Incentive program for completing 
certain preventive health screenings and 
health and wellness activities.  
Wigs (related to chemotherapy 
treatment) 
Up to an unlimited maximum benefit 
per year. 
SilverSneakers ®fitness program 
Basic fitness center membership 
including fitness classes.  17 
H5619_SB_MAPD_HMO_075000_2023_M Summary of Benefits H5619075000SB23 To find out more about the coverage and costs of Original Medicare, look in the current “Medicare &You”