Broker Buzz

Why choose a Primary Care Clinic (PCC)

Clients have an opportunity to identify a Primary Care Clinic (PCC) during enrollment. This allows them to choose a clinic and see any provider at that clinic, rather than having to select a specific provider. Choosing a PCC doesn’t mean your client has to only use this clinic. They may also switch clinics at any time.

How UCare uses PCC information:

• UCare shares PCC designation numbers with clinics, so those clinics can staff according to expected visit volume

• Helping clinics set visit expectations is one way UCare maintains strong positive relationships with clinics in its networks—helping UCare attract 96% of providers in Minnesota.

PCC designations also help UCare predict member health care costs. UCare uses this information to keep its health plans competitively priced from premiums to copays to deductibles.

Pros of submitting enrollment online

The fastest way to submit an enrollment application is via the Broker portal.

Benefits:

• Easily track the application through the enrollment process

• Keeps all your records in one place in case of audits

• Allows you to send in the application within the 24 hour window

• No postage or trips to a post office necessary

You may, as the appointed broker, fill out an online application using the information from a completed paper enrollment form. As your client’s broker, you may sign the attestation on their behalf if they have signed and checked the attestation on the paper form.

If using the online Broker Portal enrollment tool isn’t viable, we recommend mailing completed applications via overnight mail. CMS does not allow brokers to email copies of an application to a carrier.

Access via the UCare Broker Portal

Enrollment Question 9: For Cost plan transitions or Open Enrollment Period (OEP)

The UCare Medicare enrollment application, Question 9, asks "Are you enrolled in a Medicare Advantage plan that is ending its Medicare contract or choosing to make a change during the MA Open Enrollment Period?"

If the answer is yes, fill in boxes with the last day of coverage your client will have with their old plan.

Examples:

• Enter 12/31/2019 when UCare coverage begins January 1
• Enter 01/31/2019 when UCare coverage begins February 1

Missing Medicare Beneficiary number

If your new-to-Medicare client has not yet received their Medicare Beneficiary Identifier (MBI) number, they can still enroll in a UCare Medicare plan without delay. On the UCare Medicare enrollment application, Step 4 asks for their Medicare number. Instead, enter their Social Security number. UCare enrollment specialists will be able to look up their MBI with CMS using the Social Security number.

Host a Medicare Meetup

Gain new clients and present UCare plans all in one event! When you host a UCare Medicare Meetup, we’ll provide direct mail and ad templates to help you invite your clients and prospects. Marti Andro, UCare Broker Sales Manager, will travel to your area to present information about UCare plan benefits. And you’ll get to share how your broker services will make all the difference in their Medicare shopping journey.

Email Marti to find out more

Understanding medical-only Medicare Advantage plans

Medical-only Medicare Advantage plans are wonderful options for Medicare shoppers who already have creditable prescription drug coverage through Veterans Affairs, Tricare, Tribal or similar. UCare Value is a great option for these individuals.

The problem

Sometimes there is confusion for Medicare shoppers who have a separate medical plan and a standalone prescription drug plan. They might believe they can keep their standalone Part D plan by enrolling in UCare’s medical-only UCare Value plan. This is not true. They will be automatically disenrolled in their standalone Part D plan and will have no Part D coverage, per CMS rules.

The penalty

CMS will apply a late enrollment penalty to anyone who goes 63 days or more without creditable Part D coverage before enrolling in Part D coverage.

The fix

Members should enroll in a Medicare Advantage plan with prescription drug coverage to avoid the CMS penalty. You can help your clients change their enrollment by December 31 for January 1 coverage. Additionally, during the Medicare Open Enrollment Period, you can help them switch their enrollment for coverage beginning the following month—but do it by February 28 so they won't be penalized.

UCare Value shoppers might find UCare Essentials Rx appealing as it is our most similar plan to UCare Value. This plan offers medical, prescription drug and preventive dental coverage.

UCare Medicare members

UCare Medicare covers the member anywhere they travel in the U.S when getting care from a provider who accepts Medicare:

• Pay in-network copay for primary, specialty, physical therapy office visits and more
• Use out-of-network benefits any time during the year
• Emergency coverage: Within the U.S., copay is waived if admitted within 24 hours to the hospital for the same condition. In-patient hospitalization copay applies.
• Ambulance (within the U.S. and territories): Air and ground covered if transport and level of service are medically necessary
• Covers up to 80% of many other services received in the U.S.

 

Traveling with our partner network plans

UCare Medicare with M Health Fairview and North Memorial

• Members can access quality online care for many common conditions for $0 through OnCare
• In general, out-of-network cost-sharing within the U.S. is 25%; cost-sharing is the same both in and out-of-network for some services. Members may visit any provider that accepts Medicare.
• Emergency coverage: Within the U.S., copay is waived if admitted within 24 hours to the hospital for the same condition. In-patient hospitalization copay applies.
• Ambulance (within the U.S. and territories): Air and ground covered if transport and level of service are medically necessary

EssentiaCare

• Members can access quality online care for many common conditions for $0 through Essentia My Health
• In general, out-of-network cost-sharing in the U.S. applies deductible, then coinsurance (Secure 25%, Grand 20%); cost-sharing is the same both in and out-of-network for some services. Members may visit any provider that accepts Medicare.
• Emergency coverage: Within the U.S., copay is waived if admitted within 24 hours to the hospital for the same condition. In-patient hospitalization copay applies.

Ambulance (within the U.S. and territories): Air and ground covered if transport and level of service are medically necessary

Healthy Savings

UCare members can save up to $200 in healthy groceries each month. This program is available to UCare Individual & Family, UCare state public program and UCare Medicare members.

Members can download the Healthy Savings app to their smartphone, or show a wallet card at the register. Savings and weekly specials will be pre-loaded to the member’s account, and applied when their app or barcode is scanned at the checkout. Members can see the weekly specials and participating brands on the Healthy Savings website.

Participating grocery chains include Cub, Coborn’s, Festival Foods, Hornbachers, Kowalski’s, Lund & Byerlys, Wal-Mart and even Minnesota farmer’s markets.

Medicare-only note: This program is considered a “value-added” service and CMS does not allow us to promote it prior to enrollment. UCare includes information about Healthy Savings in Medicare welcome packets.

See Healthy Savings details

Beginning on January 1, UCare Medicare members will be able to save on over-the-counter (OTC) items such as cough drops, first aid supplies, pain relief, sinus medication, and toothpaste at participating retailers.

Members will receive a Health Savings OTC Benefit card and welcome kit in the mail by January 2020. Each quarter, $25 will be added to their account balance. Members can use their OTC funds at participating stores such as Walmart and CVS or order items online. Any unused balance expires at the end of the quarter.

The OTC benefit is operated by Solutran, Inc., the same organization that offers the Healthy Savings grocery discount program. The Healthy Savings card will work for both the grocery savings and to pay for eligible OTC items at participating stores. If members already have a 2019 Healthy Savings card, they will receive a new card by January 2020 to allow them to use both programs.

You may share information about the OTC benefit prior to enrollment, but the Healthy Savings program is a value-add program and may not be promoted until after enrollment.

Available to UCare Medicare and UCare Medicare with M Health Fairview and North Memorial members. Not available to EssentiaCare members.

Healthy Savings OTC Welcome Booklet (PDF)

Healthy Savings OTC Full Catalog (PDF)

UCare has partnered with TruHearing® to offer comprehensive hearing care. After a free routine hearing exam, members can get up to two hearing aids per year with a $699 or $999 copay per aid. Many of the hearing aid models can be controlled with a smartphone app and even used as earbuds for phone calls, music and other audio.

To get started, the member calls TruHearing to speak with a hearing consultant. TruHearing will schedule the hearing exam and assist the member throughout the process.

Access TruHearing materials

• Log in to the Broker Portal
• Click on Tools & Resources
• Click on Broker Marketing Tools
• Click on TruHearing

Available to members of UCare Medicare and UCare Medicare with M Health Fairview and North Memorial. Not available to EssentiaCare members.

Commissions

Commissions are paid five times each year:

• January 31
• March 31
• July 31
• September 31
• December 31

Learn more about commissions

Verifying your client list

Thank you for partnering with UCare to ensure your clients have the best possible health care coverage for their needs. Your Broker Portal will display Medicare and effectuated Individual & Family enrollees in the Members section.

Next steps

Step 1: Identify

Download:

• Download your Members list from the Broker Portal
• Save this file as: DATEMedicare_BrokerName_BrokerNumber
• Compare your personal list of submitted applications against your Broker Portal Members list

Delete:

• Applications submitted less than 10 days ago (still processing)

Add/Correct:

• Add any missing applications to the Excel document
• Make sure records include:
  • Client name
  • Date of Birth
  • Medicare ID number (New Medicare Beneficiary Identifier (MBI) preferred over HICN) if applicable
  • Effective Date
  • Date of Submission
  • Type of error (Missing from portal, Incomplete – HICN, etc)

Step 2: Inform

Be mindful of PHI security requirements.

• Using secure email, send Marti Andro or Brian Eck the list of applications that need further investigation.
  • Use subject line: "DATEMedicare – Your Name – Your Broker ID."
  • If you do not have access to a secure email, please fax the report to 612-884-2130 with the subject line "DATEMedicare – Your Name – Your Broker ID."

UCare will resolve any errors and correctly enroll your clients, and attribute your broker ID to your clients. UCare will report the results of the investigation and corrections to you, and you will see the member correctly displayed on the Broker Portal.

Medicare member survey will measure perceptions of health care quality

In mid-March, many of your Medicare clients will be invited to rate their experience with their health care insurer and doctors. The 2019 Medicare Experience survey is also informally known as the CAHPS survey (Consumer Assessment of Healthcare Providers and Systems). The goal is to help improve health care services and quality of care.

Your clients will receive a postcard, survey taking tips and automated phone calls from UCare next week to let them know the survey is arriving soon. The 2019 Medicare Experience surveys will arrive in the mail beginning mid-March and will be accepted through June 1. The survey company DSS logo and CMS logo will appear on the envelope.

Sometimes members have concerns or questions about the survey. Members are randomly selected by CMS to participate and their responses are completely anonymous. CMS uses the data to provide feedback to health insurers such as UCare so that we can both learn what we are doing well and where we need to improve. Please encourage your clients to take the survey.