fbpx
Wellcare | Sales Compensation

Wellcare | Sales Compensation

Wellcare | Sales Compensation

Comments

Wellcare Realigns Health Risk Assessment Program Effective

April 1, 2024

To support quality improvement, retention, and effectuation initiatives, Wellcare will change its payment of all D-SNP and C-SNP Health Risk Assessments (HRAs) to effectuation versus submission effective April 1, 2024.

This change applies to D-SNP and C-SNP HRAs completed in both Ascend and Sunfire on or after April 1 and for members with an effective date of May 1 and forward. Additionally, Wellcare will update its administrative payment amounts effective on the same date.

Key Change Highlights 

WellCare’s new plan will change the current administrative payment amounts to:

  • $150 for Special Needs Plans (D-SNPs and C-SNPs) HRA completion payments on effectuated members for 1099 partners.
  • Removal of payment for non-SNP HRA completion.

HRAs can be completed up to 90 days after the application submission date. 

Learn More

For HRA program questions, please take a few moments to view our helpful HRA Announcement Video and Transcript and review the HRA Program Realignment FAQ.

If you have additional questions about this change, please contact your local Sales Leader.

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

Wellcare | Sales Compensation

Wellcare | Realignment of Health Risk Assessment Program Effective April 1, 2024

Wellcare | Realignment of Health Risk Assessment Program Effective April 1, 2024

Comments

To support quality improvement, retention, and effectuation initiatives, Wellcare will change its payment of all D-SNP and C-SNP Health Risk Assessments (HRAs) to effectuation versus submission effective April 1, 2024.

This change applies to D-SNP and C-SNP HRAs completed in both Ascend and Sunfire on or after April 1, and for members with an effective date of May 1 and forward. Additionally, Wellcare will update its administrative payment amounts effective on the same date.

Key Change Highlights 

Wellcare’s new plan will change the current administrative payment amounts to:

  • $150 for Special Needs Plans (D-SNPs and C-SNP) HRA completion payments on effectuated members for 1099 partners.
  • Removal of payment for non-SNP HRA completion.

HRAs can be completed up to 90 days after the application submission date. 

For helpful HRA program questions, please review the HRA Program Realignment FAQ. If you have additional questions about this change, please contact your local Sales Leader.

As always, thank you for your valued partnership!

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

Understanding Dental Benefits in Medicare: A Simple Guide

Understanding Dental Benefits in Medicare: A Simple Guide

Understanding Dental Benefits in Medicare: A Simple Guide

Comments

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). 

Some people get Medicare automatically, others have to actively sign up — it depends if you start getting retirement or disability benefits from Social Security before you turn 65. 

It comprises various components, each of which addresses a distinct health requirement, much like puzzle pieces. We’re delving into Medicare’s treatment of dental benefits today, with a particular emphasis on Parts A and B and Medicare Advantage.

What are Parts A and B of Medicare?

On a high-level view, most of Part A is devoted to hospital insurance, skilled nursing care, and hospice care. Part B is dedicated to services from doctors and outpatient care.

Do Medicare Parts A & B Cover Dental?

This is where dental care can get a little complicated. Medicare Parts A and B typically do not cover routine dental care, including dental exams, cleanings, fillings, dentures, and the majority of tooth extractions.

There are a few exceptions, though. For instance, Part A might pay for dental care if you require it while in the hospital as part of a more extensive treatment plan. Consider that you are undergoing jaw surgery and that the procedure includes dental work. Since it’s seen as a component of your overall medical care in this instance, Medicare may be able to assist with the costs.

What About Medicare Advantage?

Things start to look up from here. Medicare Advantage Plans, sometimes referred to as Part C, are essentially an enhanced version of the original Medicare program. Medicare-approved private insurance providers provide these plans. One of its features is that many Medicare Advantage plans provide dental insurance. Keep in mind that Medicare Advantage Plans are not required to cover more than original Medicare Parts A and B, so not every MA plan will have dental.

Dental treatment for more involved procedures like crowns, bridges, and dentures as well as more basic procedures like cleanings, exams, X-rays, and fillings can be included in a Medicare Advantage Plan. It’s crucial to remember, though, that dental coverage varies greatly among Medicare Advantage plans. While some provide basic dental care, others might offer more extensive coverage.

Stand-alone Dental Coverage

Because they recognize how important dental health is, many Medicare beneficiaries inquire about dental coverage.  This is the point at which you can begin the dental coverage discussion through a stand-alone supplemental (stand-alone) dental plan.  There are numerous options, as well as dental insurance providers. Each plan offers a variety of coverage options, such as exams, cleanings, fillings, and other dental operations. It is important for beneficiaries to understand that dental plans work well only when they receive dental treatment from in-network providers. As an agent, you must confirm that the dentist they are thinking about is covered under that particular dental plan.

 

Delta Dental

Pinnacle Financial offers several options for stand-alone dental insurance. One such option, Delta Dental, is well-known for its strong network and benefits. Delta is also available in all 50 states and covers a wide variety of preventative and major services.  This can be a great option for individuals who have a Medicare Supplement plan as they do not cover any dental insurance.

To learn more about the different plan options available to your clients, contact a Pinnacle Financial Services team member today. They can be reached at 800-772-6881 x-7731 or by email at healthsales@pfsinsurance.com.

For more information, contact a Pinnacle Financial Services representative today

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

Vice President- Marketing

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 Medicare Supplement Extra Services

Humana Medicare Supplement Extra Services

Humana Medicare Supplement Extra Services
j

Comments

Medicare Supplement plans provide are important for paying costs not covered by original Medicare Parts A and B. With a Humana Medicare Supplement with extra services Humana has gone one step further. This package of extra benefits is intended to improve members’ overall healthcare experiences in addition to covering the gaps left by Medicare as part of a traditional Medicare Supplement.

Let’s explore these additional services:

Discounts on services

• Vision Care: Members can save with providers in EyeMed’s Select network including LensCrafters®, Pearle Vision®, and Target Optical®.

• Prescription medicine: Discounts available on some medicines at the drugstore with a Humana member ID.

• Hearing aids and services: Discounts available through HearUSA and TruHearing®.

• Lifeline medical alert system: Members can choose from multiple fall detection service options from Lifeline® at discounted prices.

Managing health

  • Humana Well Dine®*: Members may get 14 nutritious meals delivered to their door after an overnight stay in a hospital or nursing facility. *Not available in Montana or North Dakota.
  • HumanaFirst® Nurse Advice Line: A 24-hour a day, seven days a week toll-free line where members can speak with a registered nurse about non-emergency illnesses or injuries.
  • SilverSneakers fitness program**: Basic fitness center membership at any participating SilverSneakers® facilities. Includes group classes and working with a trained adviser to develop an exercise plan. SilverSneakers Steps®, an at-home option, is also available. **SilverSneakers is not available with Humana Achieve Medicare Supplement plans.
  • MyHumana Mobile app and website: Access to Humana.com or our secure mobile app to view plan benefits, claims, and more.

The programs and services described are not insurance and are neither contractually offered nor guaranteed under Humana Medicare Supplement insurance policies. They may be provided by a third party, discontinued at any time and are subject to geographic availability.

Expert assistance is only a phone call away for agents who are interested in learning more about how Humana’s Medicare Supplement Extra Services can fit with their clients. To get more information, call 800-772-6881 x-7731 to speak with a Pinnacle Financial Medicare professional.

For more information, contact a Pinnacle Financial Services representative today

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

Vice President- Marketing

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

Molina | Matters

Molina | Matters

Molina | Matters

Comments

Spring for New Molina Medicare Marketing Collateral!

The Molina Healthcare Marketing Team is marking the arrival of springtime with an assortment of new Medicare collateral. Check out the examples

below and find even more here at the Molina Agent Center!

Sandwich boards

Retractable banners

Special occasion cards

Postcards

CBO flyers

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