United Health Care OTC Catalog
This post will give members of the United Health Care HMO MAPD plans 1,2 and 3 access to the 2019 United Health Care OTC Catalog.
INFORMATION ON THIS PAGE HAS BEEN UPDATED. CLICK HERE TO ACCESS THE NEW PAGE.
If you are a member of either a United Health Care Medicare HMO Plan 1, 2, or 3, you have an over the counter benefit as part of your health plan. Although each plan has different quarterly benefit amounts, you can use the same form to look up products and find out what is available to you. Please refer to your specific plan benefits to find out exactly what your OTC benefit amount is. You need to be aware that the quarterly over the counter benefit not transferable and cannot be used once a given quarter has ended. This means if you do not use your benefit for each quarter you simply lose it.
In fact, when you chose to use your over the counter (OTC) benefit you must do so in one single order. This means you should plan what you will need by looking through the United Health Care OTC catalog before the end of each quarter and order everything you think you will need at once. United Health Care will only allow you to place 1 order per quarter.
Are you a Medicare Insurance Agent? Learn about programs we offer to agents:
If you would like to view a copy of the United Health Care OTC Catalog, CLICK HERE FOR THE 2019 OTC for HMO MEDICARE ADVANTAGE PLANS 1 2 & 3.
If you are a member of a DSNP plan, click here for 2019 DSNP member OTC Catalog.
You may order only items listed in the catalog for your OTC benefit.
The name of the company that handles the OTC orders is Firstline Medical. There are 2 ways to order. Either you can order by mail or you can order online. If you would like to order by mail you need to contact FirstLine Medical at 1-877-795-4521. You can call them from 7a.m. until 7 p.m. Monday -Friday and 7 a.m. until 4 p.m. Saturday (Central time). You will need to have your UHC card available before you call.
If you would like to place an order on line you can go to www.OTC-Essentials.com.
1. Click on REGISTER to create your account (you only need to register one time).
2. Login to check your balance, view product images and descriptions. Place your order.
3. Track your order status or manage your account information.
Please use these helpful tips to register on the website:
1. Have your health plan member ID card available.
2. When you enter your member ID, only enter the numbers that are before the dash.
3. Your Username is from 6 to 25 characters long.
4. Your Password is from 8 to 25 characters long and will need to have at least one number, one capital letter and one lower case letter. The password is case sensitive.
Additionally, if you need help finding the right Medicare plan or have questions on your current health care plan. Please contact us at 203-796-5403. Our agents will be happy to make sure you have the coverage you need at the best price for your budget.
Are you looking to quote or compare Medicare plans? CLICK HERE
Medicare Travel Benefits
This post will give you some information about Medicare Travel Benefits. You should understand what medical coverage you have while you are away from home. In most cases, Medicare does not cover either health care services or supplies when you travel outside of the United States. Some exceptions to this rule are listed below.
In some instances, Medicare Part B may pay for services you get if you are on board a ship within the territorial waters that join land areas of the U.S.
Rarely, Medicare might pay inpatient hospital, doctor, ambulance services, or dialysis when the following happens
If you are in the U.S. and a medical emergency occurs and the closest hospital that can treat your condition is a foreign hospital.
While you are traveling through Canada an emergency occurs that needs treatment without unreasonable delay. If the Canadian hospital is closer than the nearest U.S. hospital that can treat you.
When you live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your condition. This is the case, if there is an emergency or not.
In some instances, Medicare may cover medically necessary health care services you get on board a ship. This is the case if you are within the territorial waters that join land areas of the U.S. Although, Medicare will not pay for health care services you receive on a ship that is more than 6 hours away from a U.S. port.
Please note: If you are admitted to the hospital under the circumstances listed above; foreign hospitals are not required to file Medicare claims for you. You are responsible to submit an itemized bill directly to Medicare for all the services you receive.
If you do not fit into one of the situations described above:
You will have to pay 100% of the costs, in most cases. If you do fit into one of the situations above, you do not get the 80% coverage provided by Original Medicare.
For services that are covered, Medicare pays only for services that are covered under Original Medicare.
Medicare Part A
Part A covers care received when formally admitted as an inpatient by a doctor’s order to a foreign hospital.
Medicare Part B
Part B covers both emergency and non-emergency ambulance and doctor services you receive for your covered foreign inpatient hospital stay. You will be responsible for your portion of the charge for covered services. Your portion includes coinsurance & co-payments as well as deductibles, the same way it would if you received care in the U.S. You may want to ask your doctor for prices for tests, supplies and services. This way you will know how much you will owe your provider. There are various things that may decide your costs. This includes whether or not you have other insurance, how much the doctor charges, the type of facility, as well as where you get your tests, items or services.
Medicare does not pay for services such as return ambulance trips home when:
- Medicare refused to cover your hospital stay.
- You used either ambulance or doctor services outside the hospital after your covered hospital stay ended.
Medicare Travel Benefits, Please note:
The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are all considered part of the U.S.
Medicare drug plans don’t cover prescription drugs you buy outside the U.S.
Some Medicare supplement insurance (Medigap) policies cover you when you travel outside the U.S.
Medicare Supplement/Medigap coverage when you are outside the U.S.
Medicare Supplement Plans C, D, E, F, G, H, I, J, M or N. Plans C,F,G,M and N can actively be purchased.
- Does Cover foreign travel emergency care that begins during the first 60 days of your trip, if Medicare does not cover the care.
- Once you have met the $250 deductible for the year, Medicare supplements pay 80% of the billed charges for certain medically necessary emergency care outside the U.S..
There is a lifetime limit of $50,000 for foreign travel emergency coverage with Medigap policies.
If you would like more information on Medicare supplement plans, CLICK HERE
Be aware of your Medicare Travel Benefits before you go.
Before you take that trip outside the U.S., It is best to talk to either the customer service department of your insurance plan carrier or your insurance agent to get more information about your coverage before you travel.
Sometimes Travel insurance will help make up for limited Medicare coverage for health care services outside the U.S.
You can get information about travel insurance through your insurance agent or travel agent. Travel insurance doesn’t necessarily include health insurance, so it’s important to read the conditions or restrictions carefully.
Medicare Easy Pay (Automatic deductions for Medicare Part B premiums)
Medicare Easy Pay is an electronic Medicare part B payment option for people to have their Medicare Part B premiums set up to draft from either a savings or checking account each month.
Can I sign up for Medicare Easy Pay?
Anyone who gets a bill for their monthly Medicare Part B premium is eligible for Medicare Easy pay. Those already drawing Social Security payments are paying out of their checks automatically and do not need to set up easy pay.
Note: Those with billing through Railroad Retirement Board (RRB), are not able to utilize the service.
How do I set up Medicare Easy Pay?
To get the Medicare Easy Pay form: CLICK FOR EASY PAY FORM
Mail the completed form to:
Medicare Premium Collection Center
PO Box 979098
St. Louis, MO 63197-9000
What happens once I sign up for Medicare Easy Pay?
Sometimes it takes 6-8 weeks for Medicare to process your application. If medicare cannot process your MEP application, they will return it to you with a letter of explanation.
Two things will happen each month after your request is processed:
- You will get a Medicare premium bill stating “This is not a bill”. This will let you know that the premium will be deducted from your bank account.
- Your premium will be deducted from your bank account. This usually happens on the 20th of the month. The deduction will appear on your bank statement as an “Automated Clearing House (ACH)” transaction.
Medicare will try to deduct your premium only one time per month. If there is a problem processing your premium deduction, you will receive a letter with instructions on how to make a direct payment to Medicare.
Do I need to do anything when my premium amount changes?
No, Medicare will deduct the new premium amount from your bank account automatically.
What if I want to change bank accounts or stop Medicare Easy Pay?
You would complete another payment authorization form(SF-5510), and indicate the type of change you want to make. Mail the completed form to the address above.
If you would like more information about Medicare; contact us either by phone at (203)796-5403 or email at teal@croweandassociates.com.
Signing up for Medicare A and B
We want to give you some help when you are Signing up for Medicare A and B. This can be a stressful time for some people with all the mail and calls they receive.
- Medicare A and B will begin the first of the month someone turns 65 years old.
- If you receive social security payments for at least 4 months before the month you turn 65, you will get Medicare A and B automatically. Those not receiving payments will need to sign up for A and B online or at the local social security office.
- If you have not been receiving Social Security payments for the 4 months before you turn 65, you will need to sign up for both A and B. You will not get it automatically.
- Here is the link for those that need to sign up CLICK HERE TO SIGN UP FOR MEDICARE ONLINE The online enrollment is simple and only takes about 15 to 20 minutes
- Please Note: If you are past the age of 65 and want to sign up for Medicare part B, it cannot be done online. You must go to the local social security office to sign up. We suggest that you call the office first to make an appointment.
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Signing up for Medicare A and B – Medicare billing for part B
- If you are already receiving Social Security payments, the part B premium will be deducted from your SS payments.
- If you currently do not not receive Social Security payments, you will be billed quarterly for part B. Medicare will allow you to pay the premium automatically if you fill out a form to set it up.
Signing up for Medicare A and B – Who should enroll in Medicare Part B
- If someone is working and receiving health benefits through work or if they receive health benefits through a working spouse, they do not need to sign up for part B of Medicare. (Assuming they will continue to get work benefits)
- If either they or the spouse they get benefits through stops actively working, they need to sign up for Medicare Part B. Note: Those with groups of less than 20 employees may need to sign up for part B when they turn 65 regardless of work status.
- Retiring is a special election for Medicare Part B. You will need to take a completed Employment verification form to the Social Security office to sign up for B. The effective date will be the first of the month after you retire.
- If you are still actively working but no longer receive coverage, that is also considered a special election to sign up for Medicare Part B.
- You have an 8 month window to sign up for Part B. The 8 months start from the date you either retire or lose coverage
- If you fail to sign up for part B under either of the scenarios above, it will result in a Part B penalty The penalty is 10% of part B premium for every 12 months you did not have part B. If you delayed part B enrollment and missed your special election period, you should sign up during the Medicare Part B general enrollment period. The general enrollment is from Jan 1 through March 31 to sign up for a July 1 start date. Those that miss the general enrollment will need to wait for the next general enrollment to sign up unless they qualify for a special election period,
- click here for employment verification form.
Signing up for Medicare A and B – Employer groups with less than 20 employees
- According to Medicare, someone employed by a group with less than 20 employees needs to sign up for both Medicare A and B at age 65. This is true even if you have health coverage from work and are still working. In reality, I have had a number of people who work in groups less than 20 delay part B. Those people have not paid a penalty when they enrolled in B later down the road. They also did not have any issue with the special election to enroll in B. Regardless, the Medicare rule says they should enroll when turning 65. It is up to you how you choose to proceed in this situation.
Signing up for Medicare A and B – Contributions for those on Medicare A and B
- Those with Medicare A and/or B are advised not to contribute to an HSA account. If you are selected for an audit, you may be receive a penalty. This means your contributions are included in your taxable income. You will also pay a 10% penalty on the contribution.
If you want to get a quote for Medicare Advantage or Supplement plans, click here.
Aetna Medicare Over The Counter Catalog 2019
The Aetna Medicare Over The Counter (OTC) Catalog 2019 is now available.
To view an updated post – Click here for details
Carriers now offer a Medicare over the counter (OTC) benefit to their members. In addition to your plan benefits, over the counter benefits defray some of the cost of necessary healthcare items not covered as a medical or pharmaceutical expense.
Aetna Medicare offers members an Over-The-Counter benefit.
This benefit pays up to a $25 maximum amount every month for over the counter (OTC) items. The catalog lists eligible items. Only items listed in the OTC catalog are covered by the over the counter benefit. Many products you would normally purchase from a drugstore are critical to a healthy lifestyle. These items may include non-prescription medications, vitamins, and eye care. In addition to these you can purchase every day items that impact your health, like hand sanitizer. This benefit allows you to purchase these items from the catalog at no cost to you. Accordingly, the cost of these items is part of your Medicare OTC benefit.
- The over the counter benefit in 2019 is up to $25/member every month. However, there are rules with regard to how items must be ordered.
- The over the counter benefit is included with all Aetna Medicare Advantage plans in 2019.
- You must order from the catalog or online. Items purchased from a retail store are not part of the benefit.
- Because this is a “use it or lose it” benefit, benefit dollars do not carry over month to month. Therefore, be sure to check the catalog each months for items you will need.
- You cannot use your CVS Extra Care card toward these purchases.
- Free shipping! There are no shipping or handling fees.
- Orders typically take two weeks to arrive. Plan ahead for adequate supplies.
You can place an Over the Counter order 2 ways. You can order either by phone at 1-888-628-2770 Monday through Friday 9:00am to 8:00pm EST, or you can order online at visit:myorder.otchs.com.
Choosing a Medicare plan can be confusing! Remember, that is what we specialize in! If you still need help determining which Medicare option will suit you best, call us at 203-796-5403 and schedule an appointment today.
Agents can click for a Medicare Scope of Appointment
Your new Medicare card, things to know
Your new Medicare card, things to know
Social Security is still busy sending out the new Medicare cards in the mail. You can click this link to get an email when your new card has been put in the mail new Medicare cards. This will give you an idea when to expect receipt of the new card. This way you can keep an eye on the mail for it. Many of the new cards have already been sent out. If you have not yet received your new card, do not worry. It will get to you in the very near future.
If you need to get your new Medicare card ID, you can click the following link to create a free Medicare account. From there you will be able to get your new Medicare number without having to wait for it to arrive in the mail. CLICK THIS LINK TO CREATE A FREE MEDICARE ACCOUNT.
Once your new card arrives in the mail, you can use it right away. There are a few things you need to do once your new card arrives:
Always Carry your new Medicare card with you.
Keep in mind that your doctors and health care providers are aware that you will be receiving it and they will want to see your new Medicare ID when you come into their office for care.
- Destroy your old Medicare card. You no longer need the old card for anything, so the best thing to do with it is to carefully and completely destroy it. You do not want anyone getting your information.
- Keep your Medicare Advantage Plan card. If you are currently enrolled in a Medicare Advantage Plan, (an HMO or PPO), you will continue to use your Medicare Advantage Plan ID card when you use a health care provider. Please keep in mind you will also need to carry your new Medicare card, because you health care providers will ask to see it. Remember, these new cards are safe to carry with because they do not use you social security number anymore.
- If you have a Medicare Drug plan card you will also need to keep that with you.
If you need to sign up for Medicare, click here
Do not worry that your new Medicare card looks different than the old one. Your Medicare coverage and benefits have not changed. If you would like more information about the new Medicare card you can click here.
If you need help with choosing Medicare plans, please contact our office. You can reach us either by phone at (203)796-5403 or by email at admin@croweandassociates.com.
to learn more about us; visit croweandassociates.com.
How Much is Medicare part B
When you are getting close to the age of 65, you might get a little anxious thinking about what steps you need to take to get you Medicare benefits. One of the questions you probably have is How Much is Medicare part B. . If you are retired and living on a fixed income this is an important question to ask. Medicare Part B covers your necessary medical services and supplies. In 2018 the standard cost for Medicare Part B is $134.00 a month for an individual.
According to federal law, some higher-income beneficiaries will have to pay a higher premium for their part B coverage. This law also applies to your Medicare prescription drug coverage. Less than 5% of people will be affected by this law. Therefore, the majority of people will not have to pay the additional premium.
The document in the link below is for 2018; but the IRMAA limits are set to be the same for 2019. They will most likely go up substantially in 2020.
CLICK HERE FOR MORE INFORMATION AND INCOME/PAYMENT AMOUNTS
How Much is Medicare part B – Social Security will use your most recent tax return
Your most recent tax return will be used to decide if you need to pay the higher premium. The amount is based on your (MAGI) modified adjusted gross income. Your MAGI is your total adjusted gross income along with your tax-exempt interest income. If you are filing as single and your MAGI is more than $85,000,you will pay a higher Part B premium. In the event that you are married, filing jointly and your MAGI is greater than $170,000 you will pay a higher Part B premium. If you will have to pay a higher premium, you will receive a letter from Social Security with the reason for the higher cost as well as the amount you will have to pay.
When you have income that is not over the set income limits you will not have to pay any additional premium.
If your income has gone down, due to a change in your life, you can contact Social Security and explain it to them. They will need proof/documentation of the new information and may adjust your payment amount accordingly. We list some examples of life changes below:
You or your spouse stops working or has reduced hours.
An unforeseen event causes you to lose an income-producing property.
Recently you were either married, divorced or widowed.
You have lost income from a pension plan.
In the event that your income has gone down, you can use Form SSA-44 to ask for an adjustment. You can find the form on line at www.socialsecurity.gov/forms/ssa-44.pdf.w.
If you would like more information or help with signing up for Medicare, please contact the office. You can reach us either by phone at (203)796-5403 or by email at teal@croweandassociates.com
New Medicare Card Scams
Unfortunately, there have been reports of some New Medicare Card Scams.
Be aware that Medicare is in the process of sending out the new Medicare cards.
Therefore, if you receive a call and someone says you need to give them your personal information or payment of any sort to get the new card, hang up! It’s a scam. Medicare will never call uninvited and ask for personal information or money the cards are free and Medciare already has all the information they need to get the card to you. Click this link to check the status of your new card.
If you have not received your new Medicare card yet, don’t worry. Sending cards out to each state takes some time. You and your friends will probably get your cards at different times. If you do not have your new card yet, you can keep using your current Medicare card.
Additionally, you are able to log in to your MyMedicare.gov account to see when your new card was mailed. To sign up for a free Medicare account you can go to Medicare.gov and in a short amount of time you can create an account.
IMPORTANT: If you have received your new card, start using it right away!
YOUR NEW CARD WILL LOOK LIKE THIS:
PLEASE REMEMBER:
- Your new card will automatically be mailed to you. There is nothing for you to do. Just wait for the card to arrive, as long as your address is up to date. If you need to update your address, visit your My Social Security account.
- Once you get your new Medicare card, you should destroy your old Medicare card and start using your new card.
- Medicare uses a unique combination of numbers and letters on the new cards. They use numbers 0 thru 9. They do not use the letters S, L, O, I, B, or Z on the cards.
Call Crowe and Associates with any questions at 203-796-5403
Medicare Employment Verification form
You might wonder why you would need a Medicare employment Verification form? If you are going to apply for Medicare in a special enrollment period you need to have had group plan coverage within the last 8 months through either yours or your spouse’s employer.
If you have a disability you must also have had large group health plan coverage through either your own or your spouse’s employment. The Medicare verification form is used to prove that you have had or have this coverage. It is needed to process your Medicare enrollment application. The employer that provides you with health coverage will complete some sections of this form for you. The form includes information about your health care coverage as well as the dates of employment.
Click here for Employment verification form
HOW DO I FILL OUT THIS FORM?
You will fill out the first part of the form(section A). Have your or your spouse’s employer(whichever provides insurance coverage to you)fill in the second part of the form(Section B) and sign it.
WHAT TO DO WITH THE COMPLETED FORM:
Once both sections are complete, you need to include the form with your Medicare enrollment application. You send both forms to your local Social Security office.
If you need to find your local Social Security office click here, after you get to the page you click on the menu. Then click on contact us, and finally click on find an office.
If you have any questions or need help with this, please contact our office. You can reach us either by phone (203)796-5403 or by email at admin@croweandassociates.com
If you are a Medicare agent and need a scope of appointment form Click Here.
Have you thought about Medicare sales:
We have a great lead program for agents that are part of our team. Click here for more information.
Click here for paper agent contracting kit
For online contracting, Click here
Preventive care definition
This post will help you to better understand what the Preventive care definition is. This will give you an idea of what your health care coverage is providing to you and sometimes what it is not.
The care that you receive to prevent illness or disease is referred to as preventive care. This can also include counseling you receive in an effort to prevent health problems. The reason insurance companies provide these services at no cost to you is because; if you are healthy it costs them less to provide insurance coverage for you in the long run. The basic idea is that getting preventive care, such as screenings and immunizations, helps keep you and your family healthy. All Marketplace health plans as well as many other health plans are required to cover preventive services without charging you either a copay or coinsurance. This applies even if you have not met your yearly deductible yet.
The Preventive care list includes different services if you are an adult than the services that qualify as preventive if you are a child. The insurance industry also bases preventive care on the risk factors for each individual. These factors vary according to both your family history as well as your personal history.
CLICK THIS LINK TO VIEW THE ACA LIST OF PREVENTIVE CARE SERVICES
If you need assistance with obtaining insurance, please contact us. You can reach us either by phone at (203)796-5403 or by email at edward@croweandassociates.com. We are always happy to assist clients in finding the best coverage options available to them.
Medicare forms online
Medicare forms online can help you search for a Medicare form to file a claim, request an appeal, or for Medicare to give someone access to your personal health information?
To get the Medicare form you need, visit Medicare.gov and find the situation that applies to you.
Maybe you’ve been working past the age of 65, have had health coverage through your (or your spouse’s) employer, and are now ready to enroll in Medicare Part B. If so, you’ll most likely need to fill out CMS forms 40B and L564 and take those to your local Social Security office to start Part B coverage. You can find those particular forms on Medicare.gov, too, under “Enrollment Forms.”
To get the Medicare form you need, find the situation that applies to you. Get forms in alternate formats.
Medicare forms online – Enrollment forms
Medicare forms online – Appeals forms
Crowe and Associates is open from 8:00 am to 5:00 pm M-F. If you have questions, please contact us either buy phone at 203-796-5403 or email teal@croweandassocaites.com.
Extended Medicare Open Enrollment Period 2019
This year you have more chances to make sure you chose the best health care coverage available for your needs. There will be an Extended Medicare Open Enrollment Period 2019. The extended period is called the Medicare Open Enrollment Period (OEP) and will run from January 1 through March 31st.
The Medicare Annual Election Period (AEP) is from October 15 until December 7 each year. The dates changed in 2011, but have been the same ever since. For 2018 Medicare coverage, open enrollment ended on December 7, 2017. For 2019 coverage, open enrollment will run from October 15, 2018, until December 7, 2018.
During the annual enrollment period (AEP) you can make changes to various aspects of your coverage.
- You can switch from Original Medicare to Medicare Advantage, or vice versa.
- You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
- And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.
If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.
- You must be enrolled in Medicare Part A and B.
- You must live in the plan’s service area.
- In most cases, you cannot have End-Stage Renal Disease (some exceptions apply).
Extended Medicare Open Enrollment Period 2019 – More about OEP
During the Medicare OEP from January 1 to March 31st you will have one more chance to make a plan change. If you have a Medicare Advantage plan, you will be able to drop the advantage plan and go back to Original Medicare. You can also add a drug plan at that time if you choose. If you have a current Medicare Advantage plan or a PDP plan, you will be able to change to a different Medicare Advantage or PDP. This is a one time election.
Extended Medicare Open Enrollment Period 2019 – Information about auto renewals on Advantage, Part D and Medicare Supplements
If you are enrolled in a Medicare Part D prescription plan or Medicare Advantage Plan and you are happy with your coverage, you don’t need to do anything during open enrollment. You should just confirm your current plan will continue to be available. If your plan is going to be discontinued and isn’t eligible for renewal, you will receive a notice from your carrier before open enrollment. If you don’t, it means you can keep your plan and don’t need to do anything during open enrollment.
Keep in mind, every year your benefits and premium could change. Although you want to keep your current coverage for the following year, it’s important to check for and understand any changes that may apply. You should always check to make sure that your current plan is still the best choice available to you. The coverage of the available plans can changes from one year to the next. Although the plan you have now was the best option last year, you should make sure that is still the case for next year.
Following AEP is the Medicare Advantage Disenrollment Period that runs from January 1st through February 14th. During this time, a Medicare Advantage plan member is able to disenroll from their current Medicare Advantage Plan. They can then go back to original Medicare and purchase a Medicare supplement plan if they choose. They can purchase a new Part D Prescription drug plan ony if they disenrolled from an MAPD.
In 2019, the new enrollment period will be from January 1st through March 31st.
This enrollment period will allow Medicare Advantage Plan members to disenroll from their current plan and switch to a different Medicare Advantage plan. They can only do this one time within this period. They can also return to original Medicare and purchase a Medicare supplement if they choose. This is not Guaranteed Issue business. Similar to the dis-enrollment period, members can only enroll in a new Part D plan if they have disenrolled from an MAPD.
Crowe and Associates is open from 8:00 am to 5:00 to answer any questions. Call us at 203-796-5403