fbpx
Humana | Assisting Members impacted by loss of Medicaid Status

Humana | Assisting Members impacted by loss of Medicaid Status

Humana | Assisting Members impacted by loss of Medicaid Status
Comments

Medicaid Redetermination:
Assisting Members impacted by the loss of Medicaid Status

 

What you should know

  • Annual Medicaid redetermination was paused during the Public Health Emergency (PHE)
  • February 1, states can begin their Medicaid Redetermination Process, with the potential for Medicaid disenrollment to start April 1, 2023
  • Each state determines when its redetermination process will begin
  • Impacted beneficiaries will be notified by the state approximately 60 calendar days prior to their disenrollment effective date from State Medicaid

What this means for you

  • You can prepare for Dual Eligible Members to complete the redetermination process for continued Medicaid Coverage 
  • Dual Eligible Special Needs Plan (DSNP) members, who are found to be ineligible for Medicaid coverage, will need Agent assistance to obtain new coverage and maintain continuity of care
  • Non-DSNP members, whose eligibility level changes, may also require a plan review to ensure they’re still on the plan best suited for them

Please remind impacted DSNP members of the following:

  • Confirm contact information is up to date with the state
  • Watch for a mail from the state requesting additional documentation
  • Respond to any request from the state promptly and within the deadlines

Process at a glance

 Where to learn more

  • Visit Ignite for a dedicated resource document to help assist agents with supporting members who may be at risk of losing their Medicaid coverage.

Learn More

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Humana |  U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company
Comments

Humana recognized as the industry leader for Medicare Advantage plans overall, member experience, and low-premium plan availability

Humana recently received recognition as U.S. News & World Report’s Best Insurance Company for Medicare Advantage in three categories for 2023.

U.S. News analyzed data from the Center for Medicare and Medicaid Services (CMS) to populate its comparison tool and identify the best companies nationwide and in each state.

At the national level, Humana rose to the top in the following categories for its 2023 offerings and performance in the CMS Star ratings: 

  • Best company for Medicare Advantage plan overall rating
  • Best company for member experience
  • Best company for low-premium plan availability
For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Humana |  U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | Call Recording Service Is Now Live!

Humana | Call Recording Service Is Now Live!
Comments

Our call recording service is now available

An Ignite Compliance Communication sent Friday, 9/23/22 shared information about Third-Party Marketing Organizations (TPMOs) call recording requirements based upon CMS’s 2023 Final Rule. Humana is supporting agents by making a call recording service available. That service is now live. Agents begin recording calls with clients on October 1, 2022.

TPMO agents are required to record telephone calls and may choose a recording service that meets their needs. One option is Humana’s call recording service for Humana pre-sales calls and enrollments. TMPO agents use a different recording service for enrollments of other carriers’ plans.

How to learn more

A call recording job aid, video demonstration and FAQ can be found on MarketPoint University. The call recording phone number is 1-872-234-8269. Try out the recording service in the next few days before the start of AEP.

Call Recording – FAQ
TMPO Agent Requirements
Call Recording Steps
How to Use the Humana CarePlus Recorded Phone Line

Top of Mind Questions

  1. Do face to face appointments have to be recorded? No.
  2. If asked why I must state the disclosures, how should I reply? Inform the caller that this is a new CMS requirement of all plan carriers.
  3. What types of products must be recorded? CMS regulated products: MA, MAPD, PDP, OSB.
  4. What calls must be recorded? Humana believes that the following calls would require recording, including but not limited to: calling leads, scheduling appointments, collecting SOAs, educational calls/presentations, sales/calls/presentations, collecting medication and pharmacy information, provider discussions, telephonic enrollments, and verification calls (calls made post enrollment to confirm understanding and intent to enroll). These are examples of calls that Humana considers within the chain of enrollment. This is not an all-inclusive list.
  5. Do Zoom or Webex calls have to be recorded? No. Face-to-face Zoom or Webex calls, using the video functionality, do not need to be recorded. If the video will not be used, the meeting should be conducted by phone with call recording rather than Zoom or Webex.
  6. Do I have to read the TPMO disclaimer stating that I do not offer every plan available in the beneficiary’s service area? The disclaimers are required and must be read as written by CMS on all “chain of enrollment” related calls within the first minute of the call. Agents selling Medicare Advantage plans for more than one carrier must read the disclaimer unless the agent is selling all commercially available Medicare Advantage plans within a given service area.
  7. Do service calls related to the beneficiary’s current plan have to be recorded? Humana believes that service calls, related to the beneficiary’s current plan and without discussion of a plan change, would not be considered part of the “chain of enrollment” and therefore do not need to be recorded by the agent.
  8. What do I do if a service call transitions to a chain of enrollment call? The agent should pause the conversation and add the call recording service to record the conversation related to the chain of enrollment.
  9. How long are calls retained? 10 years

NOTE: This communication does not constitute and must not be construed as legal advice. Humana does not represent that compliance with this communication will ensure that any activity will comply with any applicable laws, rules, or regulations. TPMOs are required to review and adhere to all applicable state and federal laws, rules, regulations, and policies.

Where do I go if I have more questions?

  • You may find additional guidance in the Ignite Compliance Communication regarding Call Recording sent Friday, 9/23/22.
  • Use the FAQ first for the most frequent questions.
  • Still, need answers? Consult with your Broker Relationship Manager, Broker Relationship Executive or local Sales Manager.
  • Send a question to the Sales Integrity mailbox at salesintegrity@humana.com
  • Agent Support at 1-800-309-3163 or agentsupport@humana.com
For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Humana |  U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | One card, multiple ways to support your client’s health

Humana | One card, multiple ways to support your client’s health
Comments

1 card, multiple allowances

Plan allowances just got more convenient. For 2023 plans, we’ve created 1 convenient card with up to 3 allowances—the Healthy Options allowance (replaces Healthy Foods Card), over-the-counter (OTC) allowance, and Flex allowance. Most plans will have the card, but the allowances included will depend on the plan. 

With the Humana Spending Account prepaid card, members can pay for covered products and services, check their allowance balances, and track their spending history. Visit First Look to learn more.

New for 2023: the Healthy Options allowance

Now all Dual Eligible Special Needs Plan (DSNP), select Chronic Condition Special Needs Plan and select General Enrollment plan enrollees will be getting a big upgrade. Instead of the Healthy Foods Card, qualified members will get a Healthy Options allowance. This allowance can be used to pay for healthy food, over-the-counter (OTC) items, utilities, rent assistance, household supplies, living expenses, pet supplies and more. As part of the Humana Spending Account Card, it can be used to purchase eligible items or services at participating stores.

OTC allowance

Depending on their plan, members may have the OTC allowance on their Humana Spending Account Card. With the OTC allowance, members can buy products like cold and flu meds, vitamins, weight loss items, first aid supplies, and more at participating retailers and/or via mail order through the CenterWell Pharmacy™ online catalog, depending on their plan.

Flex allowance

The Humana Spending Account Card could provide a Flex allowance on certain plans. Qualified members can use their annual Flex allowance for the plan’s covered dental, vision and hearing services, including out-of-pocket costs or copays.

There’s more

The Humana Spending Account Card is just one new update. Keep your eyes out for more emails every week with the latest 2023 AEP news. We’re gearing up for a big 2023 AEP, and we’re here to help you every step of the way.

 If you need help or have any questions, contact your team on Ignite.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Humana |  U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | June is Oral Health Month. Help your clients protect their smiles.

Humana | June is Oral Health Month. Help your clients protect their smiles.
Comments

This month, remind your clients about the importance of oral health

Oral health impacts a person’s overall well-being. Help bring awareness to clients and prospects this June.

Help clients keep their mouths healthy for years to come

Oral health is essential to whole-person health. Not only do healthy teeth account for great smiles, but they also allow a person to speak clearly, show facial expressions, and chew nutritious foods. Whatever a person’s age–or the current state of their dental health–it’s never too late to develop healthier oral hygiene habits.

For tips for keeping your clients’ teeth healthy and the importance of dental and vision insurance, be sure to check out our dental and vision plan information on Ignite.

Help your clients maximize their dental and vision benefits

In addition to helping clients maintain healthy eyes and mouths, selling dental and vision plans can help grow your book of business with no extra certification needed and the ability to sell these plans year-round. 

Find out how to grow your lead pipeline and help your clients get the coverage they need by selling individual dental and vision plans with dental and vision plan resources on Ignite. 

And check out our updated playbook, An Agent’s Guide to Humana Dental and Vision Plans: It Takes You to Take Two, to learn why dental and vision plans matter for your clients’ overall health.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail

Humana |  U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company

Humana | Honoring and Serving Veterans

Humana | Honoring and Serving Veterans
Comments

As one of our valued partner agents, you are invited to view Humana’s training sessions on VA Healthcare, Medicare, and Medicare Advantage as well as a session on TRICARE for Life, CHAMPVA, and Medicare.

This training will enable you to be a better resource and trusted advisor to military Veterans and their loved ones. It will also allow you to gain a better understanding of VA healthcare & Medicare which will allow you to confidently engage with Veterans about their health care coverage and their Medicare options.

Watch the TRICARE for Life, CHAMPVA & Medicare training to understand how Medicare Advantage plans to interact with these coverages. Learn how to avoid pitfalls and ensure you’re putting every client in the right plan. Confidently engage with Veterans and Military Spouses about their Medicare options.

Access Training Via Links Below

  • VA Healthcare, Medicare, and Medicare Advantage Training
  • TRICARE for Life, CHAMPVA, and Medicare Training
For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

CallEmail