AEP dates
KC- intent
Definitions
Diabetic Supply
Changes
Changes
Benefits
100
the expected delivery date for the members ANOCs
September 30
100
what job aid shows side by side look at changes for the plan from 2022 t0 2023
plan comparison tool
100
Annual opportunity (October 15 - December 7) for Medicare consumers to change their plan, which will take effect for next year (January 1).
AEP
100
give 2 examples of how members will be notified of the diabetic supply changes
- Annual Notice of Change (ANOC)
- Explanation of Coverage (EOC)
- Summary of Benefits (SB)
100
if a member has Medicaid why would they have a cost share
Cost sharing amounts provided are based on the benefits processed by the Medicare Advantage Plan and do not include any other insurance or extra help the member may have which picks up the member's responsibility.
Secondary coverage is the responsibility of the provider to bill directly, except for certain Medicaid contracts. Refer to Handling Dual Member Inquiries - FAQs
to see if UHC is contracted for the Medicaid cost sharing amount.
200
prior to October 1st
CAN Discuss: Member’s 2023 plan changes reflected on their ANOC only.
We CANNOT Discuss: Any other 2023 plan options prior to
true
200
what intent do you use for AEP information
Annual Enrollment Period (AEP) Index
200
Consumers who gain or lose their assistance (Medicaid or Extra Help), or have a change in their eligibility level, can use this SEP to change plans or disenroll.
Dual/LIS (Change of Status)
200
which diabetic testing meter is no longer eligible
OneTouch Ultra Mini Glucometer is not listed as covered glucose meters. but the member can continue to use your glucose meter at this time. If/when supplies for your meter are no longer available, we recommend changing to another preferred brand.
200
what intent do you use if the member has a question about hospice
Hospice Status Verification Process
300
what are the AEP dates
October 15th to December 7th
300
what intent is used to find out important AEP timeline dates
09.01.22 MA AEP Timeline Reminder
300
This election period is used for newly-eligible Medicare consumers to enroll into an MA-Only plan. It includes the 7-month window surrounding their Medicare eligibility month.
Initial Coverage Election Period:
300
does the member need a prescription to receive diabetic supplies from the pharmacy?
Yes, you will need to obtain a prescription from your doctor or ask your doctor to send the prescription to the pharmacy.
300
what intent do you use if the member has questions about denied Medication
Pharmacy Rejections & Overrides
400
when We can discuss 2023 plan information options with existing and prospective members.
after October 1st
400
The purpose of this Index is to provide advocates and sales agents with the information needed to assist with member inquiries surrounding the ANOC and Evidence of Coverage (EOC) documents.
MA Plan ANOCs and EOCs - Index
400
program helps pay for a portion of Part D prescription drug plan costs, including Part D premiums, deductibles and copayments. Depending on your income and assets, you may qualify for the full subsidy or a partial subsidy.
Low Income Subsidy (LIS)
400
name 2 of the National Home Delivery DME providers
Byram Healthcare
877-902-9726
Edgepark Medical Supplies
888-394-5375
AdaptHealth Patient Care Solutions
https://pcs.adapthealth.com/contact-us/
855-404-6727
OptumRx Home Delivery
400
true or false we can not assist the member in locating a pharmacy
False
Use one of the following ways to locate a pharmacy:
- Launch the Locate a Pharmacy intent within the Pharmacy category within Maestro
- Launch the Formulary Lookup intent within the Pharmacy category within Maestro to access RxWeb
- Access RxWeb
Note: Offer to help member transfer prescriptions to new pharmacy. Their provider can forward prescriptions, or the new pharmacy can request the prescriptions be transferred after receiving the member's information: Member ID, RxBin, RxGroup, RxPCN. This can be found on the member ID card or in Maestro.
500
The Maestro ANOC Changes intent will be available to assist with ANOC inquiries starting on(what date). For M&R Core and Complex (but not Employer Group) and C&S DSNP
September 3
500
The purpose of this Index is to provide you with information on plan non-renewals, including plan closures, contract non-renewals and service area reductions (SAR). (Note: A service area reduction can be either a removal of a county from a plan or an entire plan closure.) Use this Index to assist with member inquiries.
MA Plan Non-Renewals - Index
500
A time outside the yearly Open Enrollment Period when you can sign up for health insurance.
SEP
500
Are there quantity limits associated with Diabetic Supply Kits and Lancing Devices?
Yes, UnitedHealthcare Medicare Advantage Plans (MA/MAPD) have a Quantity Limit on diabetic supply KITS and lancing devices. Reference Diabetic Supply KITS and Lancing Devices Quantity Limit
500
Will my medications be covered if prescribed by a doctor who is out-of-network?
Yes, medications that are covered by your plan will be covered even if the prescribing doctor is out-of-network