Anthem Medicare 2020: Important Info & Updates

Anthem is hosting a few more 2020 Product Training sessions below!

10/8/2019 10 am 2020 Product Training Click Here to Join
10/9/2019 9 am 2020 Product Training Click Here to Join

To RSVP for an event or if you have questions, please contact your Regional Sales Manager below or reach out to our Agent Services Team. Just call 1-800-633-4368 or email medicareagentsupport@anthem.com.  Learn more about the variety of broker events and networking opportunities near you by visiting www.anthembrokerconnection.com.*

Anthem 2020 Important Updates 

DSNP-HMO MAPD Updates and Reminders:

  • New Brokers will have the ability to validate DSNP eligibility from within mProducer.
  • New Added 4 New Essential Extras Benefits (See Below / Attachment)
  • New Minimal Plan Changes but huge addition of Ingenio RX (See Below)
  • Hearing Benefit
    • You sell this on the following: $3000 first dollar coverage on HMO and DSNP plans, newer technology including iPhone and Bluetooth compatible devices, 30 day free trial, 1 year warranty, and 12 months of free batteries!
    • The 2020 carrier will be Hearing Care Solutions and their website to search for providers is http://www.hearingcaresolutions.com/locations/
    • Member calls 800 number to locate provider and schedule appointment
    • They must use an in-network provider

Personal Emergency Response System

  • HMO and DSNP have this benefit.
  • No cost for set up or monthly fees!
  • GPS enabled device available
  • 3 different units to choose from and anyone can request, no medical necessity required

 

  • Meals after Inpatient Hospital Stay
  • 2 meals a day for 10 days after EVERY inpatient hospital stay
  • Discharge must be from hospital to home
  • Benefit is triggered by case manager who contacts Anthem

 

  • OTC

New OTC catalogs will be sent with OTC card. Existing members will also receive a new OTC card and catalog.

 Silver Sneakers is on all Medicare Advantage and Medicare Supplement plans!!

 

mProducer Updates- https://mproducer.anthem.com

  1. Can obtain a paper application and submit later on mProducer, eliminating fax and email.  This process will save you time and energy during AEP.
  2. New Short applications will be available via mProducer for Anthem’s existing clients.  The system will automatically recognize the members MBI and will result in less fields to be completed by the agent.  Optional Supplemental Benefits can be added on this form.  Like to like plan changes only, MAPD to MAPD, Medicare Supplement not included.
  3. New MBI “checker” is now embedded in mProducer.  If your entry does not match the correct format you will get a notification and will not be able to proceed.  This will drastically reduce pended applications due to incorrect information.  HICN will no longer be acceptable on applications for 2020 effective dates.
  4. New DSNP eligibility will also include the last time the member used LIS as their SEP to change products.  No more guessing if the member has a SEP available for the current quarter, just login to mProducer and check.
  5. New MACRA-Applicants who are not eligible for the Plan F in 2020 will not be able to be submitted via mProducer.  The system will implement CMS rules and prevent you from applying for members who are not eligible.
  6. New Application Status Tracker – Will provide start to finish updates on all applications submitted.  Submitted status all the way through Welcome Kit and ID card being sent can be tracked.  Missing information from applications can be uploaded directly from the tracker if application was submitted electronically.  MAPD products only, Med Supp coming 2/1/2020.

Why submit Electronic Enrollments with mProducer?

  1. Efficiency (increasing your capacity)
  2. Reduced Processing Time
  3. Fewer Errors
  4. Doctor Finder Embedded
  5. DSNP Eligibility Verification

 

10 Essential Extras (All HMO/DSNP products)  

  1. Selection Form will be included on the application, member does not have to select at point of sale but is highly recommended.
  2. Current members will automatically retain the same benefit from 2019, if they would like to change have them contact customer support number on the back of their card.
  3. If the benefit overlaps with a plan benefit the member will exhaust the plans benefit first, i.e. transportation.
  4. Member can change benefits one time annually as long as they have not utilized the benefit.
  5. Retaining the six current EE offerings; adding four more to make it give the member the choice of 10 options
    1. Healthy Food Deliveries- 16 meals for 4 months, total of 64 meals for the year. BMI >25, BMI < 18.5 or A1C > 9 to qualify.  GA Foods is the vendor.
    2. Transportation- 60 one-way trips per year.  Will transport to all plan covered benefits, Silver Sneakers locations, pharmacy, or any other benefit included in the plan.
    3. Personal Home Helper- up to 124 hours per year.  Non skilled services only not medical professionals.  Cooking, cleaning and personal care duties are most common.
    4. Assistive Devices-$500 allowance from catalog, administered through Walmart.  Can be ordered on CustomPoint.  https://custompoint.rrd.com/xs2/prelogin?CMPID=1064&qwerty=19091802
    5. Day Center Visits- 1 day per week, up to 8 hours per day.  Member must lack at least 2 ADLs.  Reimbursement of up to $80 per day.
    6. Alternative Medicine- Therapeutic massage or acupuncture, up to 24 visits per year.  Members must utilize ASH network, provider search link below:  https://www.ashlink.com/ASH/public/applications/providersearch/default.aspx

If you have a provider interested in being added to the network please have them contact ASH at (800)-972-4226.

    1. New Healthy Nutrition- Up to 8 dietary consultations to educate members on proper nutrition.  Will lead to specific food being delivered to the member that fits their health needs.  Will be shipped directly from Kroger.  Groceries will not be fresh foods that have short shelf life. Examples include; pasta, granola bars and other nonperishable items. Member must need a change in diet to improve health to qualify.  Anthem may communicate with member’s physician if needed.
    2. New Service Dog Support- $500 annual allowance.  Food and supplies for ADA service dogs.  Administered by Walmart via catalog or online.  Will not include vet costs, dog training costs, and the actual cost of the dog.
    3. New Pest Control- Quarterly routine preventive or 1-time eradication of infestation.  Terminex is the vendor.  Must qualify for 1/15 Chronic conditions.  Document attached to better explain.
    4. New Active Lifestyle & Wellness Device- 1 device every other year.  A Fitbit type of device to track and promote healthy lifestyle.  No precertification required.

 

Medicare Community Resource Support Benefit

A telephone based program used to identify needs, leverage resources and coordinate services for members and providers by providing specific medical or health related education and leveraging local community based services.   This benefit can help members with non-health related needs such as paying a utility bill, household expenses, legal aid and much more.  If your member is having trouble with any aspect of their life, they can reach out to our customer service team and get connected with help from their local community through Anthem’s partnerships.

 

New Medicare Community Resource Outreach

An in-person, community-based program that hosts new member orientations, benefit training sessions and other events where we can assist members directly. Members can learn about community resources available and meet new people.   They also will have the opportunity to access individual support needed.  To access this benefit, Members can call Customer Service at the number listed on the back of their ID card and ask for information about MCRO events in their area.   They may also receive notification about events in their area through the contact information they have provided us.

Ingenio RX-Replacing Express Scripts for 2020

  1. Improves affordability for our members.
  2. Provides a more seamless member experience.  Anthem will leverage our provider relationships to ensure confident, informed decision making which will lead to better health of your members.
  3. Simplified, consistent, and coordinated experience for the member.
  4. Will help in keeping MAPD benefits consistent by driving total costs down.
  5. 24/7 access pharmacy via toll free number on the back of their membership card.
  6. Electronic Prior Authorizations.
  7. Active mail-order and specialty scripts will automatically transfer 1/1/2020. Member’s will need to update is their financial information.  Anthem is not legally able to transfer this information. Communications will go out to members.
  8. Stand-alone PDP products offered as low as $18.90 monthly.  Lowering the premiums on existing PDP products offered.

Medicare Supplement

  1. Will continue to provide full  Silver Sneakers program.
  2. Discounts up to $48 per year for EFT or annual payment.
  3. Household discount of 5% available.
  4. 21% commission for years 1-6.
  5. Aggressive bonus program, increasing for first quarter of 2020.

Monthly bonus. Great to utilize in renewing your current clients and resetting that clock or for all of those 1/1 effectives during AEP. Do as many as you can in 1 month and earn major bucks.  (Flier attached to email)

3-4 sales $150 extra per application

5-9 sales $200 extra per application

10+ sales $250 extra per application (no cap)

  1. Great brand recognition, stable and realistically priced.  Don’t be fooled by companies offering premiums that are not sustainable for your members.  Poor pricing will lead to drastic increasing forcing a tough decision down the road for you and your member.
  2. Ingenio RX will offer a package deal for your MS clients.  We all know most clients prefer simple, so one carrier will deliver that in 2020.
  3. No aging increase at renewal for members who are 81+.

Provider Finder Tips

  1. Use the “shop” website for the most updated version. https://shop.anthem.com/medicare/standalonetools/find-doctor?state=IN&brand=ABCBS&role=consumer&locale=en_US
  2. The  Search Radius has been expanded to 25 Miles.  This will cast a bigger net, making sure you don’t miss any contracted doctors. You still have the option to narrow the radius or expand it to 50 miles.
  3. Change “Provider Specialty” = “All Specialties”.  This will ensure you search all contracted doctors.  Sometimes doctors can be listed under different categories than your client is referencing.
  4. Updated to recognize names that sound familiar to your search.  This is a positive change that will help you find doctors when your clients may be pronouncing them incorrectly.
  5. Please send us any provider recommendations.  It is our goal to keep our Doctor Finder as up-to-date as possible but I need your help.  I am asking for your help in this category so we can offer not only a competitive product but also a very robust network.
  6. HMO members are allowed to utilize KY, IN and OH HMO providers. The Ohio hospital flier is attached. All state hospital fliers can be found in CustomPoint.

Miscellaneous

  1. 2020 marketing pieces are available to order in the Sales Toolkit. These pieces are available to you in quantities of 200 each per month at no cost. Personalize each piece by uploading your photo and contact information.
  2. New A Temporary Proof of Membership form is provided in the Sales Kit after the application. The form includes RX bin information and can be left with the soon-to-be new member. The back of the form provides helpful contact numbers. Please note that enrollment is subject to Medicare approval.
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