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ISNP United Healthcare

If you are a Medicare agent, you have probably heard about the ISNP United Healthcare or (UHC IESNP) product.  Fortunately, this product is now available exclusively to Crowe and Pinnacle agents & agencies.

The UHC IESNP is now commissionable to our partners!

This is a great opportunity to our agents as it covers both dual and non-dual members either at home or institutionalized.  The UHC IESNP plan offers benefits that rival the best dual plans.  Clients are quickly and easily approved

Now is the time to get appointed to sell!

Why sell

This plan is available in the following states:  NY, NJ, PA, FL and CT and will be expanding into over 20 more states by the end of August. 

See link below for coverage areas:

IESNP coverage area map

Please check the list of ADLs (basic things you need to do to survive and be well) below:

Find out about upcoming webinars, zoom and agent events

Click here for more plan & training information

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UHC assisted living IESNP

The UHC assisted living IESNP plans are a great option for clients who are either moving into an assisted living, independent living, or memory care community and congregate housing.  The plan is also available to people receiving care at home. Additionally, members that need help with Activities of Daily Living (ADL’s) or instrumental Activities of Daily Living (IADL) are likely eligible for the plan.   A few examples of IADL’s are:  housekeeping, managing money, food prep, transportation or even managing medications.

Click here for additional UHC Assisted Living Plan information

This is a 5 star Medicare Advantage PPO plan!

This plan provides much needed resources to help clients navigate the transition and make life much easier.  Plans are available to both Dual and non-dual members.

It is very important to note:

These plans are exclusively offered by agents contracted with either Crowe and Associates or Pinnacle Financial Services!

If you would like to get contracted with Crowe and Associates to offer these plans; click this link

Click here for a map of the IESNP coverage area

Before you can offer these plans, there are 2 steps for training:

1.  Use the link below to complete the first step.  Once you have completed the fist step ( IESNP training video) be sure you scan the code using the camera on your phone.

   • Click here for IESNP training page (Need to be logged into the PFS site to access)  (Training called “UHC Assisted Living Plan Training”)

2.  After you complete the first step, you will receive a notification.  In a couple days, the certs are loaded into your Jarvis portal.  You will find the certification in Jarvis’ knowledge center in the “Invitation only” section.

Use this link for step by step screen shot instructions on the entire certification process

There are many great benefits offered with these plans:

The UnitedHealthcare Assisted Living Plan (IESNP) includes a dedicated care team– including a nurse practitioner and physician assistant- that help to customize a plan of care that covers your client’s needs.  This team has over 20 years experience in care coordination.  They work with both families and providers to keep everyone updated on the client’s healthcare needs.  The care team is available by phone 24 hours a day, 7 days a week to help assure any concerns your client has are addressed.

To view the ALC flyer, click here

Another important benefit of these plans is the extremely low OOP.  The OOP for the plans is between $1,500 and $1,600 annually!  The plan has a very low OOP vs. other non dual Advantage plans.   A member needs to be eligible for the plan but they DO NOT need to be a dual member to qualify.   As a result, this can be an increadible option for those not receiving any type of help from the state or for members that are drug help only.

Take a look at some additional benefits including  great dental coverage!

Verification of eligibility: 

Option 1:  Check eligibility in UHC Jarvis portal

You must have log in credentials for the PFS website to access the page:

CLICK TO ACCESS PAGE  Click on “2023 LOC Process”   

This plan has dual-type extra benefits but as well as a clinical element.  Members have access to in-person care either at a facility or in their own home from a UHC employed nurse, nurse practitioner or PA.  They also have a care coordinator that would organize the care from the clinician and help with things like medication management.

Access to WellSky once certifications are completed:

Registration
1. User will receive an email from WellSky (no-reply@wellsky.com) with information provided for
registration.
2. User will select the link in the email, provide the temporary password, and the user will be
prompted to create a new password.
3. Remember to save the URL, username, and password for future use. Users do not have to
access the portal to keep their account active.

Does Medicare Cover Hospice ?

How to Qualify for Hospice Care:

Your clients qualify for hospice care if they have Medicare Part A and meet the following conditions:

• A hospice doctor (and regular doctor if applicable) certifies that they are terminally ill (defined as a life expectancy of 6 months or less).

• They accept comfort care (palliative care) instead of continuing to try to cure the illness.

• They sign a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness and related conditions.

Your clients can usually get Medicare-certified hospice care in their home or other live-in facility like a nursing home. They can also get hospice care in an inpatient hospice facility.

What is Hospice Care:

Depending on the terminal illness and related conditions, a hospice team will create a plan of care that can include any/all of these services:

• Doctors’ services.

• Nursing and medical services.

• Equipment for pain relief and symptom management.

• Medical supplies.

• Drugs for pain and symptom management.

• Aide and homemaker services.

• Physical therapy services.

• Occupational therapy services.

• Speech-language pathology services.

• Social services.

• Dietary counseling.

• Spiritual and grief counseling for you and your family.

• Short-term inpatient care for pain and symptom management.

• Inpatient respite care, which is care provided in a Medicare-approved facility (like an inpatient facility, hospital, or nursing home), so that the usual caregiver can rest.

• Any other services Medicare covers as the hospice team recommends.

What it Costs in Medicare:

• Clients pay nothing for hospice care.

• Clients pay a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management. In the case the hospice benefit doesn’t cover a drug, the client’s hospice provider should contact the Medicare plan to see if Part D covers it.

• The client may have to pay for board if they live in a facility and choose to get hospice care.

• To learn more about what is covered under Hospice Care, visit Hospice Care Coverage.

Find out what Medicare covers

Click  here to learn 5 things Medicare does not cover.

If you would like more information on Medicare enrollment, you can find it at Medicare.gov.

Already a licensed Medicare agent?   Click here to contract with a better FMO.

Anthem OTC 2023

Anyone who is a member of an Anthem Medicare Advantage plan with the OTC benefit, will need to access the Anthem OTC 2023 benefit information.

New members of Anthem will receive their ID card and welcome guide 2 weeks after their plan is approved.  The prepaid benefit card as well as the OTC catalog should arrive the following week.

Why do I need 2 cards:

1.  Members will present the Anthem ID card when they visit a providers office for either medical treatment or to use pharmacy benefits.
2.  You will use the The Nations Benefits Mastercard to access all the extra benefits such as;  OTC, Essential Extras, Healthy Groceries, Utility Benefit and Transportation.  The extra benefits are all loaded on the Nations Benefits Mastercard.

When you receive the Nations Benefits Mastercard,   it is inactive. There is a sticker on the card with activation instructions for the card.  You can either call 1-866-413-2582 or go online MyBenefits.NAtionsBenefits.com/Activate to activate your card.

To download the Anthem 2023 OTC Catalog- Click here

Some Anthem OTC 2023 information:

1.  The OTC benefit allowance is loaded onto your card the first day of every quarter

2.  Use the Benefits card to purchase eligible items from any of these categories: OTC, Assistive devices, healthy groceries as well as flex benefits.

3.  You may shop for OTC products once your plan is effective.

4.  Unused balances carry over to the next benefit period but all benefits must be used by midnight on 12/31/23 or they will be lost.

5.  Members can purchase store branded products from any of the categories in the store shopping guide section of the OTC catalog.

6.  You can also check product eligibility by using the MyBenefits Portal app to scan the product’s UC code.

7.  Once you are checking out of the store, you can choose either credit or debit and then swipe your card to purchase.  You do not need a PIN.

There are 3 different ways to use your Benefits Prepaid card for OTC items:

Purchase items in store at a participating, local retailer.  Some examples are:  Walmart, Giant Eagle, CVS, Rite Aid, Schnucks, Kroger & Albertsons.  To search for more participating stores; go to MyBenefits.NationsBenefits.com and search for retailers.  You will find the categories to choose store branded products from in the OTC catalog.   You can also use the MyBenefits portal app to scan the UPS codes on eligible products.

Members can either Shop for products online at MyBenefits.NationsBenefits.com or by downloading the MyBenefits Portal app from the App store or Google Play.   You will receive products in your home with no delivery fee.

Place an order over the phone and get free delivery.  Just call; 1-866-413-2582 (TTY 711).  This service is available 24 hours a day, 7 days a week.

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Compare Medicare Advantage plans

If you are new to Medicare, you should Compare Medicare Advantage plans to find the one that fits you best.  Some people refer to Medicare Advantage plans as either Part C or MA Plans.  These plans are used as an alternative to original Medicare.  If you choose to participate with a Medicare Advantage plan, you do not lose your Medicare benefit.  These plans include your Medicare Part A and Part B and in most cases a prescription drug plan or Part D.

How does a Medicare Advantage Plan work with Medicare:

Private insurance companies must have their plan approved by Medicare before they can offer them to clients.  Medicare has very strict guidelines that insurance companies must follow.  Once Medicare approves the plan, Medicare will pay a certain amount to these insurance companies every month for your care.

Every plan has different charges, costs and rules for services you receive.  Some plans require you to get a referral before seeing a specialist and weather or not you have to go to certain approved providers for your medical care for non emergency care.  Insurance companies change there policies every year.  That means you should check your policy each year during open enrollment to be sure it is still the best option for you.

Compare Medicare Advantage plans to be sure what services are covered:

Although Medicare Advantage Plans cover all the services that original Medicare approves, some Medicare Advantage plans offer additional extra coverage.  The options can include things like; vision, hearing and dental coverage.  The cost for each plan also varies depending on the company you choose as well as your location and a few other things.  Click here for more cost information.

Click here to compare Medicare Advantage plans in your area.

Medicare Advantage plan prescription drug coverage:

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Medicare Advantage Open Enrollment Connecticut 2015

Crowe and Associates wants to make sure all our clients are aware of the Medicare Advantage Open Enrollment Connecticut 2015.  This is a great opportunity for both uninsured individuals as well as families to get much needed health coverage. Medicare Advantage plan companies are able to make plan and benefit changes to existing plans every January, during open enrollment. There will be major changes this year for many plans in Connecticut.  These changes include premium increases, plan terminations, as well as the introduction of referral based plans and more.

Medicare Advantage plans are currently offered in Connecticut by United Healthcare (AARP and  non AARP branded), Aetna, Connecticare, Anthem BlueCross BlueShield and also Wellcare.  Most of these companies will be making major changes to existing plan holders benefits.   Please note:  Medicare Supplement plans such as the AARP Medicare supplements (also called Medigap) do not change benefits.  They are only subject to rate increases.

The Medicare Open Enrollment Period

(OEP) is your opportunity to review your plan and make changes if necessary.  The OEP period runs from October 15th to December 7th.  If you apply for any changes during that period  they will be in force as of January 1, 2015.   OEP is the only opportunity during the year to change plans or companies. (Unless you have a special election).  Crowe and Associates works with all MAPD plans offered in Connecticut for 2015.  As a result, we are able to review all available plans to help you find the best option.  Plan reviews can be done by phone, at our office in Brookfield, our various library seminars or even in the home.

Please feel free to contact us if you would like to schedule a review for the open enrollment period.  You can contact us by either calling our office at 203-796-5403 or emailing us at admin@croweandassociates.com.

Medicare Advantage Plan Applications Connecticut 2014

In this post we will try to help you understand Medicare Advantage Plan Applications Connecticut 2014.  In fact, there are 5 companies offering Medicare Advantage plans in Connecticut for 2014.  Those companies are United Healthcare, Connecticare, Aetna, Anthem BCBS as well as Wellcare.  The post below contains links to benefit summaries of all the popular offerings from each company.  We also include links to applications for those people that want to apply.    Please keep in mind, that we have not listed all  the plans that are offered in the state.  This is only a list of the most common plans people inquire about in Connecticut.

United Healthcare Medicare Complete Plan 2–

This is a Medicare Advantage plan offered by United Healthcare.  The plan has both a $0 monthly premium and is an HMO.

Click for United Medicare Complete Plan 2 Application

 For United Medicare Complete Plan 2 Summary Of Benefits Click Here

Aetna Medicare Value Plan-

This is a Medicare Advantage plan offered by Aetna.  The plan has a $0 monthly premium and is an HMO as well.

Click For Aetna Value Medicare Application CT 2014

 For Aetna Value Summary Of Benefits CT 2014 – Click Here

Wellcare Value Plan- 

Wellcare offers a $0 monthly premium HMO in Connecticut.

 To Enroll Online – Click here

 For Summary Of Benefits

Connecticare VIP Prime 1-

Prime 1 is a Medicare Advantage plan from Connecticare.  The plan has $0 monthly premium and is an HMO

Click Here For Connecticare Medicare Application CT 2014

 For Summary Of Benefits

All completed applications can be either faxed to Crowe and Associates at 203-567-6235 or sent by email to Edward@Croweandassociates.com.   Additionally,  if you want to send them by mail, the address is : Crowe and Associates,  304 Federal Road, suite 107, Brookfield, CT 06804.

We will review all applications before we submit them.  If in fact we need any additional information, we will let you know.  If you have any questions, please call us at 203-796-5403.

Crowe and Associates (Edward K. Crowe -Owner) is a brokerage agency located at 304 Federal Road, Suite 107, Brookfield CT.  The agency is A rated with the BBB and is independent offering all major insurance companies.  The company website is croweandassociates.com

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There are only certain times when you can enroll/dis enroll or change a Medicare Advantage plan. Note that Medicare Advantage plans are sometimes called Medicare Part C or an MAPD plan.   There is a general period when someone turns 65 in which they can enroll.  This time frame is 3 months before the month they turn 65, the month they turn 65 and three months after they turn 65.  There is also the AEP period during which current members can make any type of plan change. This period runs from October 15th to December 7th every year. During this time, an application can be put in to make a change for a January 1 effective date.   The last type of period is the SEP period (Special Election Period) in which a change can be made at any time during the year.  Click on the link below for access to a grid showing all elections.

Medicare election period cheat sheet