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Home Posts tagged "Medicare Advantage plan benefits"
What A Medicare Advantage Plan Covers

What A Medicare Advantage Plan Covers

By Ed Crowe | General Articles | 0 comment | 12 December, 2024 | 0

If a client asks what a Medicare Advantage Plan covers, keep reading and get some answers. Medicare Advantage plans, also known as Medicare Part C, provide a comprehensive alternative to Original Medicare. Private insurance companies that are approved by Medicare offer the plans. The plans must cover all services covered by Medicare Part A (hospital insurance) and Part B (medical insurance). Although, Medicare Advantage plans usually provide more than just the basic coverage. Most plans provide additional benefits that make them more attractive to many beneficiaries.

Core benefits

Hospital coverage:

Just like Medicare Part A, Medicare Advantage plans cover inpatient hospital stays, skilled nursing facility care, and hospice care.

Medical Services:

Advantage plans cover the same standard Part B services as Original Medicare. This includes coverage of doctor visits, outpatient medical care, preventive services, and medical equipment.

Additional benefits

Many Medicare Advantage plans include services that Original Medicare doesn’t cover. The items below are not included in all plans as each plan varies by provider, state and exact location.

Prescription Drug Coverage:

Medicare Advantage plans labeled MAPD include prescription drug coverage (Part D) many prescription medications. If the Advantage plan is labeled MA only, it does not include prescription drug coverage.

Vision Services:

Some plans cover routine eye exams as well as some coverage for glasses and contact lenses.

Hearing Services:

Hearing coverage in some plans include hearing exams and a portion of the cost for hearing aids.

Dental Care:

Dental coverage is one of the most popular benefits that is often included in Medicare Advantage Plans. Many plans cover routine dental exams, cleanings, and sometimes restorative dental procedures.

Wellness Programs:

Many plans offer a reimbursement or a free fitness membership as well as other incentives to encourage members to practice healthy living habits.

Other Advantage Plan benefits:

Some plans provide things like; transportation services to and from medical appointments. While others provide OTC benefit cards that members can use for over the counter products, healthy foods or even to help pay utility bills or numerous other items. It is important to remember, each plan offers different benefits.

Plan costs

At present, many Medicare Advantage plans offer low to no cost plan options. Plan enrollees are required to pay a monthly Part B premium in addition to any plan premium they might have. Other costs include deductibles, copays, and coinsurance. The amount of these costs vary depending on the specific plan. Although some plans offer $0 premiums, it’s important to review all out-of-pocket costs.

Plan networks

Medicare Advantage plans use a specific network of providers. In general, there are a few different types of plans, The two main plans are either part of an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization). Whatever plan a beneficiary considers, they must be sure their doctors and hospitals are part of the plan’s network to avoid paying higher costs.

Limitations and Considerations

Although Medicare Advantage plans may include some great added benefits, beneficiaries need to consider their limitations. Their limitations include the network restriction; if the member needs to use care outside the network, they may pay added fees or even the entire cost of some care.

HMO plans require enrollees to have specialist visits approved by their primary provider before they seek care. This can add to the time it takes to receive treatment. Enrollees may also have trouble seeking care outside their plan’s immediate service area.

If a beneficiary suffers from a serious illness such as cancer; they may have to pay a percentage of the cost of their treatment until they reach their maximum out of pocket.

    Choosing the Right Plan

    Selecting a Medicare Advantage plan requires careful consideration of the beneficiary’s healthcare needs, budget, and preferred providers. It is essential to understand what is important to each individual and compare plans that provide the closest match to the client’s needs and wants. Licensed insurance agents can be an integral part of finding the best fit for the beneficiary.

    If you are an agent who is ready to join the team at Crowe, click here for online contracting.

    Medicare Advantage plans are great option for those looking for coverage at a low cost that offers additional benefits. However, it’s essential to understand the details of each plan to ensure it aligns with the healthcare needs and financial situation of each person.

    Connecticare OTC catalog 2024

    Connecticare OTC catalog 2024

    By Ed Crowe | General Articles | 0 comment | 18 October, 2023 | 0

    Connecticare OTC catalog 2024

    The Connecticare OTC catalog 2024 is just one of the many benefits MA plan members receive.  The ConnectiCare OTC benefit is provided through NationsBenefits.

    Please note:  this catalog is for all participating ConnectiCare MAPD plans, this includes the Choice Dual Vista.  It is not for use by Choice Dual plan members.  Those members will receive a card for their OTC benefits.

    There are 4 ways to use your benefit, find the one that is right for you:

    1. Benefits Pro Portal – This is one of the fastest ways to order.  Just visit ConnectCare.com/mailotc and log into your account. If this is your first time visiting the portal, you need to register by following the directions on the webpage.  You will find all the items available in the portal.  Search for what you want by price, category and more.  View product information.  Check your available benefit amount.  Place your order and track it.

    If you require help with your order or the Benefits Pro Portal, call 877-239-2942 (TTY:711).  There are Member Experience Advisors to help you from 8:00 AM until 8:00 PM, Monday through Friday.  Please note: language support and other formats are available if you need them.

    Click here to download the NationsBenefits OTC catalog 2024

    2.  Benefits Pro App – It is very easy to order using the app.  First you need to download the app onto your smart phone.  Just visit either      the App store for apple devices or Google Play for Android devices and search “Benefits Pro” and download the app from there.  Once the app is downloaded, you can easily order OTC items by scanning the QR code.

    3.  Order by Mail – To place an order by mail, just fill out the order form and send it in with the postage-paid envelope you receive with your OTC catalog when you get your annual ANOC and benefit information packet.  Send your order to:  NationsBenefits, 1700 N. University Drive, Plantation, FL 33322.  Please be aware:  It will take more time to receive your order by mail, please allow extra time when ordering with this method. In the event your order is not received by the 20th of the month, it may be processed in the following benefit period.  If you are concerned about timing it is best to order by phone or online.

    Download the Nations Benefits order form – Click here

    4.  Order by Phone – Call 877-239-2942 (TTY:711).  Member Experience Advisors are ready to help you starting at 8 AM until 8 PM local time, Monday through Friday.  Please have your order ready before you call.  This includes the item number and quantity.

    More OTC benefit information:

    This benefit is for use by plan members only.

    Certain items, amounts sizes and values are subject to change depending on availability.

    Out of stock items may be substituted for a similar product of higher value.

    Please allow two business days for product delivery.

    Due to the personal nature of these items; returns are not permitted.  Damaged items will be replaced without returning the original item.

    If you disenroll from your plan, your OTC benefit will terminate immediately.

    Click here to learn about Medicare scams

    Click here to view more images from this source
    Aetna OTC catalog 2024

    Aetna OTC catalog 2024

    By Ed Crowe | General Articles | 0 comment | 14 October, 2023 | 0

    Aetna OTC catalog 2024

    If you are thinking about joining an Aetna Medicare advantage plan, you may want to take a look at the Aetna OTC catalog 2024.  Aetna provides 2 OTC catalogs for 2024.

    One is for members of participating MAPD plans.  This benefit is called OTCHS or over the counter health solutions.

    There are 3 ways to place an OTC order.

    If you are a member of an Aetna Medicare advantage plan; click the link below to download a copy of the OTC catalog.

    Download the MAPD OTC catalog 2024

    In store at a CVS pharmacy:

    there are a few exceptions; CVS pharmacies inside Target or Schnucks stores and some other select locations.  To see if your local CVS participates, just go to CVS.com/storelocator.

    You can refer to your OTC catalog to find the items that you want to purchase.  Please note: only items listed in the catalog are available with this plan.

    Once you are at the store, you can locate products marked with the blue shelf tag in the store.  Some store prices may differ from the price listed in the catalog.

    Redeem your benefit at any register by letting the cashier know you have the OTC benefit.  Just show them your member ID card of another valid ID and verify your eligibility for the quarterly benefit.

    The OTC Health Solutions offers members an easy way to access their benefit with the use of an app.  Just download the app from either the App Store for apple users or from Google Play for Android devices.  There are 3 steps to use the OTC app in CVS stores.  Some store have a dedicated OTCHS section.  If they do not, you an find eligible items with blue tags on store shelves.

    1.  Scan the item’s barcode to make sure it is an approved item.
    2. When you are ready to make your purchase, just show the cashier your digital barcode from you phone for a faster checkout.
    3. Once you are finished, you can check your remaining OTC benefit balance on your app as well as find answers to many FAQs.

    Purchase items online 24/7:

    First thing you will need to do is create an account.  Just go to CVS.com/otchs/myorder.

    Choose the create account button and follow the directions from there.  You will need your member ID, date of birth, zip code and email address.

    After you sign in, you will see your benefit amount displayed on the page.  You can then view available products and add them to your basket.  When you are finished shopping just click, checkout.  From there you will confirm the shipping address and review and place your order.  Items arrive within 14 days.

    You will receive an email with tracking information when your order is shipped.

    Order items over the phone:

    to place a phone order; call 1-833-331-1573 (TTY:711).  You will need to enter your birthdate so the system can verify your account.  They will also check your name and address.

    You should have the code for the items you wish to select.  If the item code is A10, you will enter the numerical code 10 only.  Once the system finds your item it will verify that it is correct.  When you are finished ordering, you can review the items in the cart and submit the order.

    Members of Aetna DSNP plans:

    Place OTC orders either online, by phone, through the mail or in select stores.

    Member of the Aetna DSNP plans can download a copy of their OTC catalog by clicking the link below.

    Download the Aetna DSNP OTC catalog 2024 Nations benefits

    To order by mail:

    please fill out the form provided in your OTC catalog and mail it to: NationsBenefits, 100 N. University Drive, Plantation, FL 33322.

    Ordering online

    Go to Aetna.NationsBenefits.com and create an account by following the instructions on the page.  Once you are logged in, you can:

    Search for items

    View product descriptions

    Check the available benefit allowance

    Order products

    Track your order

    Order by phone:

    To place a phone order; just call 1-877-204-1817 (TTY: 711).  Member experience advisors are there 8AM until 8PM, local time 7 days a week, except for holidays.

    Language support is available if needed.

    Please note:

    Due to the personal nature of the items, no returns or exchanges are permitted.  If you receive a damaged item, please call OTC health solutions within 30 days of receipt.

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    Emblem 2022 OTC Catalog

    Emblem 2022 OTC Catalog

    By Ed Crowe | General Articles | 2 comments | 25 February, 2022 | 0

    Emblem 2022 OTC Catalog

    Anyone who is considering a Medicare Advantage plan, should take a look at what Emblem has to offer.  One of the many benefits of joining an Emblem MA plan is the Emblem 2022 OTC Catalog.

    If you are a member of a participating Medicare Advantage plan, you will receive an OTC card in the mail to use when you are ready to order OTC items.

    Click here for a copy of the 2022 OTC Catalog

    Emblem Members of participating Medicare plans can use their over-the-counter benefit one of three different ways:

    1. Order OTC items online; just go to ConveyBenefits.com/EmblemHealth.  From there, you can either log into your account or new users can create an account.  Once you are in, you can browse available OTC products, place them in your cart and check out.  If you chose to use the online account, you have access to many useful tools such as: the available balance on your card, order tracking, order history and more.

    2.  You can order by phone.  Use this number 855-858-5940(TTY:711) either if you have questions or want to place an order.  OTC advocates are available Mon – Fri from 8:00am until 11:00pm, EST.  Please be sure to have your OTC card and your item, number available when you call.

    3.  If you would prefer, you can place your order by mail.  Use the order form that you find in the back of your OTC catalog or download it here – EmblemHealth OTC order form.  Send the order form to the OTC Servicing Center, P.O. Box 526266, Miami, FL 33152-9819.  Please be aware; if the benefit period is ending, we may not receive your mail order in time.  If that is the case, please place your order either over the phone or online.

    Some important things to remember:

    Any unused benefits do not carry over to the following benefit period.  In other words, if you don’t use the benefit, you lose the benefit for that period.

    Order totals that exceed your available benefit amount must be paid by you.  Once your entire benefit amount is used, Emblem will apply the balance to another form of payment.

    The OTC items ordered are intended for use by the member only.

    Because of the personal nature of these items, returns are not accepted.

    Please call within 60 days of placing your order if:
    Your order has not arrived yet.
    The items you received are either defective or damaged.  Emblem will replace your item at no additional cost to you.

    Please note:

    During the year, Emblem may change the available items.  It is a good idea to check the online catalog for any product updates.

    All applicable sales tax will be added to your order total and be deducted from your available OTC balance.
    If there is a market shortage of a particular item, Emblem may limit your order quantity.

    Please allow 5-7 business days for delivery from the time you place your order.

     

    To download a copy of the 2022 OTC catalog, click here

    If you need help finding a Medicare plan, feel free to contact us either at 203-796-5403 or by email at teal@croweandassocites.com.

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