Medical Mutual Feb. Updates- PLUS Summa Health Added to Network!

MMO Broker Update: 2.2.21:

Summa Health Added to Medicare Advantage Network Effective April 1, 2021
Category: Network
Applies to: Medicare Advantage
Effective April 1, 2021, Summa Health and their employed physicians will be part of the Medical Mutual Medicare Advantage network. Summa Health offers a wide range of high-quality primary care providers, specialists, hospitals and other facilities throughout Summit, Medina, Portage, Stark and Wayne counties.

We are in the process of updating our directory for the effective date. In the interim, please direct provider inquiries to your Medical Mutual representative.

 
 
Aultman, Aultman Orrville and Alliance Community Hospitals Added to NE Ohio HMO Network Effective Feb. 15, 2021
Category: Network
Applies to: Individual
Effective Feb. 15, 2021, Aultman Hospital, Aultman Orrville Hospital and Alliance Community Hospital will be part of the Medical Mutual NE Ohio HMO network. Aultman offers a wide range of high-quality hospitals and other facilities throughout Stark, Tuscarawas, Carroll, Holmes and Wayne counties.

We are in the process of updating our directory for the effective date. In the interim, please direct provider inquiries to your Medical Mutual representative.

 
2021 COSE MEWA Benefit Changes and SuperMed Share® Launch
Category: Network
Applies to: MEWA
The COSE MEWA product portfolio is updated with new plan additions and plan modifications for 2021. Among these updates, is the expansion of SuperMed Share® to the COSE MEWA market. All 2021 COSE MEWA plan designs are available for quoting in early February, with an effective date of May 1, 2021…
Read More »
 
 
Formulary Updates Effective April 1, 2021 for National Preferred Formulary
Category: Pharmacy
Applies to: Individual, Small Group (1-50), 51-99, 100+, MEWA
Effective April 1, 2021, minor changes are being made to the exclusion list for our National Preferred/National Preferred Plus formulary. A list of drugs added to the list can be viewed here. In addition, a full updated exclusion list is available here. There are no changes to the Basic/Basic Plus or High Performance Plus formularies at this time.

As a reminder, the National Preferred/National Preferred Plus formulary applies only to specific self-funded groups that elected it, including most MedFlex plans. Any members currently taking affected medications will receive a letter notifying them of these changes at least 60 days before they take effect. These changes will immediately apply to new groups that enroll on or after April 1, 2021 and any members who begin taking these medications after April 1, 2021.

 
 

MMO News: COVID-19 Vaccine Coverage and Availability

Special Broker Update Release from MMO – 12/14/20
Important Information About COVID-19 Vaccine Coverage and Availability

The U.S. Food & Drug Administration (FDA) has authorized the first COVID-19 vaccine. The vaccine is an important step toward preventing the spread of the virus. While there is still a lot of uncertainty around the vaccine distribution plans, we want to keep you informed regarding Medical Mutual’s plans related to coverage for the vaccine.

COVID-19 vaccine availability for all members

The federal government is coordinating the distribution plans for the COVID-19 vaccine with state health agencies. Initially, there will be a limited supply of the vaccine and it will be distributed to the populations at the highest risk, including healthcare workers, first responders such as police and paramedics, individuals residing in group settings (such as nursing homes), and people with underlying health conditions that put them at risk for serious complications from COVID-19.

Each state will communicate its distribution plans to the population. Groups and members located in Ohio can visit Coronavirus.Ohio.gov and click the COVID-19 Vaccination Program tab for more information. Members who live outside Ohio, or groups with a large number of employees located outside Ohio, should refer to the state health agency’s COVID-19 website for details.

Once the COVID-19 vaccine becomes widely available, members will be able to receive the vaccine from healthcare providers and pharmacies. There may also be community vaccination sites set up throughout the state. Members should use the national vaccine finder website at VaccineFinder.org to find a convenient location to receive the vaccine. Please note: It may take several weeks for the information on the national vaccine finder to be updated as the vaccine makes its way across the country.

MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT PLANS

Coverage of the COVID-19 vaccine

For the remainder of 2020 and all of 2021, Original Medicare will cover the costs of all necessary doses of the COVID-19 vaccine, as well as the cost to have someone administer the vaccine, for Medicare Advantage, EGWP and Medicare Supplement members. No member cost sharing will be applied. After the public health emergency ends, the COVID-19 vaccine will be included as a preventive benefit under the members’ health plans beginning with the 2022 plan year.

Medicare Advantage and EGWP members can receive the vaccine from providers outside of the Medical Mutual Medicare network with no member cost sharing during the public health emergency declared by the U.S. Department of Health and Human Services.

Medicare Supplement members can receive the vaccine from any provider or location that accepts Medicare.

QUESTIONS
If you have questions about Medical Mutual’s response to COVID-19, please contact your Cornerstone Senior Marketing Representative.

MMO: Unity Health Removed from Network- 1/1/21

November 13, 2020
Special Broker Update

Unity Health Removed from Network Starting Jan. 1, 2021

Category: Network
Applies to: All

We were unable to reach an agreement with Unity Health Network, a multi-specialty physician group with locations in Summit, Portage, Medina, and Stark counties. As a result, all providers associated with the Unity Health Network will be removed from Medical Mutual’s commercial and Medicare Advantage networks, effective Jan. 1, 2021.

To communicate this change and provide direction for members to find new in-network providers, we will send a letter to approximately 7,800 commercial and 900 MHS members who received services from a Unity Health provider in the past year. Letters have already been mailed to affected Medicare Advantage members.

 

Get your 2022 AHIP Cost Covered with Medical Mutual

Receive a free AHIP code when you sell 5 Medicare Advantage applications

Get rewarded for selling Medicare Advantage plans.  MMO will give you a free AHIP code to cover your 2022 AHIP training when you sell 5 new Medicare Advantage applications with January 1, 2021, effective dates.

MMO recognizes that AHIP is costly so they would like to cover the cost so you can use that money elsewhere.  Codes will be distributed prior to the 2022 AHIP training.

 

If you have questions on where your sales are to-date, please reach out to your Cornerstone Senior Marketing rep.

MMO Med Supp Premium Credits Offered to Members

Medical Mutual Issuing Premium Credits to Individual Plan and Medicare Supplement Plan Members

10/16/2020

Medical Mutual is issuing a premium credit to all members enrolled in our Individual plans (ACA, grandfathered and grandmothered) and members enrolled in a Medicare Supplement insurance plan prior to June 1, 2020. The credit reduces the members’ December medical and dental premiums by 40%.

 

While Medical Mutual has been at the forefront of offering support to our communities through our Pandemic Relief Initiative, the premium credit is meant to make that support a little more personal for our members where we can, and provide some financial relief during these challenging and uncertain times.

 

Eligible existing members in Individual ACA plans are being notified of the premium credit via letter the week of Oct. 12, 2020. These members can expect to see the premium credit when they receive their December 2020 invoice or deduction amount if the member is on autopay. Letters to eligible members in Individual grandfathered and grandmothered plans, as well Medicare Supplement insurance plans, are expected to be released the week of Oct. 19, 2020.

 

Invoices for December premiums that show the premium credit could reach members as early as Nov. 1, 2020. Information regarding Medical Mutual’s plan to offer relief to fully insured group customers will be coming soon.

 If you have questions please contact your Cornerstone Senior Representative. 

MMO October Medicare Updates

Medicare Updates 

·         Send members the quote so they can complete the entire application.

·         Complete the application on behalf of your clients and email them the application to sign and submit.

·         Purchase a screen-sharing service, such as Zoom. You can then screen-share while completing the application on a member’s behalf. Once you arrive at the signature page, the member must request access to your screen to sign and submit the application.

For all three options, start with these steps:
·         Visit MyBrokerLink and log in.

·         Go to the Sales & Quoting tab and click Quote/Enroll Medicare.

  • Key changes for 2021 include:
    • A new $0 premium Signature HMO plan in Regions 1 and 3
    • An expansion of our Secure HMO plan to all of Regions 1 and 3 – while this plan has a $0 premium for members who receive 100% of the Low Income Subsidy (LIS), it’s a budget-friendly option for all members
    • The Classic, Secure and Signature HMO plans provide between $100 and $150 in over-the-counter benefits for members in Regions 1 and 3
    • All plans include more dental coverage, with some offering comprehensive coverage
    • All plans now include an on-demand telehealth (telemedicine) benefit
  • If your clients have questions on how to access care when their provider is not available or they are traveling, please share the Where to Receive Care Away from Home flier.
  • If you have submitted your Medicare Advantage (MA) Addendum but haven’t completed your MA certification, it’s not too late.
    •  Visit MyBrokerLink and log in.
    •  Go to the Sales & Quoting tab and click Medicare Advantage.
    •  Select Training and Certification.
  • The 2021 Medicare Supplement rates and online enrollment will be released mid-to-late October.

 

Mutual of Omaha: Aim High During This Medicare AEP!

To ascend great heights, you must prepare. Literally. Above 7,000 feet, you must go through a process of altitude acclimation. And the higher you climb, the more you must prepare.
The same goes for your Med supp sales during Medicare’s Annual Enrollment Period (AEP).

Here are a few things that will help you on your way to the top by selling our Medicare supplements:

MACRA – You’ll need to understand how MACRA (the Medicare Access and CHIP Reauthorization Act) impacts which Medicare supplement plans your clients are eligible to purchase.
Guaranteed Issue Rights – It’s important to know if your clients have guaranteed-issue rights and what plans are available to them.
Proof of MA Disenrollment – You’ll need to make sure to submit documentation for Medicare Advantage enrollees switching to a Med supp plan.

Don’t worry. We have a handy flyer to help you get ready for your AEP ascent.
  Download the Flyer  

 

If you have any questions or want to get contracted with Mutual of Omaha please contact your CSM representative. 

Medical Mutual September 2020 Updates

Medicare Updates (Over 65)

  • Be sure to review MMO’s 2021 Medicare Advantage products. They have made several enhancements to current portfolio to meet your clients’ needs. In addition, MMO will be offering a new $0 monthly premium plan in select counties and have expanded the Secure HMO plan into 44 counties. Click here to view our First Looks Medicare Advantage plan overview.
  • Medicare Advantage kits are available for agents who are currently certified. Follow these steps to order:
    • Visit MyBrokerLink and log in.
    • Go to the Order Supplies tab.
  • If you are not currently Medicare Advantage-certified, please follow these steps to access Medical Mutual’s 2021 Medicare Advantage certification training:
    • Visit MyBrokerLink and log in.
    • Go to the Sales & Quoting tab and click Medicare Advantage.
    • Select Training and Certification.
Note: If this is your first time getting certified, you will need to complete the Medicare Advantage addendum.
  • Don’t forget! Medicare Supplement and Medicare Advantage plan members have access to SilverSneakers®. Check out these SilverSneakers fliers and PowerPoint presentation to share with your clients. Included is information on the Tuition Rewards program available to SilverSneakers members.
  • As a reminder, effective July 1, 2020, Medical Mutual is waiving copays for in-network primary care provider (PCP) visits and in-network lab and diagnostic testing performed on the same day as PCP visits for all Medicare Advantage members through Dec. 31, 2020.
  • For Medicare Advantage members wanting to receive acupuncture treatment – MedMutual Advantage members can receive 12 acupuncture sessions for the first 90 days of treatment, with an additional eight sessions if improvement is seen in the member’s condition. A maximum of 20 acupuncture sessions per year will be covered.
  • Effective Jan. 1, 2021, all PCPs, specialists and facilities associated with the Ohio State University Wexner Medical Center (OSU) — including Ohio State University Hospital, Ohio State East Hospital, The James Cancer Hospital and The Ohio State University Physicians — will no longer participate in Medical Mutual’s Medicare Advantage network. To communicate this change and provide options for members to find new in-network providers, letters were mailed in August to Medicare Advantage members with recent claims from OSU providers. Those utilizing OSU for PCP-related services also received alternative provider contact information for in-network PCPs.

MMO: Pre-Order Your MA Supplies NOW!

Pre-orders for 2021 Medicare Advantage materials are now available in the Order Materials section of MyBrokerLink. This pre-order opportunity will close on Friday, September 11, though you will be able to continue ordering after that date. Only orders placed by September 11 will be guaranteed for arrival prior to October 1. Any orders received after September 11 will start shipping on October 1 in the order they were received.

Visit MyBrokerLink now to place your order for any materials you need for the 2021 Annual Enrollment Period, including updated pre-enrollment kits for all three regions. This year’s kits are customized to the HMO and PPO plans in each region, and include individual Summary of Benefits documents, an application specific to that region and a brochure explaining the benefits of our plans.

If you are selling in Region 1 or Region 3 , MMO expecs a majority of your sales to be in the HMO Classic, Secure and Signature plans. They recommend only ordering a few of the other HMO and PPO kits.

If you are selling in Region 2, MMO expects a majority of your sales to be in the HMO Classic plan. They recommend only ordering a few of the PPO kits.

If you are not selling in multiple regions, MMO encourages you to only order 1-2 of the kits that are outside of your service area.

If you plan to sell virtually this Annual Election Period, please attend one of MMO’s webinars. Click a link below to R.S.V.P.

MedMutual Advantage plans include:

  • $0 medical deductibles
  • $0 or low prescription drug deductibles
  • Dental and vision coverage with options for extra coverage
  • A credit to spend on over-the-counter medical supplies like bandages, aspirin and cough medicine delivered to a member’s home
  • SilverSneakers® fitness membership
  • Telemedicine visit options
  • Transportation services and home meals program after inpatient hospital stay

 

Any Questions contact your CSM representative.

Medical Mutual of Ohio July Updates: 2021 Certs and More

Medicare July 2020 Updates
  • Medical Mutual’s 2021 Medicare Advantage certification is now available. To access the certification, follow these steps:
    • Visit MyBrokerLink and log in.
    • Go to the Sales & Quoting tab and click Medicare Advantage.
    • Select Training and Certification.
You will be required to complete the AHIP certification before the Medical Mutual modules. If you did not get certified for 2020, this certification will apply for both 2020 and 2021.
  • Medicare Advantage Online Enrollment Enhancement: MMO is continually evaluating their processes to ensure brokers can assist clients in the way they are most comfortable during COVID-19. Many agents are moving toward a no-contact approach and using tools such as Zoom to secure enrollment. If you are using Zoom or a similar program, you can secure the enrollment form with the client (applicant). You must give the applicant control to sign and complete the enrollment process. In doing so, it is MMO’s expectation that the client is driving the enrollment form, not the agent. This feature can be used for both Individual and Medicare product lines.

 

  • Effective July 1, 2020, Medical Mutual is waiving copays for in-network PCP visits and in-network lab and diagnostic testing performed on the same day as PCP visits for all Medicare Advantage members through Dec. 31, 2020. Members are receiving an email or letter telling them about the applicable change(s).

 

  • MMO recently created two Turning 65 fliers that agents can send to clients who are aging in to Medicare. View sample #1. View sample #2. If you are interested in customization, please let me know.

 

 

  • As part of MMO’s ongoing Member Health Quality campaign, they will be sending in-home Hemoglobin A1C Test kits to approximately 2,500 Medicare Advantage plan members who have been diagnosed with diabetes and are due for this screening based on prior claims.

 

  • As you know, Centers for Medicare & Medicaid Services guidance states that individuals are not permitted to be enrolled in a Medicare Supplement and Medicare Advantage plan at the same time. Please guide your clients on how to terminate their Medicare Supplement plan if they are enrolling in a Medicare Advantage plan.