Wellcare | Enhanced PCP Change Service, DST-SEP Updates, 24/7 Nurse Advice & More
Important Updates and Reminders for Wellcare Agents
Welcome to the latest edition of Wellcare Insider, your source for important updates and reminders to help you provide excellent service and grow your business all year long.
Today’s edition has information on the following topics:
- New! PCP Changes – Enhanced service options for making PCP changes
- DST-SEP Updates – View our updated resource for pending & current SEPs
- 24/7 Nurse Advice – Connect your members to Wellcare’s care advice line
- Broker Resources – Bookmark these links for ongoing sales success
Set Your Members Up For Success!
New! PCP Changes Via Broker Support or Centene Workbench
We’ve recently expanded our service capabilities to accept PCP changes through Centene Workbench or by calling Broker Support, 866-822-1339.
Important Information
- For the PCP change to be processed, the requesting broker must reflect as the Broker of Record for the member’s active policy.
- Requests to retroactively change the PCP effective date should be directed to Member Services using the number on the back of your client’s member ID card.
- Approved PCP changes will be effective on the 1st of the following month from the date the ticket was resolved in Centene Workbench. The new provider must be in the member’s network and accepting new patients.
Please review the Member PCP Change Request resource for details on required information for initiating a request and instructions on submitting a PCP change through Centene Workbench.
Access Centene Workbench through your Single Sign-On portal.
DST-SEP Updates
As a reminder, an emergency or disaster Special Enrollment Period (DST-SEP) may be granted to individuals that reside in an affected service area where a Federal, State or Local Government Entity has declared a State of Emergency impacting individuals in a specific geographical area. The declaration allows for a one-time SEP in the event an individual was unable to make an election during another qualifying election period.
Stay up-to-date with all the developments pertaining to DST-SEP declarations in your service areas. Our updated Special Enrollment Period (SEP) – FEMA / State Declarations resource provides links to all active state and Federal declarations, details on DST-SEPs pending compliance review and a listing of declarations expired within the last six months.
DST-SEP Guidelines
Agents should keep in mind the DST-SEP should not be used as a marketing tool to promote Medicare Advantage (MA) or Prescription Drug Plan (PDP) sales. Agents should never actively market this special enrollment period. The opportunity for a SEP is ONLY available to beneficiaries who:
- Reside, or resided at the start of the SEP eligibility period, in an area for which a federal, state or local government entity has declared a disaster or other emergency, or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area; and
- Were eligible for another election period at the time of the SEP eligibility period, and;
- Did not make an election during that other valid election period due to the disaster or other emergency.
Should you have any questions regarding the DST-SEP application process, please reach out to your local Sales Leader.
24/7 Nurse Advice Line
We understand that helping your members make informed health-care choices is an important part of being their trusted advisor. When members have questions about when, where or if they should seek care for a particular concern, connecting them with Wellcare’s 24/7 Nurse Advice Line is a safe and convenient resource for obtaining needed healthcare guidance.
Members may connect with nurse practitioners to discuss symptoms and get advice on what to do next, including:
- Answers to questions about their health
- Determining whether treatment from a doctor should be sought immediately
Members may call the Nurse Advice Line, 800-581-9952 (TTY: 711) anytime of the day or night. The number is also available on the back of the Member IDcard.
