Special Enrollment Period for PACE and PACENET Members

PACE and PACENET offer low-cost prescription assistance for older adults, age 65 and older, who qualify. Members enrolled in either of these programs may choose a SEP once per year, any time during the year, to join a Medicare Advantage plan or Part-D plan for the first time or to change to another Medicare Advantage plan or Part-D plan. However, if a member is automatically enrolled in a Part-D plan by their State Pharmaceutical Assistance Program, they will not have this SEP option.

In case you missed it: effective January 1, 2019, the Commonwealth of Pennsylvania is paying the late enrollment penalty (LEP) in full for members in either of these programs; see additional info below:

PACE:

The Commonwealth will pay a maximum of $37.03 for a member’s Part-D premium and full Part-D LEP for non-low-income subsidy (LIS) individuals.
Individuals that qualify for LIS will receive a subsidy of no more than $37.03 benchmark amount and no Part-D LEP.

PACENET:

The Commonwealth will pay full Part-D LEP only for non-LIS individuals.
The Commonwealth will not pay towards any PACENET premiums in 2019.

Special Enrollment Periods (SEP) permit changes to a Medicare Advantage Plan or Medicare prescription drug plan coverage outside of the regular enrollment periods when certain life events occur. Common examples of these events are:

Relocation
Loss of employer coverage
Loss of dual eligibility status
PACE/PACENET/LIS

May is National Stroke Awareness Month

Strokes are a leading cause of adult long-term disability, and the fifth leading cause of death. In observance of Stroke Awareness Month, we recommend familiarizing yourself with stroke risk factors and symptoms. The acronym FAST is an easy way to identify the most common symptoms of a stroke; see below:

F-FACE: Ask the person to smile. Does one side of their face droop?
A-Arms: Ask the person to raise both arms. Does one arm drift downward?
S-Speech: Ask the person to repeat a simple sentence. Is their speech slurred?
T-Time: If you observe any of these signs, call 9-1-1 immediately.

Did You Know?

Allegheny General Hospital, part of the Allegheny Health Network, was one of the first medical centers in the country and the first in western Pennsylvania to be designated as an Advanced Comprehensive Stroke Center by the Joint Commission.

Additional Reminders:

Changes to our Enrollment Kits

We have made some changes to the contents of our enrollment kits. The kits will now contain the top 100 list of drugs! To view this list, click here. Please note that this list will be updated for AEP.

Plan benefit comparison guides, network sharing brochures, and formularies will no longer be a part of the enrollment kits. These items will be available for order on ShopPRO in the Plan Information section by May 13.

Follow the steps below to view a formulary online:

1. Visit Medicare.Highmark.com.
2. Click "Find a Prescription Drug" in the Quick Links section on the right, and enter ZIP Code.
3. Locate plan on the following page.

Highmark Coffee & Chats

Have you met with your local Highmark Medicare Broker Representative yet? Representatives will continue to be available to meet with you over coffee this month. We would love for you to stop by and say hi! Highmark materials including client giveaways, sales kits, and marketing collateral will be available for you.

To view May dates, click here. Once you arrive onsite, look for your representative in a Highmark shirt.

This email was sent from the Highmark Senior Markets Sales team. If you have questions, please contact our Broker Services Team at highmarkseniormarkets@highmark.com or call (800) 652-9459.