HEALTH & WELLBEING

At First Lantern, your health and wellbeing are a priority. Our goal is simple: make sure every Lantern and their household has access to high-quality care, clear information, and reliable support when it’s needed most. Use this page to understand what your coverage includes and how to make the most of it.

Medical Coverage

Your medical benefits are designed to give you access to a broad network of doctors, specialists, hospitals, and urgent care centers. Most services are covered when you use in-network providers, which helps you control costs.

What your medical coverage includes

• Doctor visits
  Primary care and specialist visits are covered. Costs vary depending on the type of visit — for example, a primary care appointment typically has the lowest out-of-pocket cost, while specialist visits may have a higher copay or coinsurance.
• Hospital care
  In-network hospital services — including scheduled surgeries, inpatient stays, outpatient procedures, and emergency care — are covered. Preauthorization may be required for some procedures.
• Preventive care at no extra cost
  Annual checkups, age-appropriate screenings, vaccinations, and many routine lab tests are covered at 100% when you use in-network providers.
• Urgent and emergency care
  Urgent care centers are a good choice for non life-threatening issues that require quick attention. Emergency rooms should be used for serious or life-threatening conditions. Emergency services are covered anywhere in the U.S.

Using your medical plan wisely

• Always confirm your provider is in-network before making an appointment.
• For complex care, your medical plan may require prior authorization — your doctor’s office will help submit this.
• Virtual care may be available for many common conditions.

Prescription Drug Coverage

Your prescription benefit helps you get the medications you need, whether for short-term illnesses or long-term conditions.

How the pharmacy benefit works

• Tiered pricing
  Medications fall into tiers — typically generic, preferred brand, and non-preferred brand. Generics offer the lowest cost, and your plan encourages their use when clinically appropriate.
• Specialty medications
  If you take a specialty drug, you may work with a designated specialty pharmacy that provides additional support, such as refill coordination and nurse outreach.
• Mail-order savings
  Maintenance medications — those you take regularly — may be less expensive through a mail-order pharmacy, which also provides convenient 90day refills.

Tips for lowering prescription costs

• Ask your doctor whether a generic equivalent is available.
• Check the plan’s preferred drug list to avoid higher-cost alternatives.
• Use mail-order delivery for ongoing prescriptions.

Dental Benefits

Good oral health supports overall health. Your dental benefits include coverage for preventive services as well as basic and major dental work.

What’s covered

• Preventive care
  Routine exams, cleanings, and standard X-rays are typically covered in full or at very low cost when you see an in-network dentist.
• Basic restorative services
  Fillings, simple extractions, and treatment for minor oral conditions are covered at an affordable rate.
• Major services
  Crowns, bridges, dentures, and certain surgical procedures are covered, often with higher cost sharing. Some services may require preauthorization.
• Orthodontia
  If orthodontic benefits are included in your plan, coverage may be available for both children and adults. Limitations or lifetime maximums may apply.

Vision Benefits

Your vision benefit helps cover eye exams and eyewear, making it easier to maintain good eye health.

Vision coverage includes

• Annual eye exams
  Covered at low or no cost with an in-network provider.
• Lenses and frames
  You receive an allowance toward frames or contact lenses. Additional lens features — such as anti-glare coatings or progressive lenses — may be available at discounted rates.
• Contact lenses
  Allowances may apply to either contacts or glasses within a coverage period.

Mental Health & Emotional Wellbeing

Caring for your mental and emotional health is just as important as caring for your physical health.

Support available to Lanterns and their households

• Counseling services
  Confidential support for stress, grief, relationships, substance use, and more. Sessions may be virtual or in-person.
• Behavioral health specialists
  Access to psychologists, psychiatrists, therapists, and clinical social workers in the plan’s network.
• Crisis support
  24/7 access to urgent mental health assistance through designated support lines.
• Online programs and tools
  Self-guided modules for stress management, sleep improvement, mindfulness, and resilience.

Wellbeing Programs

First Lantern offers a variety of programs to help Lanterns stay healthy, prevent illness, and manage chronic conditions.

Available programs may include

• Digital physical therapy & musculoskeletal support
  Personalized exercise programs, video coaching, and condition monitoring for back, knee, shoulder, and joint pain.
• Condition management
  Support for diabetes, hypertension, asthma, heart conditions, and other chronic illnesses, including nurse outreach and educational tools.
• Family health support
  Programs for pregnancy, postpartum health, fertility journeys, and newborn support.
• Lifestyle coaching
  Help with nutrition, quitting tobacco, improving sleep, and managing weight.

Getting Care When You Need It

You have flexible options for receiving care, depending on your needs.

Your care pathways

• Primary care — Best for routine health issues, ongoing conditions, and preventive care.
• Telehealth/virtual visits — Convenient for common illnesses, follow-ups, or mental health sessions.
• Urgent care centers — When you need quick care for non-emergency issues.
• Emergency rooms — For sudden or severe conditions that require immediate attention.

If Your Coverage Is Based on Hours or Contributions

For Lanterns covered under a multi-group system:

• Coverage is typically maintained through hour banks or contribution credits.
• If reported hours fall below the required threshold, you may have the option to self-pay to maintain continuous coverage.
• Details vary by group — refer to your specific eligibility summary.