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Aetna | OEP | Member retention | Grocery delivery through Uber Eats | App status | Training opportunities

Aetna | OEP | Member retention | Grocery delivery through Uber Eats | App status | Training opportunities

Aetna | OEP | Member retention | Grocery delivery through Uber Eats | App status | Training opportunities
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Broker news

Your source for Aetna Medicare broker news and information

January 30, 2024

January is Mental Health Awareness Month: Find out how your clients can improve their mental health.

Open Enrollment Period (OEP)

What is the Medicare OEP?

OEP runs from January 1 to March 31. During this time, beneficiaries who elected a Medicare Advantage plan (MA/MAPD) during the Annual Enrollment Period can switch to a different Medicare Advantage (MA/MAPD) plan or return to Original Medicare (with or without prescription drug coverage). Review OEP do’s and don’ts.

You can continue supporting D-SNP and LIS-eligible clients during this time

While you’re not allowed to proactively market to MA/MAPD enrollees during OEP. You are allowed to continue marketing to consumers who are eligible for Dual Eligible Special Needs Plans (D-SNP) or Extra Help (Low Income Subsidy), as these clients are able to make one change per quarter

Member retention

Top tips for welcoming and supporting new members

You can help ensure your clients have a positive start to 2024 by helping them with questions on hot topics like member ID cards, prescription refills, finding providers and plan benefit questions. Get tips on answering their FAQs.

Watch this member retention podcast: Get tips from the pros on how to help prevent rapid disenrollment (12 min.)

Product and benefit information

Eligible members with an Extra Benefits Card through NationsBenefits can now get grocery delivery through Uber Eats

Members with an Extra Supports Wallet or Healthy Foods Wallet on their Extra Benefits Card can now access grocery delivery through Uber Eats. Some of the major retailers who sell grocery products out of Uber’s network include—Walmart, Costco, Albertsons, SEG, Hyvee, CVS, Walgreens, Target, and others. Members can place their order through the UberEats app or online at UberEats.com. You can share this flyer, “Uber Eats grocery delivery, explained” with your clients.

Aetna Medicare Payment Card is now administered by Inspira Financial (formerly PayFlex)

Some Aetna Medicare plans include an Aetna Medicare Payment Card, which was previously administered by PayFlex®. In 2024, PayFlex is becoming Inspira Financial. Let members know what to expect during this transition:

  • The physical card will continue to show “PayFlex.”
  • But members will start seeing “Inspira Financial” on related materials.
  • PayFlex websites will now automatically redirect to www.inspirafinancial.com.
  • If members try to download the PayFlex app to manage their card, they will find the Inspira Financial app instead.

Broker training and tools

Share your feedback on the Aetna Marketing Portal (AMP)

The AMP tool is your source for customizable and compliant marketing materials like flyers, mailers, and more. Provide feedback to help us build our AMP strategy for the future. Submit your responses by the end of the day, Friday, February 2.

Take the Survery

Check the status of applications

We made it easy. Use Producer World to access the member application tool and check the status of your applications. See how.

Need help with commissions?

Producer World is your go-to place to review commission information.

  1. Click the Reports tab
  2. Click “Access reporting”

You can also visit the Compensation tab to learn how and when we pay, for help understanding your reports and statements.

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

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Contact a Pinnacle Financial Service representative today for assistance.

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Aetna | OEP | Member retention | Grocery delivery through Uber Eats | App status | Training opportunities

Aetna | Finish strong: AEP deadlines, compliance reminders

Aetna | Finish strong: AEP deadlines, compliance reminders
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AEP wrap-up information

We’re in the home stretch! Thank you for all your efforts this AEP, and for your dedication to helping members and clients enroll in a plan that will best meet their needs in 2024. We’re here to support you with any last-minute needs or questions that arise.

Finish strong

Review AEP enrollment deadlines

  • December 7: All AEP enrollment applications must be completed, signed, dated and received by the agent no later than 11:59 PM, December 7, 2023. 
  • 48 hours: We must receive signed enrollment applications within two calendar days after you receive them from beneficiaries. 
  • December 9 is the last day to submit all applications that were signed and dated December 7, 2023.

Remember, if you receive a completed enrollment application after AEP ends on December 7, do not hold or destroy it. Under CMS rules, you must still submit it to us within two calendar days as noted above. We then will process or deny the enrollment as appropriate.

Ensure your enrollments are processed – 

Encourage clients to contact us if their enrollment is pending due to a request for information (RFI) 

You can check the member application search report in Producer World to see if any enrollments are in a “pending RFI” status. Encourage these clients to call us so we can verify any outstanding items and finish processing their enrollment. They should call the customer service number in the message we leave or the letter they receive. 

If we’re unable to reach them (within 21 days or by the end of the enrollment period, whichever is longer), their application will be denied. 

Compliance

Remember, you must get approval before using an image of the Medicare card 

As announced in the CY2024 CMS Final Rule, you cannot use the Medicare card image unless you get authorization from CMS. This restriction applies to ALL communication and marketing materials, not just those materials which meet the CMS definition of marketing. For example, not only does it apply to traditional materials like flyers, it also applies to marketing and communications on private vans, public buses, billboards, etc. Read more

In case you missed it

BenefitsPRO: Words as medicine: Creating a healthier tomorrow through literacy

Brokers can play a role in increasing people’s access to resources and empowering individuals and their loved ones to navigate the process of choosing a plan with confidence.

HealthLeaders: The Exec: Terri Swanson details Aetna’s largest-ever MA portfolio, Part 1

HealthLeaders: The Exec: For Aetna’s Terri Swanson, Better Outcomes Don’t Have to be Complicated, Part 2

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.

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Aetna | OEP | Member retention | Grocery delivery through Uber Eats | App status | Training opportunities

Aetna | compliance connection For Aetna Medicare Distribution Partners

Aetna | compliance connection For Aetna Medicare Distribution Partners
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Note: This edition revises the newsletter sent earlier today. We’ve clarified below that the second paragraph applies to both PPO plans and HMO Point-of-Service plans.

Aetna Medicare dental offerings give your clients plenty to smile about Here’s how to make that smile last throughout 2024

In this issue, we’ll take you through the Who, What, and Why of Aetna Medicare dental to help you avoid client confusion and complaints to CMS.

WHO can your clients see to obtain dental care?

It depends on the type of dental package they have, as detailed below.

Plans with a network-based dental package

For HMO medical plans with a network-based dental benefit, your client must use a dental provider that is part of the dental network. Most plans use the Aetna Dental Preferred Provider Organization (PPO) network. However, those in California, Florida, and Nevada use the Liberty Dental network.

For PPO medical plans and HMO Point-of-Service (POS) medical plans that have a network-based dental benefit, your client can use a dentist outside the network, but in some plans, they will have a greater cost-share. Both PPO and HMO-POS medical plans use the Aetna Dental PPO network.

TIP #1: Check the type of medical plan that your client has, since this drives their network dental benefit. HMO plans always require members to use a network dental provider. PPO and HMO-POS plans allow members to use out-of-network dental providers.

TIP #2:  Check if your client’s dentist is in the network.

Plans with the Aetna dental direct member reimbursement (DMR) package

Clients can see any licensed dentist but they may need to pay out-of-pocket and then seek reimbursement.

TIP #3: For clients with a dental DMR benefit, make sure they understand how reimbursement works.

WHAT dental services does Aetna offer?

Aetna offers dental coverage in all its 2024 Medicare Advantage with Prescription Drug (MAPD) plans and many different dental packages. Each package covers one or more of the services below. Most packages provide coverage up to an allowance/maximum amount each year.

Preventive services Covered by all dental packages and offered by all plans; includes oral exams, cleanings, and bite-wing x-rays.

Basic comprehensive servicesOffered in most packages; includes fillings, routine extractions, and other services.

Major comprehensive services – Offered in most packages. Includes but is not limited to molar root canals, crowns, and dentures. Some packages cover implants. Check the Evidence of Coverage for details.

TIP #4: Always check to see if the dental benefit has an annual dental allowance and what services are covered. For example, your client’s plan may pay up to $2,000 annually for covered preventive and comprehensive services combined. Other plans may include preventive services outside this annual maximum.

WHY are dental benefits important to your clients?

Original Medicare only pays for some specific dental services that are closely related to other covered medical services, such as surgery to treat jaw fractures. Aetna Medicare plans provide coverage for additional services your client may need. Dental services are expensive, but your clients’ oral health is a vital part of their overall physical and mental health.

  • Untreated gum disease has been linked to cardiovascular disease and rheumatoid arthritis.
  • Tooth loss can seriously impact your client’s ability to speak, socialize, and eat.
    • As an example, Jane loved having breakfast every Sunday with her friends, but since she lost her front tooth she’s embarrassed and has stopped going out. She’s feeling increasingly isolated and lonely. If Jane can find a plan to cover her needed dental work, she’ll be ready to socialize again.
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

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Contact a Pinnacle Financial Service representative today for assistance.

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Aetna | AEP Updates and Wrap-Up Information

Aetna | AEP Updates and Wrap-Up Information

Aetna | AEP Updates and Wrap-Up Information
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As we head into the last part of AEP, we want to thank you for all of your hard work and partnership. We’re excited about the feedback we’re hearing from all of you. That said, we’ve received a number of questions about some of our new benefits and plans. In this email, we want to make sure you have the comprehensive information you need to support your clients and help them get the full value of their plan. Specifically, we’ll address:

  • Fitness reimbursement benefit
  • High-value provider bonus benefit
  • Reminders for narrow network plans
  • Finishing AEP strong: Ensure all enrollments are processed

Fitness Reimbursement Benefit Clarification

In 2024, some non-SNP Aetna Medicare plans offer a fitness reimbursement benefit. With this benefit, members can be reimbursed for eligible activities and supplies that improve fitness and health outcomes.

To ensure you and your clients understand how this benefit works, we’ve created a new guide. It provides clarity on the reimbursement process.

We’ve also updated our broker flyer on this benefit. Be sure to check out the new version.

Help Clients take Advantage of the new High-Value Provider (HVP) Bonus Benefit

In 2024, some plans offer a new HVP bonus benefit. With these plans, eligible members can receive increased funds loaded onto their Extra Benefits Card by selecting a primary care provider (PCP) from a designated HVP group.

Please ensure your clients know they must select a PCP from one of these HVP groups as one of the requirements to receive this benefit.

Remember, you can find a list of participating HVP providers on Producer World. These providers appear with a special indicator in most provider search tools.

Clients who’ve already enrolled in one of these plans can call Member Services to add or update their PCP on file to an HVP.

Remember, for narrow network plans, ensure your clients select an in-network PCP

For 2024 plans that have a narrow network, like Prime plans, please encourage your clients to select an in-network PCP when they enroll. Or if they already enrolled without one, they can call Member Services to change their PCP on file. This is especially important for narrow network plans because if beneficiaries don’t select a PCP when they enroll, we will auto-assign one.

Finish AEP Strong

Review AEP Enrollment Deadlines

  • December 7: All AEP enrollment applications must be completed, signed, dated, and received by the agent no later than 11:59 PM, December 7, 2023.
  • 48 hours: We must receive signed enrollment applications within two calendar days after you receive them from beneficiaries.
  • December 9 is the last day to submit all applications that were signed and dated December 7, 2023.

If you receive a completed enrollment application after AEP ends on December 7, do not hold or destroy it. Under CMS rules, you must still submit it to us within two calendar days as noted above. We then will process or deny the enrollment as appropriate.

Ensure your enrollments are processed – Encourage clients to contact us if their enrollment is pending due to a request for information (RFI)

You can check the app status report in Producer World to see if any enrollments are in a “pending RFI” status. Encourage these clients to call us so we can verify any outstanding items and finish processing their enrollment. They should call the customer service number in the message we leave or the letter they receive.

If we’re not able to reach them (within 21 days or by the end of the enrollment period, whichever is longer), their application will be denied.

We wish you a happy Thanksgiving!

We appreciate your partnership! If there is any way we can help during AEP, please contact your local Aetna Medicare Broker Manager. Or reach out to Aetna Medicare Broker Services at 1-866-714-9301 or brokersupport@aetna.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.

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Aetna | AEP Updates and Wrap-Up Information

Aetna | 2024 Star Ratings: We’re Back!

Aetna | 2024 Star Ratings: We’re Back!
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Eighty-seven (87) percent of Aetna Medicare Advantage members in 4-star plans or higher for 2024

Commitment to exceptional service for members across the nation drove a significant improvement in member experience ratings

Today, we’re excited to announce that 87 percent of Aetna Medicare Advantage (MA) members are in 2024 Medicare Advantage Prescription Drug (MAPD) plans that are rated 4 stars or higher (out of 5 stars) by the Centers for Medicare & Medicaid Services (CMS). This represents a significant achievement, given the considerably more stringent CMS measurement criteria this year.

“We are committed to delivering outstanding experiences and driving improved health outcomes for our Medicare Advantage members.”

“We are committed to delivering outstanding experiences and driving improved health outcomes for our Medicare Advantage members,” said CVS Health President and CEO Karen S. Lynch. “Our strong 2024 Star Ratings for Aetna are a result of focused execution and seamless collaboration across our entire company. We remain unwavering in our efforts to drive continuous improvement to support our members now and well into the future.”

We're Here to Help

For questions about plans in your local market, please reach out to your local Aetna Medicare Broker Manager.

For questions about producer certification, tools, reporting, or for help checking D-SNP eligibility, please contact Aetna Medicare Broker Services at 866-714-9301 or brokersupport@aetna.com.

Starting October 14, Broker Services will be open on Saturdays, too, from 9 AM to 4 PM ET.

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.

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