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UHC OTC catalog 2021

Some UHC Medicare Advantage plans provide members with OTC benefits.  For anyone who is in one the participating MA plans,  the UHC OTC catalog 2021 is a useful tool. There will be a lot of great information included in the welcome packet you will receive.  This packet includes, your ID card, benefit information and a fulfillment by Walmart OTC card.

UPDATE:   CLICK HERE FOR THE 2022 CATALOG

Are you a Medicare insurance agent?  CLICK HERE TO LEARN ABOUT OUR FREE LEAD PROGRAM

Download  the health & Wellness catalog for 2021 here.

Members of specified UHC Medicare Advantage plans receive OTC credits every quarter to use on approved items.

On the first day of each new quarter, the credits will arrive in your UHC OTC account.  The amount of credits each member receives depends on the plan you are on.  The plan summary of benefits will specify the plan benefit amount. After that, your credits will expire at the end of each quarter and do not rollover.

Here are the ways you can use your benefit credits:

Go online and create an account at; MyUHCMedicare.com/HWP.  Once you have created your account, you can check your OTC balance, look for approved items and place your order.

Order over the phone at; 1-833-845-8798 TTY 711.  Please be sure you have your product number as well as name of item and your account number handy before you call.  The customer service representative will also ask you for the security code found on the fulfillment by Walmart card.

Place your order through the mail.  Just use the mail order form and the postage paid envelope you find in your health and wellness product catalog.

CLICK HERE FOR CATALOG

Medicare changes  2021

Image by Niek Verlaan from Pixabay

Have you thought about adding dental, vison or hearing coverage?

THE INFORMATION ON THIS PAGE HAS BEEN UPDATED.   CLICK HERE TO ACCESS THE NEW PAGE.

Aetna OTC catalog 2021

Are you a member of an Aetna Medicare advantage plan?  If you are, you need the Aetna OTC catalog 2021, because it offers many great products at no cost to you.  Not sure if your plan offers this benefit; check the summary of benefits for your plan.  If you do not have a summary of benefits, you can find out if your plan offers the OTC benefit by calling: 1-833-331-1573 (TTY:711).  Due to the fact that different Medicare Advantage plans offer different benefits, be sure to note if you have either a monthly or a quarterly benefit amount.

Members of participating plans can access both plan documents and the OTC catalog online: AetnaMedciare.com/OTCCatalog.

Once you are on the website; choose plan year 2021 and sue the drop down menu to fill in other necessary information.  Once this is done, you will be able to access all plan documents including the OTC catalog.

Download the 2021 OTC catalog

Members of the Aetna 2021 DSNP plan can click here for the OTC catalog.

Because people like to do things differently, Aetna gives members 3 ways to order OTC items:

Before you place an order, please have your Aetna member ID number ready.

To order by phone, call 1-833-331-1573 (TTY:711).  You can reach customer care representatives Monday-Friday, 9am- 8pm local time except in Hawaii.

Pick up your order in person at any participating CVS OTCHS-enabled pharmacy. To find a participating CVS; just go to the store locator at: cvs.com/otchs/myorder/storelocator.

Order online at: cvs.com/otchs/myorder.  The first time you  go to the site, you will need to create an account.

Do you need a paper copy of the catalog?  Just call member services; you will find this number on your member ID card.

If you are a D-SNP plan member, you will automatically receive an OTC catalog in the mail with your other plan documents.

If you would like to download a copy of the Aetna OTC catalog:

CLICK HERE – 2021 AETNA OTC CATALOG

CLICK HERE – 2021 AETNA DSNP OTC CATALOG

Should I choose a Medicare Advantage Plan or a Medicare Supplement Plan?

We can set up a time for you to speak with a licensed insurance agent, if you need help choosing an insurance plan.   Contact us either at (203-796-5403) or email admin@croweandasociates.com.

Learn more about Crowe and Associates

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How to sell Medicare plans over the phone

It is not difficult to learn how to sell Medicare plans over the phone.  We will provide the blueprint in the article below.   If you do not have experience in Medicare sales, there are some steps to take prior to starting.

You will need a health insurance license to sell Medicare plans

Click here to see the steps to get a health insurance license

Starters guide for Medicare Contracting

After you have an insurance license, there are steps to take for contracting and certifications.  Use the link for step by step instructions.   Medicare contracting and certifications guide

How to sell Medicare plans over the phone- The set up

There are a number of ways to sell Medicare plans over the phone.   The most obvious option is to get set up as a call center/telesales agency.  While this set up can ultimately work very well, there are some obstacles to doing it which are time and cost.  Call scripts will need approval by the carriers. All calls will need to be recorded as well. The other negative is the cost to start the call center.  Those with funding and time to invest should call us to discuss the call center option further at 203-796-5403 or email Edward@croweandassociates.com.    For most people we will suggest a different approach.

Selling by phone in conjunction with online enrollment

A quicker and less expensive way to start is selling over the phone and processing enrollment online. The online enrollment function is available at no cost through our online enrollment portal Connect4Medicare  (C4M)  C4M provides agents with their own approved enrollment website and consumer facing URL.  Agents and prospects can quote and compare plans, run drug comparisons, search doctors and enroll prospects online without a face to face meeting.  The agent can enroll the prospect or the prospect can self enroll through the link sent to them by the agent. You can text or email the enrollment links.  CLICK HERE TO LEARN MORE ABOUT CONNECT4MEDICARE   Under this set up, agents can talk to prospects over the phone and then email or text them the link to complete the enrollment.

How to sell Medicare plans over the phone: Generating lead volume

You will need to generate prospects to try to close so figuring out the method to use is important.  There are a number of ways to do this but we will focus on two of them here.

Telemarket leads:  There are companies that will generate leads by phone at a set price per lead.  The calls are recorded and the information is sent to the agent to close the sale.  We have worked with a vendor to offer one of the best prices for teleleads.  With call back leads at $10.00 and live transfers at $16.00 a large amount of volume can be generated at a low cost.  CLICK HERE TO LEARN MORE

Online leads:  Online leads are also a good way to generate prospect volume at a low cost.  You can get online leads for $8 to $15 each depending on the lead aggregator/lead company.  Shared and exclusive leads are available but we suggest using shared leads due to the high price point of exclusive leads.

CLICK HERE TO LEARN MORE ABOUT USING ONLINE LEADS

We offer a free lead program to help off set your lead costs- Learn more about the Crowe and Associates Free Medicare Lead Program

How to sell Medicare plans over the phone: Other important things to know

Having the correct set up for phone sales is important but organization is also key. As a result, it will be important to have a good CRM. Connect4Medicare is a basic CRM but we suggest having your own in order to stay organized.  It will be important to keep all prospects in your database, schedule return calls and keep notes on each call.   In addition, you need to have a scheduled routine every day.  How many leads will you work? What time will you be contacting new prospects vs. calling existing prospects you are working with?   Other things to consider are: How much money will you have in your daily lead budget?  Do you have access to all competitive plans in the area/states you are working?   Thought and preparation is needed in order to be successful when starting any type of phone sales.

WORK WITH ONE OF THE NATION’S TOP FMOs.  CLICK HERE TO GET STARTED.

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IRMAA Part D

Most people do not pay IRMAA part D and only pay their Part D premium.  Be aware if you do not sign up for Medicare part D when first eligible, you may have to pay a Part D late enrollment penalty.

Click this link, to see an updated IRMAA chart for 2022.

If your modified adjusted gross income (MAGI) is above a certain amount of income for you and/or your spouse, you may have a Part D income-related monthly adjustment (Part D-IRMAA). Medicare will use the MAGI   on your IRS tax return from 2 years prior to the current year. If the income is over the stated 2019 guidelines you will pay the Part D-IRMAA amount in addition to your monthly part D plan premium, this extra amount of monthly premium is paid directly to Medicare but is billed through your plan. The chart below shows the additional amounts and income for 2019 but is based on 2017 earnings.

IRMAA Part D

Social Security will send a notice stating the Part D-IRMAA, based on your income. The amount you pay is adjusted each year based off the prior two years earnings. If you do not agree with the IRMAA amount or make a lot less than you did two years ago you can appeal, just fill out this form and send it in to Social Security using the instructions provided.  If you have questions about your Medicare prescription drug coverage, contact our office.  Crowe and Associates phone number is 203-796-5403

The chart below shows your estimated prescription drug plan monthly premium based on your income as reported on your IRS tax return. If your income is above a certain limit, you’ll pay an income-related monthly adjustment amount in addition to your plan premium. 

Do you want to learn more about Medicare Part B IRMAA?   Click to learn more

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.

1. 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.
2. The over the counter  benefit is included with all Aetna Medicare Advantage plans in 2019.
3. You must order from the catalog or online. Items purchased from a retail store are not part of the benefit.
4. 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.
5. You cannot use your CVS Extra Care card toward these purchases.
6. Free shipping!  There are no shipping or handling fees.
7. 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 

Medicare Advantage or Medicare Supplement Plan

Which is better, a Medicare Advantage or Medicare Supplement plan?  Medicare Supplements are also called Medigap plans.  This is a common question and the answer is “it depends”.  Medicare Advantage Plans and Medicare Supplement plans are very different.  They both have strengths and weaknesses.  The key is to know the difference between them as well as how they work with your situation.  We can start by pointing out how each plan works and how they are different.

Medicare Supplement plans

Medicare Supplement plans are private plans that insurance companies offer.  There are a number of different plans that range from A through N.  All have different benefit structures although they are standardized in most states. This means the benefits must be the same regardless of the company that offers the plan.  If 8 companies offer a plan N in a state, they must all have the same benefits. The only difference is price.

Medicare supplement plans are secondary to Original Medicare.  When someone goes to the provider, they show their Original Medicare card.  The provider bills the card and Medicare pays their portion of the benefits.  Your Medicare supplement company will receive a charge for the portion that is left over and they will then pay that portion. It is a very simply process and offers some big positives over an Advantage plan.  Below, we will list the advantages as well as disadvantages of using a Medicare Supplement.

• Advantages
  • No network. Since Original Medicare is primary, the person using a Medicare Supplement can go to any provider that accepts Medicare. The company offering the supplement makes no difference.
  • No Managed Care. This usually means you do not need to get prior authorization on services such as surgeries, major or advanced radiology, skilled nursing and other services.
  • You can determine the exact amount of Medicare coverage you want based on which supplement plan you choose.
• Disadvantages
  • Monthly premium. In addition to your monthly part B Medicare premium, you will also pay a monthly premium for the Medicare supplement.  Premiums can range from $35 a month to $270 a month depending on the plan and state you live in.
  • Medicare supplements do not include drug coverage.   Additionally, you must purchase a stand alone part D plan if you want drug coverage.

Medicare Advantage Plans

In fact, Medicare Advantage plans are also called MAPD’s, Medicare Replacement Plans and Managed Medicare Plans. Medicare Advantage plans are not secondary to Original Medicare.  The Medicare Advantage plan becomes the primary insurance.  The insured is still in the Medicare program but Original Medicare is not used for insurance. An advantage plan works in a similar manner to a group or individual health insurance plan. (they are not the same but have a similar set up.)  This means the client has set benefits which are in the form of co-pays and cost shares.  There are some major pro’s and Con’s with Advantage plans which we have listed below.

• Advantages
  • Advantage plans have little to no premium in most states.  The insured will still pay the monthly Medicare Part B premium of $134 a month, but there will be no additional charge for the advantage plan.
  • Advantage plans include a part D drug benefit.  There is no additional premium charge for the drug plan and you can use one ID card for both Medical and RX.
  • Advantage plans may have additional value added benefits that are not covered by Original Medicare such as; dental and vision benefits.
• Disadvantages
  • Advantage plans have networks.  On an HMO advantage plan you must stay in the network to have your expenses covered. (The exception to this would be emergency room visits and urgent care)
  • Advantage plans have co-pays which can lead to higher out of pocket costs.  The out of pocket max on many advantage plans is as high as $6,700.
  • Advantage plans have prior authorization requirements on some services.
  • Some advantage plans may require referrals to see a specialist.

Overall – Medicare Advantage or Medicare Supplement Plan

In general, someone with minimum health care needs may want to try an advantage plan.  They will not be laying out any premium on a monthly basis and will only pay a copay when they do see a provider.  If someone does not want to be limited by a provider network or if they utilize a lot of healthcare, they may want to consider a Medicare supplement instead. The supplement allows them to go to any provider they want (as long as they accept Medicare) and they can choose a plan that leaves them with very little out of pocket.  The negative is the premium they will pay for the supplement and Part D Rx plan regardless of if they utilize care or not.

Medicare Part D Enrollment Penalty

How much is the Part D penalty?

The cost of the Medicare part D enrollment penalty depends on how long you go without Medicare Part D or creditable prescription drug coverage.

How do I know if there will be a Medicare part D enrollment penalty?

After you join a Medicare drug plan, the plan will tell you if you owe a penalty and what your premium will be. Most people will have to pay this penalty for as long as you have a Medicare drug plan. The exceptions would be for those that drop coverage or are approved for a drug help program such as MSP.

What if I don’t agree that I have a penalty?

You may be able to ask for a “reconsideration.” Your drug plan will send you a letter explaining how to appeal.  All appeals will be sent to a company called Maximus that will review appeals.  Maximus is the only company that can review them. As a result, you will need to wait until they make a decision. You must do this within 60 days from the date on the letter telling you that you owe a late enrollment penalty. Also send any documentation that supports your case.

Do I have to pay the penalty even if I think it is wrong?

You must pay the penalty until a decision has been made on the appeal. Failure to pay the penalty could result in termination of your enrollment.

How long does it take to decide on the appeal?

In general, Maximus (Medicare contractor) has 90 days to make a decision.

What happens if Maximus decides the penalty is wrong?

If Maximus decides you should not have a penalty, they will send you a letter stating that fact.   Your drug plan will then stop charging you the penalty and will send details regarding a refund of the penalty amount you already paid.

What happens if Maximus decides the penalty is correct?

They will send you a letter stating the penalty is correct. You will be forced to continue paying the penalty if you want to maintain you drug coverage.

Do you have a Medicare supplement plan (also called Medigap)?  If so, a high deductible plan F supplement may be a way to save money compared to your current supplement plan. CLICK TO LEARN ABOUT HIGH DEDUCTIBLE F PLAN SUPPLEMENTS

Medigap Plans CT

Medigap plans Ct are also called Medicare supplement plans.   They provides coverage for these “gaps” in your Medicare coverage and can save you money.  Medigap plans are not Medicare Advantage plans rather, they provide coverage after Original Medicare A and B benefits pay.  As a result, it is important to note that Medigap plans will only cover services that are approved by Medicare. They will not help cover costs that Medicare does not allow/approve.

Access all Medigap plans CT (Medicare supplement plans) with this link.  Site will show you all plans and rates in CT.

Are you a broker looking to sell Medigap plans?  If so, click here to learn more about Medigap sales.

Medicare supplemental plans are offered by private insurance companies.  These plans help to pay the ‘gap’ between costs covered by original Medicare and your out of pocket costs.  Medigap plans are regulated by national and state governments and therefore benefits are generally the same, regardless of the insurance company.   For example, Plan A has the same benefits regardless of the company you purchase it from.  As a result, rates and value add benefits are the only difference from company to company.

Medigap plans do not cover medication expenses.  If you enroll in a Medigap plan, you should also consider a Medicare Part D (prescription drug) plan.  The rule is different for drugs under medicare part B. As a result, it is important to pick the right part D drug plan.  The pharmacy you like to use and the specific prescriptions you take make all the difference when selecting a drug plan.  Call our office to learn more or use the CMS drug plan finder tool. 

Want to learn more about the differences between a Medigap plan and a Medicare Advantage plan? Click here to learn about all your medicare options.

We are one of Connecticut’s leading Medicare brokerage firms.  Please call us at 203-796-5403 or email us at edward@croweandassociates.com if you have questions.  Better yet, we can set a time to sit face to face and discuss all of your options.  If you aren’t able to travel to our office, we will gladly come to you.

Medicare Eligibility

Medicare Eligibility is available to anyone turning 65, disabled prior to the age of 65 or with ESRD.  People turning age 65 need to have 40 quarters of working credits or have a spouse with 40 quarters. You must also be a U.S resident or be legally in the U.S. for 5 concecutive years.  The CMS website has a lot of very detailed information on this topic.   Click for CMS details on Medicare A and B enrollment

Steps for Medicare eligible people

Currently enrolled in Medicare: Click here to check your enrollment 

Medicare Eligibility: Other Resources

Sign up for Medicare after age 65 ( Medicare general enrollment period)

Medicare Part D Rx income penalty

Connecticut Medicare Plans 2017

The term “Connecticut Medicare Plans 2017” can mean different things. This blog will address the options a person aging into Medicare or already on Medicare will have in Connecticut for 2017.  For additional information including signing up for Medicare A and B and rates, you can look at our other blog Medicare Plan Choices Connecticut 2017.  We will focus on basic choices for Medicare eligible people in this post.  The intent is to provide a general understanding of options available.  Look to our other blog if you already know your choices and want more detail. Please email or call us with any questions at 203-796-5403 or email admin@croweandassociates.com.

There are three basic options or types of plans seniors typically use.  The Medicare Supplements (also called Medigap) plans,  Medicare Advantage plans (also called part C, Managed Medicare or Medicare replacement plans) and finally, there are Medicare part D plans (also called Medicare Rx/drug plans or stand along PDP plans).  Medicare Advantage plans (MAPD) include a part D prescription drug benefit.  Medicare Supplements (Med Supp) do not have drug coverage so you would need to buy a Medicare part D plan (PDP) if you want drug coverage.

Original Medicare A and B

Connecticut Medicare plans 2017: First things first:  In order to enroll in a Medicare Advantage plan or Medicare Supplement plan, you must have Original Medicare A and B.  There are rules for eligibility and costs associates with Medicare A and B we will not get into detail about here.  Use this link if you want to know the rules for enrolling and costs.  Medicare A and B provides medical coverage on its own.  It does not provide Rx coverage but does a good job on the medical side.  It is feasable to have Medicare A and B only and then a PDP plan for those that want drug coverage. The only flaw with A and B on its own is the lack of an out of pocket max on the benefits.

Other than that, the 20% cost share is not as bad as it sounds due to the Medicare allowable cost amount the providers can bill.  This just means Medicare controls how much you are billed for Medical services.  Its hard to get a set number but they usually have a discount rate for charges between 50% to 75% depending the service.

Medicare Supplement/Medigap Plans

Connecticut Medicare Plans  2017: Many people choose to limit and/or cap the cost share they would pay being on Original Medicare.  A Med Supp is a policy that covers some or all of the costs not covered by Medicare A and B.  There are 11 different Med Supp plans. Each plan has a letter name that differentiates it from others.  Companies offer plans A – N.  Not all companies offer all plans.  A Med Supp Plan A or B should not be confused with Medicare A and B.  They are in  no way related.  A Med Supp A or B is just two of the 11 supplement options to choose from.

There are a number of plans that are “good deals” in Connecticut.  Plans F,N,K, L and High F are available from companies at good prices in CT.  Multiple companies offer supplements in CT.   United Healthcare is the insurer of the branded supplement plans.

Contrary to the opinion of many,

There are NOT pre-existing condition clauses on Medicare supplements in CT if you have had any type of other coverage in the last 63 days. The only time there are pre existing conditions clauses is if someone did not have any other type of coverage for 63 days and then tries to sign up for a supplement.  Some states do allow pre-existing conditions clauses even if there was other coverage in place but Connecticut (and NY for that matter) is not one of them.

The other important thing to note in CT is a person can change from one Medicare Supplement plan to another the first of any month.  This is not the case in some states.  It is possible in CT.  CT is a guaranteed issue state.  Also note: If someone is under the age of 65, they do not have access to all the plans.  In most cases, clients under the age of 65  are limited to plans A-C.

Medicare Part D Rx Plans (PDP)

Connecticut Medicare plans 2017: PDP plans are stand alone drug plans offered by insurance companies.  Medicare does not offer a plan but instead determine what the standard benefit model should look like.   Click here for the standard part D benefit parameters. Various companies offer stand alone part D plans including United Healthcare, Aetna, Wellcare, Humana, Envison, Silverscript to mention a few.  They all have different benefits and prices but work in a similar manner.  Be sure to use a plan that has your drugs in the formulary and also has your pharmacy in network.  Some plans will have preferred vs. non preferred pharmacies. It may not be obvious which pharmacies are preferred for your plan. Be sure to use a preferred pharmacy as your copays for the medications will likely be lower there.

Please note: you cannot have a stand alone part D plan and a Medicare Advantage plan at the same time.  Enrolling in one will disenroll (kick you out) of the other.  The only exception to this is if you have a Medicare Advantage plan called a PFFS plan.  They do allow someone to enroll in a PDP at the same time.

Medicare Advantage Plans

A Medicare Advantage Plan, also known as Medicare Part C, Medicare replacement or a Managed Medicare Plan,  plans offered by private insurance companies. They often combine medical and drug coverage.  While they are not group health plans, they do work in a similar manner.  Members pay copays for medical services they recieve.  Different services have different copays such as a copay for a primary doctor and a higher copay a specialist doctor.   Copays vary from company to company and plan to plan.  Most advantage plans offer a part D drug benefit which works similar to a stand alone part D drug plan.  Some plans require referrals for specialists while others do not.

Not all HMO plans require referrals but they do require members to stay in network for most services. Advantage plans may cover benefits not covered by Original Medicare and/or a Medicare supplement plan. Benefits and value added services such as dental, vision, Telemedicine, Silver Sneakers , OTC benefits and other programs.

Types of Medicare Advantage Plans

1. Health Maintenance Organization (HMO) Plans
2. Preferred Provider Organization (PPO) Plans
3. Private Fee-for-Service (PFFS) Plans
4. Special Needs Plans (SNP)

People are able to change a Medicare plan during Open enrollment.  Open enrollment runs from Oct 1 to Dec 7th every year.  They can make any changes they want for a Jan 1 start date.  Please note:  In states that allow underwriting, the member will be subject to medical underwriting if moving to a Medicare Supplement plan.  There are additional periods when you can make plan changes such as the MADP, SEP’s and if there is a Trial Right.

Call or email us with any questions regarding this Connecticut Medicare plans 2017 blog.  We are able to quote plans options and provide advice at no charge to you.  Independent brokers receive commission pay from the insurance companies.  You can contact the office either by phone at 203-796-5403 or by email to Edward@croweandassociates.com