Florida Blue | AEP Keeps Getting Better! Let’s Explore the Power of the PPO

Florida Blue | AEP Keeps Getting Better! Let’s Explore the Power of the PPO

Florida Blue | AEP Keeps Getting Better! Let’s Explore the Power of the PPO
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Hold on to your seats, Florida Blue Medicare’s PPO plan offering, the fastest-growing in the state over the past 2 years has gotten even more incredible! Buckle up, as we dive into the many plan highlights and benefits to share with our future Florida Blue Medicare members. Check out this great coverage!

Additional Information

We’ve got some exceptional benefits that our members sure adore, including a $0 premium LPPO, known as Value PPO, and our newly expanded MA Only Patriot PPO.

Value PPO & MA Only Patriot PPO Highlights

  • National Coverage extending to 48 states (excluding Wyoming and Alaska), Puerto Rico, and Hawaii.
  • Members can now reside outside of Florida for up to 12 months, doubling the normal Medicare rule of 6 months (maintaining official Florida residency with Social Security).
  • No prior authorization or referral needed to see a PCP or Specialist outside of Florida – just call 1(800) 810-BLUE or go to BCBS.com (in-state providers, visit floridablue.com).
  • MA Only Patriot PPO expansion into 24 new counties, in addition to our existing 17 counties.
    • Monthly Part B giveback increased from $50 to a whopping $75 per month (totaling $900 per year).
    • Veterans now have the flexibility to participate in a private network for local providers while still using their VA benefits for prescription drugs.

Dental Improvement Across all PPO Plan Offerings

  • Introducing a brand-new schedule of services with a jaw-dropping $0 Co-Pay.
  • Say goodbye to annual limits within the schedule of services, ensuring you get the care you need.
  • Enjoy an unbelievable 66% discount for additional services, giving you more bang for your buck compared to the average market rate.

Dental Plans

Plan 10

Plan 68

Product

Patriot PPO

Select PPO

Value PPO

Member Cost

$0

$0

PREVENTIVE

Exam

2 per calendar year

2 per calendar year

Cleaning

2 per calendar year

2 per calendar year

X-Ray

1 set per calendar year

1 set per calendar year

COMPREHENSIVE

Fluoride Treatment

2 per calendar year

Extraction

2 per calendar year

4 per calendar year
(simple and surgical)

Crown

1 per calendar year
(only in conjunction with a covered root canal procedure)

Filling

2 per calendar year

Root Canal

1 per calendar year

Denture

1 set per 60 months

Denture Adjustment

2 per calendar year

1 per calendar year

Denture Repair

2 per calendar year

Deep Cleaning / Root Planing

1 per quadrant per 24-month period

Full Mouth Debridement

1 per 36-month period

All preventive and comprehensive services are covered up to an annual allowance except:

  • Implants
  • Cosmetic dentistry (including orthodontia (braces and Invisalign)
  • Veneers
  • Teeth whitening

PPO National BlueCard Map

For your convenience, access our PPO National BlueCard Map to explore the extensive network.

Extra Resources

Need easy access to benefits on the go? Scan the QR Code and enter the login credentials below to gain access to our 2024 First Look Benefits. You can find each Broker Manager’s email and direct cell phone number. Click on any county in the map to see all the plans available within that area.

Helpful Phone Numbers and Links

Below is a list of helpful links and phone numbers for our Florida Blue value added benefit vendors.

Service

Vendor

Phone Number

At Home Care

Papa

888-941-393

Blue Rewards

Florida Blue

833-509-1546

Caregiver Support

Carallel

855-955-3010

Dental

Florida Blue

888-223-4892

Drug Lookup

Prime

877-794-3574

Drug Lookup (FHCP)

FHCP

386-676-7110

DSNP Eligibility

Florida Blue

866-780-4240

Fitness

Silver Sneakers

888-423-4632

Fitness (FHCP)

Preferred Fitness

386-676-7110

Food Card

Nations

833-509-1546

Hearing Aids

Nations

866-311-3617

Meals

ILS Meals

888-941-3933

Members Services

Florida Blue

800-926-6565

Nutrition

Florida Blue

800-955-5692

OTC

Nations

877-270-4569

Transportation

Modivcare

855-875-5194

Vision

Premier

866-434-0015

Need Help?

Reach out to your Broker Manager today.

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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Molina Matters

Molina Matters

Molina Matters
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New & Exciting

Important AEP Information

Health Risk Assessment (HRA) – IMPORTANT!

The HRA option is only available for new Molina Medicare enrollments.  At this time, we will accept only paper HRAs for 2024 enrollments.  You will find the fillable, multi-state HRA form on the Molina Agent Center in the 2024 Medicare HRA Toolkit.

This form may not currently be used for the CA DSNP, VA DSNP, or TX or MA plans. Upon completion, please upload, attach and send your paper HRAs to: molinabrokerHRA@MolinaHealthcare.com. Be sure to use the subject line Secure Broker Sales Medicare HRA.

New! MyChoice/Healthy You Card FAQ for Agents

is now available on the Molina Agent Center  under Broker Resources.

BSU Extended Weekend Hours through AEP

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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Lincoln Financial Group | Optiblend Fixed Index Annuity Rates are Increasing Effective 10/23/2023!

Lincoln Financial Group | Optiblend Fixed Index Annuity Rates are Increasing Effective 10/23/2023!

Lincoln Financial Group | Optiblend Fixed Index Annuity Rates are Increasing Effective 10/23/2023!
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Please see attached rate sheet for specifics but wanted to highlight the $100k or more OptiBlend 7 Opportunity!

  • 1YR S&P 500 Performance Trigger Rate increasing to 10.50%
  • Fixed Rate increasing to 5.75%

100% allocation 1 Year S&P500 Performance Triggered Index at current rate of 10.50% for 100k or more in the Optiblend 7.

  • If the S&P500 is negative 1 year out of 7 years = Average return 9.00%
  • If the S&P500 is negative 2 years out of 7 = Average return 7.50%
  • If the S&P500 is negative 3 years out of 7 = Average return 6.00%

What if a Client doesn’t want to see a 0% crediting? Consider a 50/50 allocation between the 1 Year S&P500 Performance Triggered Index at 10.50% and the Fixed Account Rate at 5.75%

  • In a policy year that the S&P500 is negative the total interest at current rates would be 2.875% because of the fixed rate crediting regardless of the S&P500 performance.
  • In a policy year that the S&P500 is positive the 1 Year S&P500 Performance Triggered Index and the Fixed Account rate would both credit for a blended return of 8.125%.
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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GTL’s HIP Elite Guaranteed Issue Now up to Age 70!

GTL’s HIP Elite Guaranteed Issue Now up to Age 70!

GTL’s HIP Elite Guaranteed Issue Now up to Age 70!
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Reach even more clients and write more Hospital Indemnity business this AEP with GTL’s NEWEST Guaranteed Issue ages!

Advantage Plus Elite and Indemnity Plus Elite’s Guaranteed Issue ages have just expanded AGAIN!

Guaranteed Issue ages are now 64½ up to age 70!

Why is GTL’s HIP Plan the best product on the market?

N

Robust base plan with short stay benefit payable starting at 6 hours, if hospitalized.

N

Affordable riders including ambulance, lump sum cancer & more.

N

Easy application with only 5 basic underwriting questions.

N

Simple e-App process & paper app submission!

Expanded Guaranteed Issue 64 ½ up to age 70 Current State Availability

Please contact Sales Support with any questions by texting or calling 800-323-6907 or by emailing agency@gtlic.com.

Indemnity Plus Limited Benefit Certificate, providing Hospital Confinement Indemnity Benefits, is issued on Form GC2150-IL & Rider GRG21ASB-IL, GRG15CLS-IL, GRG15CLSR-IL, GRG21OPS-IL, GRG21SNF-IL, GRG21SNF-EP-IL, GRG21CA-IL, GRG16DV, GRG21LSH-IL and GRG21OPT-IL by Guarantee Trust Life Insurance Company. This product, its features, and riders are subject to state availability and may vary by state. Certain exclusions and limitations may apply. For cost and complete details of coverage, please refer to the Certificate.

*Not available in all states. Up to age 70 is not available in Ohio and Utah does not have Guaranteed Issue.

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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Wellcare | VBE/HRA Process Remains In Place for 2024

Wellcare | VBE/HRA Process Remains In Place for 2024

Wellcare | VBE/HRA Process Remains In Place for 2024
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Health Risk Assessments (HRA) are a valuable tool for improving the overall health of our members. In addition to identifying health needs to ensure beneficiaries are receiving the right care at the right time, HRAs also play an important role in understanding the overall patient population with the goal of improving personalized and targeted care for all.

To expedite this important initiative, Wellcare is pleased to continue to provide the opportunity to earn administrative payment for the completion of each HRA.

  • No changes will be made in 2024 for the current administrative payment structure:
    • A $225 administrative payment is available for eligible D-SNP/C-SNP enrollments.
    • A $75 administrative payment is available for eligible MA/MAPD enrollments.
  • An HRA may be captured directly within Ascend and Sunfire after the enrollment is submitted, using the integrated tool.   

We also offer a standalone Value-Based Enrollment (VBE) link for submissions for each plan year.

2023 link: wellcareisf.io/2023/vbe/addmember 
2024 link: wellcare.isf.io/2024/vbe/addmember 

Note:
 Refer to the Ascend 2024 Integrated and Standalone Value Based Enrollment Training Guide for instructions when using the standalone link.

As always, thank you for your continued 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

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Contact a Pinnacle Financial Service representative today for assistance.

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