Retirement/Medicare
A resource for members UNDER 65 needing assistance with SSD and Medicare information.
What is Allsup?
These 2 vendors/services can provide assistance to your member that want to quit smoking.
What are:
- The Smoking Cessation Program: Members can speak with a licensed counselor by phone or set up in-person meetings (up to 5 sessions at no cost to the member) to help you quit
- Express Scripts: Managed Prescription Drug Plan Program: Provides nicotine replacement therapy products at no cost to eligible participants in the Managed Prescription Drug Program, as part of the U.S. Medical Plan, with a prescription from their doctor
The program provides up to 10 visits of care per dependent per year at a nominal fee. Care may be provided through a child care center or through an agency if you wish to have care provided in your home.
Backup care for children or adults when regular care arrangements aren’t available.
Care in centers or in the home, for a daily cost of $40, for up to 10 days per dependent per year.
What is LifeCare?
the programs plan design is set up where members MUST fill their Specialty medications through this Express Scripts Specialty Pharmacy
What is Accredo?
These rxs cannot be filled through Retail. Due to the nature of specialty medications, Accredo has special services which include reaching out to members to schedule their orders, personalized care with a team of specialty trained pharmacists, nurses and patient care representatives who are trained in the different disease conditions. Accredo provides 24/7 support. There is also a special app for Accredo – “Accredo” for specialty medication users.
is the account's partner for the administration of:
-short term disability
-state leave
-FMLA
-Paid Parental Time Off
-Unpaid Child Care Leave
-Accommodations
What is Sedegwick?
This provides information regarding post Medicare Retiree medical to retirees and or retiree spouses who are over 65.
what is the AON Retiree Exchange?
This program is available to Active Members who are breastfeeding
provides refrigerated, express shipping or easy toting of breast milk at no cost to the member
What is Milk Stork?
A lifestyle-focused weight management program that combines the program's diet with physical activity, weekly group phone coaching sessions and tracking tools. Proven effective, this program uses the same HMR foods and lifestyle change techniques offered at some of the nation’s leading hospitals.
What is Healthy Weight Program/HMR Healthy Solutions at Home ?
Smart 90 Voluntary allows members to fill their maintenance medications for 90 days supply at these 2 retail pharmacies at cost savings.
what are CVS and Walgreens?
Provides free and private counseling for:
Work life services, Family support, legal/financial matters, every day matters, education
what is EAP (Resources for Living)?
The age an individual becomes eligible for Medicare (related solely to age).
what is age 65?
Welcome Kit includes smart meter, test strips, lancing devices and lancets. Access to coaches who are Certified Diabetes Educators-are available 24 hrs/day, 7 days/wk to answer questions on nutrition or lifestyle changes.
Connected Meter automatically uploads your blood glucose readings to your secure online account and provides real-time personalized tips
Unlimited strips at no cost to you-when you are about to run out, we ship them direct to your door!
Communicate anytime with a coach about diabetes question on nutrition or lifestyle changes.
what is Livongo?
*Coordination between Livongo and CM will take place via Referral/Coordination email templates, direct phone calls and/or secured email. Clinical Health Guide will manage members with chronic and/or medical needs in addition to Livongo.
Gives parents-to-be useful information to care for their babies and themselves throughout pregnancy and connects them with services designed to help them prepare for baby, answer questions and save money
what is Precious Additions?
2 different technologies allow members to access their Express Scripts RX benefit using the website.
Toll Free 866-766-0250
What is the Toll Free number to the Health Guide Program
These two factors can qualify individuals for earlier Medicare benefits (before age 65).
What is End Stage Renal Disease (ESRD) and Disability?
When you are under 65, you become eligible for Medicare if:
connecting employees with doctors 24/7/365 via video, chat or phone – no appointment needed
Ideal for outside office hours, while traveling or too sick to drive.
The $39 visit is subject to a member’s cost share (coinsurance and deductible).
Primary care, behavioral health and nutritionist visits are available.
What is Horizon Care Online?
Provides immediate access to Fertility Support, assistance with navigating medical treatment & medications, provides medication education and guidance with self-administered injections, provides ongoing support and education throughout the infertility treatment journey
what is WinFertility (WIN NCM 24/7)
This service allows members to fill a 90 day supply of maintenance medications at a cost savings – doctors fax or e-prescribe the rxs directly to the Express Scripts pharmacy.
what is Home Delivery?
Because only a handful of doctors specialize in trans-care, those that need services by accredited physicians or providers, regardless of location or whether they accept insurance or receive coverage at an in-network level can receive it based on this benefit.
What is the Expanded 2020 Comprehensive transgender benefit?
*this includes behavioral health therapist who specialize in transgender patients.
Once a member retires from the company and they become sixty five years of age they become eligible for Medicare coverage & CM services will end.
members are eligible for case management despite age as long as they are actively working.
If they are retired and become Medicare eligible, name some important steps in transitioning your member to Medicare and closing them to your CM.
What is:
- are they aware they are nearing Medicare age?
- complete referral in CP for Medicare Advantage/AON Retiree Exchange
- Educate/close relevant care alerts/gaps
- members should be encouraged to sign up for Medicare Part A & B (refer them to AON Retiree Exchange).
provides expert medical consultation services, via video or telephone, with leading medical specialists to eligible employees and eligible dependents
currently covering more than 120 American Board of medical specialties and more than 3,000 diseases and conditions like cancer treatment, back/spine/knee/hip surgery, transplants etc.
what is 2nd MD?
Provides:
- Weight and activity tracker, progress charts, recipes and restaurant guides
- Connect the “WW social media platform” to connect with other WW members
- Program discounts
- Wellness Wins rewards program
- Custom workouts provided by Aaptiv
what is Weight Watchers?
Januvia, Dulera, Gardasil, Emend, Fosamax Plus D, Pegintron and Keytruda (to name a few) are all manufactured prescription medications that will cost members this much in copay related costs if prescribed by their physician.
What is $0
In 2020, the account is offering its members a unique, consolidated medical plan. This service can provide options, help you make an informed choice on medical services and treatments, help you make appointments, coordinate care and manage complex medical conditions. They can recommend programs or services that you may not even know about.
What is the BCBS Health Guide?