Medicare Annual Enrollment Period: Who to Call, How to Connect and Where to Find Answers
Health insurance can seem complicated. Our patients want answers when they’re shopping plans, getting care, making payments and using their benefits. We should know where to point them.
Many of our patients have, or are considering, coverage through the Simplete® Medicare Advantage plans we offer through Health Alliance™. For these individuals, here’s a quick run-down of who they should contact for what.
Prospective plan members should call (877) 642-4753 (TTY 711) or visit simplete.org/medicare to:
- Ask questions about what plan’s right for them.
- Ask questions about how to enroll.
- Enroll.
Prospective members can sign up here to attend a webinar to learn more about the plans.
Current plan members should call Members Services at (877) 933-8481 (TTY 711) to:
- Get answers to questions about their plan, including topics like eligibility, premiums, authorizations and more.
- Find a Primary Care Provider or see if their doctor is in-network. They can also do so virtually at simplete.org/Find-Care.
- Find an in-network pharmacy. Also easy to do virtually at simplete.org/Find-Care.
- Learn what drugs are covered by their plan.
- Get assistance with claims and billing.
- Request plan information in a different format, including large print.
- Connect with free language interpreter services available for non-English speakers.
- Discover information about benefits, perks and extras.
For general information, our patients can visit this page about Medicare and this link about our Simplete Riverside plans.
Please remind our patients to review their Medicare coverage by December 7.
Article provided by Health Alliance.
Medicare Annual Enrollment Period: Helping Patients Avoid Sickness and Complications
As our patients continue to shop and enroll in Medicare plans, they’re searching for options that’ll not only cover care when they’re sick, but help them avoid illness in the first place.
The Simplete® Medicare Advantage plans we offer through Health Alliance™ include many preventive services at no additional cost:
• Annual wellness visits that review a patient’s medical and family histories; check blood pressure, height and weight; assess cognitive functioning; discover risk factors and treatment options; and more.
• Routine cancer screenings (including mammograms and colonoscopies).
• Cardiovascular disease risk-reduction visits.
• Flu, hepatitis B and pneumococcal shots.
• Bone mass measurements.
• Depression, diabetes and HIV screenings.
• Medical nutrition therapy.
• Obesity screening and therapy.
• Screening and counseling for alcohol misuse.
• Screening for sexually transmitted infections (STIs) and counseling to prevent STIs.
• Counseling to stop smoking or tobacco use.
The plans also offer care coordination, a cost-free program that connects members with a team of providers, like nurse practitioners, social workers, dietitians, pharmacists and more, who work with their doctor to ensure they have the resources they need to stay healthy or work through medical issues.
Additionally, cost-free disease management programs help members with asthma, diabetes or high blood pressure stay on track.
Our patients can learn more about our plans by calling (877) 642-4753 (TTY 711), attending a webinar or visiting the links below. They have until December 7 to review their Medicare coverage.
• Learn more about Medicare.
• Learn more about our Simplete Riverside plans.
• View plans, enroll and more.
Article provided by Health Alliance.
Medicare Annual Enrollment Period: Medicare and Veterans Affairs Benefits
Did you know that even if our patients receive Veterans Affairs (VA) healthcare benefits, the VA still encourages them to sign up for Medicare? There are many reasons why veterans should consider having both VA and Medicare coverage once they turn 65:
- To use VA benefits, veterans must get care at a VA facility or have the VA preauthorize their care elsewhere. When veterans also have Medicare, they can get care at non-VA facilities and have Medicare cover it.
- Veterans might have a copayment when using VA benefits for care unrelated to their military service.
- If the VA only preauthorizes some services or a certain number of days at a non-VA facility, Medicare might pay for other services or days needed.
- With Medicare Part D, veterans can get medications from local pharmacies and non-VA doctors and mail-order services, instead of using the VA mail-order service.
- With Medicare Advantage plans, veterans can combine their healthcare coverage with dental and vision services, wellness programs and more.
- The Simplete® Medicare Advantage plans we offer through Health Alliance™ provide a network of local doctors and access to health coaches, care coordinators and more.
Veterans can learn more by viewing this flier.
Please remind our patients to review their Medicare coverage by December 7. They can learn more by:
- Calling (877) 642-4753 (TTY 711).
- Attending a webinar to learn about our Simplete Riverside plans.
- Visiting this page about Medicare and this link about our Simplete plans.
- Visiting simplete.org/medicare to view plans, enroll and more.
Article provided by Health Alliance.
Medicare Annual Enrollment Period
The ABC’s (and D’s) of Medicare
Help our patients understand the pros and cons of the different types of Medicare. Here’s a quick overview.
Original Medicare
- Includes Part A (hospital insurance) and Part B (medical insurance).
- Only pays for about 80% of healthcare costs.
- Doesn’t cover every type of service.
- Doesn’t cover most dental, vision and hearing services.
- Covers only a small number of medications.
- Has no out-of-pocket limit.
Medicare Supplement (Medigap)
- An add-on to Original Medicare.
- Covers remaining costs once Original Medicare has paid its share.
- Only covers services Original Medicare covers.
- Doesn’t include prescription drug coverage.
Medicare Part D
- Prescription drug coverage.
- For those on Original Medicare, Part D is an add-on they purchase separately from a private insurance company. If they don’t enroll when they’re first eligible, they’ll pay a penalty if they choose to add Part D later.
Medicare Advantage (Part C)
- Takes the place of Original Medicare.
- Typically combines Parts A, B and D (hospital, medical and prescription drug coverage) in one single plan.
- Plans have out-of-pocket limits, so members won’t pay over a certain amount.
- Plans often include dental, vision and hearing coverage.
- Plans can include extra perks such as fitness benefits and wellness programs.
Please remind our patients to review their Medicare coverage by December 7. They can learn more by:
- Calling (877) 642-4753 (TTY 711).
- Attending a webinar to learn about our Simplete® Riverside Medicare Advantage plans.
- Visiting this page about Medicare and this link about our Simplete plans.
- Visiting simplete.org/medicare to view plans, enroll and more.
Medicare Annual Enrollment Period – Busting Common Myths About Medicare Advantage Plans
It’s Medicare Annual Enrollment Period and your patients might have questions about Medicare Advantage plans. Help them separate myth from fact.
Myth – Medicare Advantage plans don’t offer access to enough providers.
Fact – The government makes sure all Medicare Advantage members have access to in-network providers. Plus plans must find a doctor and cover their services at the in-network rate if they don’t have an in-network specialist for a member’s specific condition.
Myth – With Medicare Advantage you need a referral to see a specialist.
Fact – Many plans, including the Simplete® plans we offer through Health Alliance™, don’t require you to get a referral, although a member’s doctor might.
Myth – Low premiums mean the coverage must be bad.
Fact – A plan with a low or $0 premium doesn’t mean it offers bad coverage. In some cases, these plans even cover extra services, like dental, vision and hearing.
Myth – A Medicare Supplement plan gets you more coverage than a Medicare Advantage plan.
Fact – Medicare Supplement plans cover only the services Original Medicare does. Medicare Advantage plans can offer additional coverage. They often include drug coverage and extras, like dental, vision, fitness perks and more.
Please remind your patients to review their coverage by December 7. They can learn more by:
• Calling (877) 642-4753 (TTY 711).
• Attending a webinar to learn about our Simplete Medicare Advantage plans.
• Visiting this page about Medicare and this link about our Simplete plans.
• Visiting simplete.org/medicare to view plans, enroll and more.
