Bright Health – Your Medicare Assist
]]>Counseling services via telehealth may be available to you. Be sure to check, as some healthcare providers and plans are reducing or waiving the amount you pay for telehealth visits during the COVID-19 pandemic.
Always take care of your mental health, and call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
Visit Medicare.gov or CDC.gov for more information.
Sincerely,
The Medicare Team
]]>Our member’s health is our priority. Recently, we shared news that UnitedHealth Group is taking additional action to directly support people affected by the COVID-19 pandemic by providing over $1.5 billion of additional support for our customers. We wanted to share more details with you.
To help members get the care they need, we are waiving cost-share (copays, coinsurance and deductibles) for our Medicare Advantage plan members as follows. Members will have a $0 copay for primary care provider (PCP) and specialist physician services, as well as other covered services (listed below) between May 11, 2020 until at least September 30, 2020. By lowering our PCP and specialist copays to $0, along with our telehealth cost-share waiver, we hope to help make it easier for member’s to access care.
]]>The Centers for Medicare & Medicaid Services (CMS) confirmed that the Special Election Period (SEP) for Individuals Affected by a Federal Emergency Management Agency (FEMA) Declared Weather-Related Emergency or Other Major Disaster is applicable to individuals affected by COVID-19 who meet the criteria outlined below. With this announcement, Medicare Advantage and Part D beneficiaries affected by COVID-19 nationwide may be eligible for a Special Election Period (SEP). No advertising, treated like OEP
SEP Time Period
March 1, 2020 with an SEP running through June 30, 2020.
SEP Start Date: 3/1/2020
SEP End Date: 6/30/2020
This SEP is available nationwide to residents of all states, tribes, territories, and the District of Columbia.
Who is eligible?
1. Any beneficiary who resides in, or resided in (at the start of the SEP time period), an area that Federal Emergency Management Agency (FEMA) declared an emergency or major disaster (see http://www.fema.gov/disasters) is eligible to apply for individual or public level assistance. Beneficiaries who do not live in the impacted areas but receive assistance making healthcare decisions from someone who lives in one of the affected areas are also eligible; and
2. The beneficiary had another valid election period at the time of the incident period, but did not make an election during that other valid election period.
What does this mean for beneficiaries?
Beneficiaries who were eligible for a different election period, but were unable to enroll in a plan during the allotted time period, have until June 30, 2020, to enroll. Enrollments received are effective the first day of the following month.
Agent action
If a consumer contacts you as a result of this SEP, you may help them enroll in one of our plans and earn a commission. You must:
1. Ask the beneficiary for proof that the beneficiary resided in an affected area (e.g., driver’s license or utility bill reflecting the beneficiary’s address).
2. If the beneficiary is unable to provide proof, ask the beneficiary if they attest that they lived/live in an area impacted by the weather-related emergencies.
3. Once you verify eligibility, you can proceed with the application.
4. Application details:
a. For paper, use the SEP election type code on the application. Write in Weather Related Emergency.
b. For LEAN, please select the FEMA Disaster reason code.
]]>Our member’s health is our priority. Recently, we shared news that UnitedHealth Group is taking additional action to directly support people affected by the COVID-19 pandemic by providing over $1.5 billion of additional support for our customers. We wanted to share more details with you.
To help member’s get the care they need, we are waiving cost-share (copays, coinsurance and deductibles) for our Medicare Advantage plan members as follows. Members will have a $0 copay for primary care provider (PCP) and specialist physician services, as well as other covered services (listed below) between May 11, 2020 until at least September 30, 2020. By lowering our PCP and specialist copays to $0, along with our telehealth cost-share waiver, we hope to help make it easier for member’s to access care.
Services included
The following services, if covered by a member’s plan, are eligible for a $0 copay under the cost share waiver, but do not include diagnostic tests and certain other services.
Primary care provider (PCP) office visits
Specialist physician office visits
Physician assistant or nurse practitioner office visits
Medicare-covered chiropractic and acupuncture services
Podiatry services and routine eye and hearing exams
Physical therapy, occupational therapy and speech therapy
Cardiac and pulmonary rehabilitation services
Outpatient mental health and substance abuse visits
Opioid treatment services
The $0 copay applies to services from a network provider and out-of-network services covered by the plan.
Member cost share is not waived for the following services, unless they are related to COVID-19 testing or treatments:
Lab and Diagnostic tests (radiological and non-radiological)
Part B and Part D drugs
Durable Medical Equipment, Prosthetics, Orthotics and Supplies
Renal Dialysis
Other services not covered by your plan
Copays, Coinsurance and deductibles for services in the following settings are not waived. Members will be responsible for their share of the cost under their benefit:
Inpatient hospital and Outpatient surgery or observation services
Skilled Nursing Facilities
Emergency, Urgent and Ambulance services
Eligible Members
The cost-share waiver applies to all UnitedHealthcare Medicare Advantage members, including members of Special Needs Plans (SNP) and UnitedHealthcare Group Medicare Advantage plans.
This information is posted on our UnitedHealthcare COVID-19 Health and Wellness page for members. Thank you for being a partner in care to our members during this time.
]]>Who’s eligible?
According to the CMS announcement, the SEP is open to all individuals who meet these three prerequisites:
Reside, or resided at the start of the incident period, in an area for which the Federal Emergency Management Agency (FEMA) has declared an emergency or a major disaster and has designated affected counties, including all states and the District of Columbia, as eligible to apply for individual or public level assistance;
Had another valid election period at the time of the incident period [ Medicare Advantage Open Enrollment Period (MA OEP) or other special opportunity]; and
Did not enroll or make a change during that other enrollment period.
Additionally, individuals who don’t live in the affected areas but rely on help making healthcare decisions from friends or family members who live in the affected areas may also benefit from this SEP. Further, an eligible beneficiary would be given one opportunity to make that missed election as a result of this SEP.
]]>Today, UnitedHealth Group announced that we are taking additional action to directly support people affected by the COVID-19 pandemic by providing over $1.5 billion of additional support for our customers.
Actions we announced today include
For people served by UnitedHealthcare under Medicare Advantage plans, all specialist and primary care physician cost sharing will be waived at least through the end of September.
For people served by UnitedHealthcare AARP ® Medicare Supplement policies, we will provide both new and renewal premium price stability and support.
For people served by UnitedHealthcare Medicaid plans, the company is accelerating funds to state partners and critical care providers to serve more people and expanding its Housing+Health and homeless support programs, providing shelf stable food and baby formula.
These measures build upon our ongoing efforts to address COVID-19 challenges by expanding coverage, supporting the health care system, protecting the health care work force and assisting those most affected by the pandemic.