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

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.

• For Aetna Dental PPO network, search for dentists here.
• For Liberty Dental, search for dentists here.

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.

• To learn more about Aetna Medicare 2024 dental packages, click here.

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 services – Offered 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.

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

Finish AEP Strong