NM</option>
          <option value="NY">NY</option>
          <option value="NC">NC</option>
          <option value="ND">ND</option>
          <option value="OH">OH</option>
          <option value="OK">OK</option>
          <option value="OR">OR</option>
          <option value="PA">PA</option>
          <option value="RI">RI</option>
          <option value="SC">SC</option>
          <option value="SD">SD</option>
          <option value="TN">TN</option>
          <option value="TX">TX</option>
          <option value="UT">UT</option>
          <option value="VT">VT</option>
          <option value="VA">VA</option>
          <option value="WA">WA</option>
          <option value="WV">WV</option>
          <option value="WI">WI</option>
          <option value="WY">WY</option>
        </select>
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-2">
        <label class="tw-text-sm tw-font-bold" for="zip_code">Zip Code</label>
        <input class="dynamic-valid-zip" type="text" placeholder="27608" x-model="zip_code" name="zip_code" pattern="[0-9]{5}" title="Please enter a valid 5-digit US ZIP Code." required="">
      </div>
    </template>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="email">Email Address</label>
      <input type="email" placeholder="joedaniels@example.com" x-model="email" name="email" value="" title="Please enter a valid email address." required="">
      <p class="tw-text-sm tw-p-2 tw-italic"> By providing my email address, I understand a sales representative may contact me. </p>
    </div>
    <div x-data="{ is_aep: false, today:'', month:'' }" x-init="
        today = new Date();
        month = today.getMonth();
        if (month > 7 &amp;&amp; month < 11) { is_aep = true };
      " class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full tw-px-2">
      <template x-if="is_aep">
        <label for="opt_in_aep_stream" class="tw-flex tw-flex-row tw-items-baseline">
          <input id="opt_in_aep_stream" class="opt_in_aep_stream tw-mr-2" x-model="opt_in_aep_stream" name="opt_in_aep_stream" type="checkbox" value="true">
          <span class="">Sign up for our emails to get smart tips and timely reminders</span>
        </label>
      </template>
      <template x-if="!is_aep">
        <label for="opt_in_n2m_stream" class="tw-flex tw-flex-row tw-items-baseline">
          <input id="opt_in_n2m_stream" class="opt_in_n2m_stream tw-mr-2" x-model="opt_in_n2m_stream" name="opt_in_n2m_stream" type="checkbox" value="true">
          <span class="">Sign up for our emails to get smart tips and timely reminders</span>
        </label>
      </template>
    </div>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-text-center tw-col-span-full">
      <input type="text" class="tw-hidden" name="honeypot">
      <button type="submit" class="ux-button tw-bg-blue tw-text-white tw-mx-auto tw-mb-4"> Submit </button>
      <p class="tw-text-sm tw-text-center">Or <a class="tw-underline" href="/helpful-resources/info-kit">you can receive it by mail</a>.</p>
    </div>
  </div>
</form>

POST https://experiencehealthnc.com/!/forms/prospects

<form method="POST" action="https://experiencehealthnc.com/!/forms/prospects"
  x-data="{&quot;first_name&quot;:null,&quot;last_name&quot;:null,&quot;email&quot;:null,&quot;email_service_provider&quot;:null,&quot;delivery_option&quot;:&quot;download&quot;,&quot;address_1&quot;:null,&quot;address_2&quot;:null,&quot;city&quot;:null,&quot;state&quot;:&quot;NC&quot;,&quot;zip_code&quot;:null,&quot;form_name&quot;:null,&quot;asset&quot;:null,&quot;submission_type&quot;:&quot;prospect&quot;,&quot;opt_in_2020_aep&quot;:null,&quot;opt_in_webinar_call&quot;:null,&quot;seminar_date&quot;:null,&quot;opt_in_aep_stream&quot;:null,&quot;opt_in_n2m_stream&quot;:null,&quot;seminar_id&quot;:null,&quot;zoom_webinar_id&quot;:null,&quot;campaignmonitor_list_id&quot;:null,&quot;activecampaign_list_id&quot;:null,&quot;utm_source&quot;:null,&quot;utm_medium&quot;:null,&quot;utm_campaign&quot;:null,&quot;utm_content&quot;:null,&quot;utm_term&quot;:null}"
  autocomplete="on"><input type="hidden" name="_token" value="GjmHmLf7X3EsYBFIUb5s2VACNvkr6V0tRAmFttap">
  <div class="tw-grid tw-grid-cols-1 tw-gap-4 md:tw-grid-cols-8 tw-text-blue">
    <input class="formname" name="form_name" type="hidden" value="prospect_asset_request_hero">
    <input class="asset" name="asset" type="hidden" value="info-kit">
    <input class="email_service_provider" name="email_service_provider" type="hidden" value="campaignmonitor">
    <input class="submission_type" name="submission_type" type="hidden" value="prospect" data-abide-ignore="">
    <input class="utm_campaign" x-model="utm_campaign" name="utm_campaign" type="hidden" value="" data-abide-ignore="">
    <input class="utm_content" x-model="utm_content" name="utm_content" type="hidden" value="" data-abide-ignore="">
    <input class="utm_source" x-model="utm_source" name="utm_source" type="hidden" value="" data-abide-ignore="">
    <input class="utm_medium" x-model="utm_medium" name="utm_medium" type="hidden" value="" data-abide-ignore="">
    <input class="utm_term" x-model="utm_term" name="utm_term" type="hidden" value="" data-abide-ignore="">
    <input class="delivery" name="delivery_option" type="hidden" value="email">
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="first_name">First Name</label>
      <input type="text" class="form-input" placeholder="Joe" x-model="first_name" name="first_name" value="" pattern="[A-Za-z '-]+" title="Please enter your given name." required="">
    </div>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="last_name">Last Name</label>
      <input type="text" class="form-input" placeholder="Daniels" x-model="last_name" name="last_name" value="" pattern="[A-Za-z '-]+" title="Please enter your family name." required="">
    </div>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
        <label class="tw-text-sm tw-font-bold" for="address_1">Street Address</label>
        <input type="text" class="form-input" placeholder="1 E. Edenton St." x-model="address_1" name="address_1" pattern="[A-Za-z0-9 '-:/]+" autocomplete="address-line1" title="Please enter a valid street address." required="">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
        <label class="tw-text-sm tw-font-bold" for="address_2">Apt. / Unit / Building</label>
        <input type="text" x-model="address_2" name="address_2" pattern="[A-Za-z0-9 '-:/]+" title="Please enter a valid detailed address." autocomplete="address-line2">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-4">
        <label class="tw-text-sm tw-font-bold" for="city">City</label>
        <input type="text" placeholder="Raleigh" x-model="city" name="city" pattern="[A-Za-z '-]+" title="Please enter a valid city." required="">
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-2">
        <label class="tw-text-sm tw-font-bold" for="state">State</label>
        <select class="dynamic-valid-state" x-model="state" name="state" required="">
          <option value="AL">AL</option>
          <option value="AK">AK</option>
          <option value="AZ">AZ</option>
          <option value="AR">AR</option>
          <option value="CA">CA</option>
          <option value="CO">CO</option>
          <option value="CT">CT</option>
          <option value="DE">DE</option>
          <option value="District of Columbia">District of Columbia</option>
          <option value="FL">FL</option>
          <option value="GA">GA</option>
          <option value="HI">HI</option>
          <option value="ID">ID</option>
          <option value="IL">IL</option>
          <option value="IN">IN</option>
          <option value="IA">IA</option>
          <option value="KS">KS</option>
          <option value="KY">KY</option>
          <option value="LA">LA</option>
          <option value="ME">ME</option>
          <option value="MD">MD</option>
          <option value="MA">MA</option>
          <option value="MI">MI</option>
          <option value="MN">MN</option>
          <option value="MS">MS</option>
          <option value="MO">MO</option>
          <option value="MT">MT</option>
          <option value="NE">NE</option>
          <option value="NV">NV</option>
          <option value="NH">NH</option>
          <option value="NJ">NJ</option>
          <option value="NM">NM</option>
          <option value="NY">NY</option>
          <option value="NC">NC</option>
          <option value="ND">ND</option>
          <option value="OH">OH</option>
          <option value="OK">OK</option>
          <option value="OR">OR</option>
          <option value="PA">PA</option>
          <option value="RI">RI</option>
          <option value="SC">SC</option>
          <option value="SD">SD</option>
          <option value="TN">TN</option>
          <option value="TX">TX</option>
          <option value="UT">UT</option>
          <option value="VT">VT</option>
          <option value="VA">VA</option>
          <option value="WA">WA</option>
          <option value="WV">WV</option>
          <option value="WI">WI</option>
          <option value="WY">WY</option>
        </select>
      </div>
    </template>
    <template x-if="Statamic.$conditions.showField({&quot;if&quot;:{&quot;delivery_option&quot;:&quot;equals mail&quot;}}, $data)">
      <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full md:tw-col-span-2">
        <label class="tw-text-sm tw-font-bold" for="zip_code">Zip Code</label>
        <input class="dynamic-valid-zip" type="text" placeholder="27608" x-model="zip_code" name="zip_code" pattern="[0-9]{5}" title="Please enter a valid 5-digit US ZIP Code." required="">
      </div>
    </template>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full">
      <label class="tw-text-sm tw-font-bold" for="email">Email Address</label>
      <input type="email" placeholder="joedaniels@example.com" x-model="email" name="email" value="" title="Please enter a valid email address." required="">
      <p class="tw-text-sm tw-p-2 tw-italic"> By providing my email address, I understand a sales representative may contact me. </p>
    </div>
    <div x-data="{ is_aep: false, today:'', month:'' }" x-init="
        today = new Date();
        month = today.getMonth();
        if (month > 7 &amp;&amp; month < 11) { is_aep = true };
      " class="tw-flex tw-flex-col tw-justify-items-start tw-items-stretch tw-col-span-full tw-px-2">
      <template x-if="is_aep">
        <label for="opt_in_aep_stream" class="tw-flex tw-flex-row tw-items-baseline">
          <input id="opt_in_aep_stream" class="opt_in_aep_stream tw-mr-2" x-model="opt_in_aep_stream" name="opt_in_aep_stream" type="checkbox" value="true">
          <span class="">Sign up for our emails to get smart tips and timely reminders</span>
        </label>
      </template><label for="opt_in_aep_stream" class="tw-flex tw-flex-row tw-items-baseline">
        <input id="opt_in_aep_stream" class="opt_in_aep_stream tw-mr-2" x-model="opt_in_aep_stream" name="opt_in_aep_stream" type="checkbox" value="true">
        <span class="">Sign up for our emails to get smart tips and timely reminders</span>
      </label>
      <template x-if="!is_aep">
        <label for="opt_in_n2m_stream" class="tw-flex tw-flex-row tw-items-baseline">
          <input id="opt_in_n2m_stream" class="opt_in_n2m_stream tw-mr-2" x-model="opt_in_n2m_stream" name="opt_in_n2m_stream" type="checkbox" value="true">
          <span class="">Sign up for our emails to get smart tips and timely reminders</span>
        </label>
      </template>
    </div>
    <div class="tw-flex tw-flex-col tw-justify-items-start tw-text-center tw-col-span-full">
      <input type="text" class="tw-hidden" name="honeypot">
      <button type="submit" class="ux-button tw-bg-blue tw-text-white tw-mx-auto tw-mb-4"> Submit </button>
      <p class="tw-text-sm tw-text-center">Or <a class="tw-underline" href="/helpful-resources/info-kit">you can receive it by mail</a>.</p>
    </div>
  </div>
</form>

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Last Name
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Apt. / Unit / Building
City
State AL AK AZ AR CA CO CT DE District of Columbia FL GA HI ID IL IN IA KS KY LA
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Email Address

By providing my email address, I understand a sales representative may contact
me.

Sign up for our emails to get smart tips and timely reminders Sign up for our
emails to get smart tips and timely reminders
Submit

Or you can receive it by mail.


GET READY FOR A NEW MEDICARE EXPERIENCE!

You can start by learning more about the local-designed Experience Health
Medicare AdvantageSM (HMO) plan with a $0 monthly premium for 2024 and:

 * ‌
   
   $0 doctor visit copays

 * ‌
   
   $0 medical and drug deductibles

 * ‌
   
   $0 prescription copays on many commonly prescribed drugs

 * ‌
   
   $20 specialist copay with NO REFERRALS

 * ‌
   
   Low $3,500 maximum out-of-pocket limit for in-network covered hospital and
   medical services*

 * ‌
   
   No cost SilverSneakers® fitness membership

 * ‌
   
   Valuable plan extras to save you money

That’s just the beginning! See our plan overview for all of the benefits
included with your Experience Health Medicare Advantage (HMO) plan.

Plan Overview


REQUEST YOUR FREE INFORMATION KIT NOW.

Please provide the following information to get your Information Kit

First Name
Last Name
Street Address
Apt. / Unit / Building
City
State AL AK AZ AR CA CO CT DE District of Columbia FL GA HI ID IL IN IA KS KY LA
ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT
VA WA WV WI WY
Zip Code
Email Address

By providing my email address, I understand a sales representative may contact
me.

Sign up for our emails to get smart tips and timely reminders Sign up for our
emails to get smart tips and timely reminders Sign up for our emails to get
smart tips and timely reminders
Submit

Or you can receive it by mail.


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FIND MY PRESCRIPTIONS

Our Medicare Advantage plan covers thousands of prescription drugs. See if your
drugs are covered by Experience Health!

Find prescription drugs


FIND YOUR DOCTOR

Your doctor is important to you. Experience Health knows that. That’s why we’ve
provided an easy online tool to see if your doctor is part of our growing
network.

Find your doctor


FIND MY PRESCRIPTIONS

Our Medicare Advantage plan covers thousands of prescription drugs. See if your
drugs are covered by Experience Health!

Find prescription drugs


FIND YOUR DOCTOR

Your doctor is important to you. Experience Health knows that. That’s why we’ve
provided an easy online tool to see if your doctor is part of our growing
network.

Find your doctor


OUR CARE SUPPORT TEAM IS AT THE HEART OF EXPERIENCE HEALTH

Learn More


OUR CARE SUPPORT TEAM IS AT THE HEART OF EXPERIENCE HEALTH

Learn More


READY TO ENROLL?

Enroll Now


HAVE A QUESTION?
CALL 1-833-905-1311 (TTY: 711)
8 A.M. TO 8 P.M., 7 DAYS A WEEK


READY TO ENROLL?

Enroll Now


HAVE A QUESTION?
CALL 1-833-905-1311 (TTY: 711)
8 A.M. TO 8 P.M., 7 DAYS A WEEK


WELCOME MEMBERS

Don’t forget your Annual Wellness Visit.

It’s your time to talk with your health team so you can prevent health problems
and get the medical care you need. And it’s included in your plan with a
$0 copay!

Read 5 Things To Do At Your Annual Wellness Visit:

Read Article



IMPORTANT NEW STAR RATING FROM MEDICARE ANNOUNCED!

Learn More


MEMBER PORTAL

The easy, online way to manage your account.

Sign In


VALUABLE EXTRAS

Your 2024 plan includes valuable plan extras.

See Extras


PLAN DOCUMENTS

Download reimbursement forms & more.

See Documents


QUESTIONS? SPEAK TO OUR CUSTOMER SERVICE TEAM:

1-833-777-7394 (TTY: 711)

8 a.m. to 8 p.m., 7 days a week


DON'T FORGET

Remember to complete your Health Risk Assessment form electronically or by mail.
It’s important!

Download and Mail Complete Online


FIND YOUR DOCTOR

Your doctor is important to you. Experience Health knows that. That’s why we’ve
provided an easy online tool to see if your doctor is part of our growing
network.

Find Your Doctor


ARE MY PRESCRIPTIONS COVERED?

Our Medicare Advantage plan covers thousands of prescription drugs. See if your
drugs are covered by Experience Health!

Find Prescription Drugs
Privacy Policy Terms and Conditions External References API Access Fraud and
Abuse Medicare Complaint Form Notice of Nondiscrimination
For Providers

© 2024 Experience Health, Inc. All rights reserved.

*The most you’ll pay out-of-pocket for in-network covered hospital and medical
services in 2024. Please note that you’ll still need to pay your Part D
prescription drug cost share.

**Medicare evaluates plans based on a 5-Star rating system. Star Ratings are
calculated each year and may change from one year to the next.

For accommodation of persons with special needs at sales meetings, call
1-833-905-1311 (TTY: 711), 8 a.m. – 8 p.m., 7 days a week.

Experience Health is an HMO plan with a Medicare contract. Enrollment in
Experience Health Medicare Advantage (HMO) depends on contract renewal.

The federal government requires all Medicare Advantage members to continue
paying their Part B premium each month.

To join Experience Health Medicare Advantage (HMO), you must have Medicare Part
A and Part B, and live in the service area (Durham, Franklin, Granville, Lee,
Orange, Person, Vance or Wake counties, North Carolina). Please contact the plan
for more information. Medicare beneficiaries may also enroll in Experience
Health Medicare Advantage (HMO) through the CMS Medicare Online Enrollment
Center located at www.medicare.gov.

This information is not a complete description of benefits. Call 1-833-905-1311
(TTY: 711) for more information. Other providers are available in our network.
Out-of-network/non-contracted providers are under no obligation to treat
Experience Health Medicare Advantage (HMO) members, except in emergency
situations. Please call our customer service number or see your Evidence of
Coverage for more information, including the cost-sharing that applies to
out-of-network services.

ATTENTION: If you speak a non-English language, call 1-833-905-1311 (TTY: 711)
and you will be connected to an interpreter who will assist you at no cost.

SilverSneakers® is a registered trademark of Tivity Health. © 2023 Tivity
Health, Inc. All rights reserved. Tivity Health is an independent company
providing fitness services on behalf of Experience Health.

Blue Cross NC contracts with independent companies to provide supplemental
benefits. Those companies are responsible for the services they provide. They do
not provide Blue Cross or Blue Shield products or services. Marks and trade
names are property of their respective owners.

®, ℠ Marks of the Blue Cross and Blue Shield Association, an association of
independent Blue Cross and Blue Shield Plans. Experience Health is an
independent licensee of the Blue Cross and Blue Shield Association, serving
North Carolina.

This page was last updated 2023-10-01

H3777_EX5028_M_2024

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To learn more call 1-833-905-1311 (TTY:711)

To learn more call 1-833-905-1311 (TTY:711)

Members call 1-833-777-7394 (TTY:711)

Providers call 1-877-397-4584 (TTY: 711)

8 a.m. to 8 p.m., 7 days a week

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