WellCare | Agent Advisory: COVID-19 Response and Process Change

March 17, 2020

Thank you for all that you do to transform the health of our communities and your dedication to our underserved and vulnerable populations, particularly in this time of uncertainty. 

Our teammates and partners are the heart and soul of this organization, and the health and safety of our employees, partners, members, and communities is our uncompromising priority. We are closely monitoring the coronavirus (COVID-19) situation and are engaging regularly with medical professionals, the Centers for Disease Control (CDC), the World Health Organization (WHO), and other government agencies as the situation evolves. 

Company leadership, our business resilience teams, and representatives from across our businesses are engaging daily to monitor the situation as it evolves and are taking measures to keep employees and partners safe, minimize the risk of exposure to COVID-19, and ensure that we can continue to provide the services that our members rely on for their health and well-being.

Telephonic MAPD Marketing Presentation

Due to the current state of COVID-19 as of 3/16/2019, WellCare will allow agents to conduct telephonic MAPD sales appointments with beneficiaries!

Remember, when conducting telephonic MAPD marketing presentations to Medicare prospects seeking only MAPD information; all current CMS Medicare Marketing Guidelines, WellCare policies, etc. must be followed.

MAPD Telephonic Marketing Presentation Do’s and Don’ts

After all CMS requirements are met including consent-to-contact and SOA, an agent may proceed with a telephonic MAPD marketing presentation and assist with formulary/physician searches.

If the prospect agrees to enroll, the agent MAY:

  • Provide PURL information to the prospect; or
  • Send paper application (and all required documents) to be completed by the prospect

If the prospect agrees to enroll, the agent MAY NOT conduct telephonic enrollments on behalf of the prospect

Protecting our Members, Employees, and Partners Conducting Home Visits:

  • Centene is taking steps to cover COVID-19 testing and screening services for Medicaid, Medicare, and Marketplace members and is waiving all associated member cost-share amounts for COVID-19 testing and screening.
  • We will not require prior authorization, prior certification, prior notification, or step therapy protocols for COVID-19 testing and screening.
  • Enhanced protocols have also been created to ensure our pharmaceutical services continue to be available for members through supply chain management.
  • To lower the risk of transmission of illness we suggest taking precautions, such as reaching out by telephone prior to home visits to ensure that those being visited are not experiencing any symptoms related to COVID-19. As always, please ensure to adhere to all CMS guidelines.

Hours of Operation:

As of now, all call centers will be operating business as usual. As our country continues to prepare and execute safety measures, we will continue to evaluate business processes that will ensure the safety of all partners.

We encourage you to reference the Centers for Disease Control and Prevention (CDC) website as well as local government guidance for current updates.

Further, ensure to use the following precautionary measures to support a safe and healthy environment:

  • Thorough handwashing with soap and water for at least 20 seconds — hand hygiene is the most effective method to control the spread of many viral illnesses.
  • Using alcohol-based (containing at least 60 percent) hand sanitizer.
  • Covering your mouth when you cough or sneeze by coughing and sneezing into a tissue and then disposing of the tissue in a wastebasket.
  • Thoroughly cleaning surfaces that may be contaminated.
  • Avoiding shaking hands and close contact with people who are sick.

We appreciate your cooperation and support in serving our members and communities in this time of need and uncertainty. As the situation evolves, please know that additional measures will be taken with a local-oriented approach, and we will continue to ensure our employees and partners are supported and safe.

For more information, contact a Pinnacle Representative today at 1-(800)-772-6881 x7731 or email sales@pfsinsurance.com.

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881


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