Medicare Flashes

2018 Medicare ID Cards

January 3, 2018

If your Medicare members have not received 2018 ID cards yet, please let them know that the cards are on the way. Some of our ID cards were delayed, but all ID cards have been mailed now. The delay involved a fire at one of our printers.

If members need to use their coverage before they receive their ID cards, they can use their welcome letters, which include their member numbers, or they can use their member number to log in or register on Your Health Alliance or the Your Health Alliance app to print or show a digital version of their ID cards.

New Preferred Cost-Sharing Pharmacy in Kankakee, IL

January 2, 2018

We’re excited to add Riverside Family Pharmacy to our preferred cost-sharing pharmacy network for Medicare Advantage plan members. Riverside Family Pharmacy is located at 350 N Wall St in Kankakee, IL.

Members can get Tier 1 generic drugs for $0 when they fill their prescriptions at this location or any other preferred cost-sharing pharmacies, including any Walgreens. They can also get a 90-day supply of their tier 2 and 3 drugs for a 2-month copay.

New Preferred Cost-Sharing Pharmacy in Richmond, IN

December 19, 2017

We’re excited to add Phillips Drugs in Richmond, IN, to our preferred cost-sharing pharmacy network for our Reid Health Alliance Medicare plan members.

Phillips Drugs locations include:

Members can get Tier 1 generic drugs for $0 when they fill their prescriptions at these locations or any other preferred cost-sharing pharmacies, including Reid Hospital Pharmacy or any Walgreens. They can also get a 90-day supply of their tier 2 and 3 drugs for a 2-month copay.

Upcoming Medicare Advantage Commission Payment Schedule

December 12, 2017

As we near the end of the year, we want to update you on the Medicare Advantage commission schedule for the next few months. This year, you’ll receive 2 payments in December.

  • December 23 for November effective dates
  • December 30 for December effective dates and November retroactivity

We’re also working to process January’s Medicare Advantage commissions as quickly as possible, and the payment for January 2018 new sales and renewals will be out by the end of January. Normally, our policy is to pay commissions the month after the effective date, but knowing you sell and renew the majority of your Medicare Advantage book of business in the fourth quarter, we strive to pay January’s commissions in January.

January through March schedule:

  • January 25 for December retroactivity
  • January 31 for January effective dates and January renewal payment
  • February 24 for January retroactivity
  • March 24 for February effective dates

Commercial commissions are not affected by this and will follow their normal payout schedule.

And remember, you can review your Book of Business on Your Health Alliance for brokers any time. Thank you for your hard work and partnership.

Changing Plans Outside the AEP

Now that the Annual Enrollment Period (AEP) is over, you might have questions about how members can change plans during the rest of the year.

Medicare Advantage Disenrollment Period

From January 1 to February 14, during the Medicare Advantage Disenrollment Period, members can leave their Medicare Advantage plan and switch back to Original Medicare.

If they switch back to Original Medicare during this time, they’ll also have until February 14 to join a Medicare Prescription Drug Plan (PDP) to add drug coverage.

They cannot:

  • Join a Medicare Advantage plan from Original Medicare
  • Switch from one Medicare Advantage plan to another
  • Switch from one PDP to another
  • Join, switch, or drop a Medicare Medical Savings Account Plan

Remember, members who qualify for Extra Help (LIS) might have other options.

Special Enrollment Periods

Outside the AEP, Medicare beneficiaries can only enroll in a Medicare Advantage plan or PDP after a special event with a Special Enrollment Period (SEP).

To enroll during an SEP, we must receive an Attestation of Eligibility form, which must include the date of the qualifying event, with the application. CMS requires us to get that date, so applications won’t be processed until it’s confirmed.

You can find enrollment forms and attestations forms on HealthAllianceMedicare.org or on Your Health Alliance for brokers in the Forms & Resources.

Learn more about the types of SEPs, when coverage will start, and other enrollment periods on the Understand Medicare section of our website.

Expanding Our Home Visit Program in Yakima

December 12, 2017

A yearly visit with a healthcare provider is an important piece of overall wellness, and we want to make sure all of our members have that opportunity. Members who can’t make it to their doctors’ offices may be good candidates for our home visit program.

We’ve expanded this program of home visits by advanced registered nurse practitioners (ARNPs) to the Yakima service area.

At the free in-home visits, our ARNPs can help members with these wellness services:

  • Checking blood pressure, oxygen levels in the blood, feeling in feet, and more
  • Going over options for pain control and ways to talk to primary care providers (PCPs) or specialists
  • Completing a health risk assessment
  • Talking about prevention and treatment options for diabetes, heart disease, and other conditions
  • Answering questions about medications, sleep patterns, nutrition, and more

Members pay nothing for in-home nurse visits. These visits don’t change their coverage, and they do not replace the care or advice members get from their own doctors.

Each week, our local office will receive a report detailing who has been contacted about these visits, in case you or a member have questions about the validity of the outreach. You can also contact Dawn Peterson at Dawn.Peterson@healthalliance.org with questions.