UHC Ohio Medicaid Updates: Verification & Emergency Assistance Changes

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Ohio Medicaid Verification Update via PHD, Jarvis, Mira
UnitedHealthcare has recently learned that the state of Ohio Medicaid verification system is undergoing a transitional stage that will prevent agents from verifying Medicaid in our state. Jarvis, Mira and the Producer Help Desk (PHD) are impacted by this change and currently do not have a workaround to verify eligibility.

What you need to know:

• The state system will likely go down at 5 pm tomorrow, Tuesday, Jan. 31. This outage could potentially last for several days.
• You are able to continue writing new business during the outage, but you may need to ask additional questions of your prospects to verify their status & eligibility (ask if or who’s paying their Part B premium, are they part of MyCareOhio, do they have a local JFS office case worker they work with re their benefits, etc.)
• Please submit enrollment applications as soon as possible before the blackout window to avoid any potential delays.
• There may be a delay for applications being approved for Feb. 1 and March 1 effective dates.

At this time, UHC is unable to determine how long this outage will be. UHC will keep brokers updated as they receive additional information. UHC is working with the state of Ohio to get this resolved as quickly as possible.

 

Ohio Medicaid – Emergency Assistance Changes

Beginning in April, Medicaid expansion is set to begin unwinding across each state that took part in the COVID pandemic related Medicaid coverage increases. This will result in a county by county effort by local JFS offices to contact over 1 million Ohio Medicaid recipients letting each person know they need to reenroll.

 

This is very likely to cause confusion & frustration among clients & prospects at the low income venues and organizations you partner with. At the same time, this becomes an OPPORTUNITY for each of you to provide additional service and assistance and value to the locations you visit each week.

 

For additional information, please see this recent local TV video report from the local Columbus NBC station: Changes approaching for Medicaid recipients | NBC4 WCMH-TV (nbc4i.com)

 

The Health Plan: New OTC Vendor – InComm

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Sourced from THP Broker Communication from 1/19/23:

The Health Plan has a new OTC vendor, InComm.  Enclosed is an instructional video “How to Access and Navigate My Benefits Center” that may help you communicate this benefit to your THP Medicare Advantage members.

Please advise your members that this benefit / Visa Card is already activated upon receipt and ready-to-use for their OTC purchase needs.  DSNP plan members can also use it for healthy foods and utility bill assistance, as instructed in the video. Every member who earns rewards & incentives for getting their annual physical, mammogram and / or colonoscopy will access their rewards through this card as well.

Click here to view the instructional video.

Please direct your members to contact The Health Plan’s Customer Service department with any questions at: 1-877-847-7907, M-F 8:00 am – 8:00 pm

If you have any questions, please reach out to your CSM Service Rep

Biden Administration Releases Timeline IRA Medicare Provisions

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Biden Administration Releases Timeline for Implementation of Inflation Reduction Act Medicare Provisions

The administration released a timeline for implementation of certain Inflation Reduction Act (IRA) provisions, including provisions related to Medicare drug price negotiations.

As we have mentioned previously, the IRA grants the secretary of HHS the ability to negotiate the prices of certain drugs for the Medicare program with new prices beginning in 2026. Ten Part D drugs will be negotiated in 2026, with an additional 15 Part D drugs in 2027, 15 Part B or D drugs in 2028, 20 Part B or D drugs in 2029, and 20 more drugs each year beyond that. The bill dictates that the secretary can only negotiate prices on costly single-source drugs, those among the highest-spend products in Part B or Part D that do not have competing small-molecule generics or biosimilars that are both FDA-approved and marketed. The legislation also exempts “small biotech drugs” from negotiation until 2028….

 

READ FULL ARTICLE

PLUS! DOWNLOAD A CMS PDF OF THE IRA TIMELINE FOR A QUICK REFERENCE 

Mutual of Omaha 2022 1099’s Coming to SPA

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Great news, 2022 1099s will be available through Sales Professional Access (SPA) for all producers.

Please note: if the producer has a Compensation PIN assigned for SPA already, they will not be able to view their 1099 without their compensation pin. We wanted to give all of you the heads up before we send a general announcement in February.

 

READ MORE… 

Georgia Market – OEP 2023 D-SNP Sales Incentive Program  – Learn More! 

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Aetna is excited to announce to all brokers in Georgia that we have a NEW SALES INCENTIVE to help support you during Lock-In.

The top three D-SNP producers will be able to access marketing dollars in the form of traditional co-op or funds through our Medicare Marketing Studio, marketing collateral to support community events, and local Aetna support to host community events throughout the year.

Producer Rewards & Qualifications

Top 3 Producer Rewards:

#1 Top Producer
• $5,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#2 Top Producer
• $3,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#3 Top Producer
• $1,500 in marketing co-op dollars in Q1 Only
• Aetna Swag

Sales Incentive Details & Qualifying Criteria:

• New to Aetna D-SNP sales for February 1- April 1 effective dates (CMS issued sales only).
• Final sales numbers will run in early May. Winners will be announced at that time.
• Cancelled applications and rapid disenrollments will be removed from final counts.
• To qualify for the contest, the broker must have a minimum of 10 New Sales
• Top three winners will be announced in each of the following markets:
Atlanta Metro/North Georgia
Macon/Columbus/South Georgia
Augusta/Savannah

***NOTE: Plan replacement is excluded***

 

The Qualifying Plans Include the Following:
• Aetna Medicare Dual Choice Plus Plan (PPO Full D-SNP)
• Aetna Medicare Dual Preferred Plan (HMO Full D-SNP)
• Aetna Dual Choice Plan (PPO Partial D-SNP)
• Aetna Medicare Dual Select Plan (HMO Partial D-SNP)

The Aetna Medicare FULL D-SNP plans are available in 78 counties in Georgia. Our plans offer competitive benefits and includes many extras:

• Extra Benefits Card: $600 combined quarterly allowance on a prepaid debit card for OTC and healthy foods. No pre-qualifying conditions required.
• $0 Rx copays on all tiers at standard and preferred pharmacies.
• Dental: up to $4,500 allowance that covers preventive comprehensive care, including dentures and implants (excluding cosmetic services).
• Eyewear: up to $500 allowance.
• Transportation: up to 60 one-way trips (100 Mile radius) to medical appointments, pharmacies and SilverSneakers locations through SafeRide.
• LifeStation Personal Emergency Response: $0
• Hearing aids: up to $1,250 allowance per ear.
• Fall Prevention: $150 for home/bath safety devices.
• Plus … earn an extra $110 service fee when you complete the HRA via electronic submission.

CMS Med Advantage Reminder: Addition of Race and Ethnicity Data Fields on Enrollment Transactions for 2023

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SUBJECT: Model Individual Enrollment Request Form to Enroll in a Medicare Advantage Plan (MA) or a Medicare Prescription Drug Plan (Part D), and Advance Announcement of January 2023 Software Release – Addition of Race and Ethnicity Data Fields on Enrollment Transactions

 

The Centers for Medicare & Medicaid Services (CMS) implements software changes to the enrollment and payment systems that support Medicare Advantage Prescription Drug (MAPD) programs. The purpose of this memorandum is to announce the addition of race and ethnicity data fields on the model Individual Enrollment Request Form to enroll in an MA or Part D plan, OMB No. 0938-1378 and provide high level advance notification of the associated system changes scheduled for release in January 2023. These new fields are required to be included on the enrollment form; however, applicant response to these questions is optional. When provided by an applicant, MA and Part D plans will submit these data to CMS as part of the enrollment transaction. If a plan receives a rejected transaction reply code (TRC) 394 or informational TRC 396 (see attachment C), the plan must send a subsequent corrected transaction code (TC) 92 to rectify. CMS expects plans to submit the beneficiary response to the race and ethnicity field, including confirming if the beneficiary did not provide the optional data. Until all race and ethnicity data are accepted by CMS, including annotating that the beneficiary did not answer the question, the field is not considered complete.

 

READ FULL PRESS RELEASE 

AultCare’s Medicare Supplement Guaranteed Issue Extended thru 6/30/23

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AultCare Choices extends Guaranteed Issue Medicare Supplement until end of June 2023 with an effective date no later than July 1, 2023.

Med Supp Guaranteed Issue Advantage
Through July 1, 2023 effective dates, AultCare offers clients to move from Plan F to Plan G from any carrier or within the PrimeTime network and anyone coming from an existing/active Plan C supplement plan will receive the Guaranteed Issue to downgrade to Plan G, M or N.

PLUS! Enrollment app enhancements….
A new PrimeTime Choices Enrollment Application is available with upgraded features that mirror the current Medicare Advantage submission process. The enhancements include:
• Single submission for both member and broker information, eliminating the need for brokers to submit a separate form.
• Attachments can be included with your submission
• A progress gauge
• Ability to print the completed application before submission
• A confirmation message when the submission process is complete

 

Get started today! AultCare PrimeTime Choices

For 35 years, AultCare has provided quality healthcare at an affordable cost to the Ohio communities it serves, state-wide for the PrimeTime Choices Medicare Supplement Plan.

Cornerstone Senior Marketing offers our broker partners the exclusive opportunity to contract with AultCare and offer their plans as a significant part of a well-rounded product portfolio.

REQUEST AULTCARE CONTRACTING

 

REQUEST AULTCARE RATE & PLAN INFO

 

Questions?  Contact your Sales or Service Rep to discuss the benefits of adding AultCare to your product portfolio.  614-763-2255

Devoted Health: 3 Tips To Help You Sell In The Final Week of AEP

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This AEP has been Devoted Health’s biggest one yet. Thanks to the hard work of you and more than 4,600 brokers, Devoted has received more applications than ever before.
And they are still expecting a final bump in sign-ups. Last year, 26% of applications came in the last week of AEP. Here are 3 talking points you can share with those last-minute prospects to get them signed up before December 7.

• Devoted benefits are really rich. Members could save thousands each year, thanks to extras like their dental benefit and over-the-counter allowance.

• Devoted’s member Guides make our plans easy to use. Members can call or text a Guide whenever they need help. Guides respond fast. And they can help with everything from understanding benefits to troubleshooting bills, finding doctors, and more.

• All plan benefits start right on January 1. Members don’t need to wait to use any of Devoted’s benefits. Starting in the new year, they can order a free medical alert device, use their dental benefits, buy glasses, and shop for over-the-counter items, among many other benefits.

 

Questions? Contact your CSM Rep for more information on Devoted Health!

AEP 2023 Reminder: Last Day for 2023 AEP Enrollments

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AEP Ends Wednesday, December 7, 2022

 

Important information about the last days of AEP and submitting enrollment applications

The following tips will help ensure your hard work this AEP pays off and your applications are processed correctly, including those submitted on Wednesday, December 7, 2022.

  • AEP application submission deadline: ALL applications must be submitted no later than 11:59 pm on December 7, 2022.
  • Date the application.  It is important to include a date on every enrollment application.  Applications without a date, received after December 7, 2022, are assigned the date the application was received by the carrier, which can invalidate apps received after AEP ends.  Apps that you received on December 7, 2022, must be submitted to the carrier, dated December 7, 2022.
  • Faxing Applications:  If faxing the application, remember to keep a copy of your successful fax transmittal as confirmation of submission.
App Submission Guide
2023 AEP Tips & Guidance

MedicareCENTER Tip: Custom and SEP Tags in CRM

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Knowing which clients to call — and when — is important to building your business. MedicareCENTER can help with auto-assigned and custom Tags in Contact Management!

Tags are easy to use, can help you prioritize the actions you take with your clients, and are available on the Medicare Mobile App and at MedicareCENTER.com.

Our latest addition — the “SEP” Tag (Special Enrollment Period) — is automatically applied to any clients in your CRM who may be eligible to enroll through December 31, 2022, due to living in a natural disaster area.

Other auto-assigned Tags, such as “Cross-Sell” and “Switcher,” can help you identify which of your clients you may have cross-selling opportunities with and which clients have plans that might change benefits, indicating a likely candidate for switching plans. These technology-driven insights are just what you need to keep reaching your AEP goals!

You can also quickly and easily create your own custom Tags based on how you like to organize your clients or who you need to check in with. For example, a “Welcome 2023” Tag could be created to flag your new clients you need to check in with after the enrollment period to help them understand their benefits.

Click below to download a step-by-step tip sheet to use as a quick reference on Tags in Contact Management, available on MedicareCENTER.com and the MedicareCENTER Mobile App.

 

DOWNLOAD TIP SHEET 

 

Log in and take advantage of MedicareCENTER’s powerful solutions today!

 

LOG INTO MEDICARECENTER HERE