AmeriHealth Caritas VIP Care Newsletter

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Plan Updates

February, 2021

Medicare Advantage Open Enrollment Period

Starting January 1, 2021, we are now in the Medicare Advantage Open Enrollment Period (MA-OEP) and Special Election Period for Dual Eligible (SEP-L).

· Medicare Advantage Open Enrollment Period (MA OEP) is one of the six types of Election periods during which an individual may make an enrollment election.

· During the MA-OEP, MA plan enrollees may enroll in another MA plan, enroll in an MA-PD, or disenroll from their MA plan and return to Original Medicare.

· During the MA OEP, MA-PD enrollees may enroll in another MA-PD plan, enroll in a MA – only plan, or disenroll from their MA-PD and return to Original Medicare.

· Individuals enrolled in a Stand Alone Prescription Drug Plan (PDP) do not qualify for an MA OEP election. Stand Alone PDP plans start with an “S”

· Individuals may make only one election during the MA OEP.

· The effective date for an MA OEP election is the first of the month following receipt of the enrollment or disenrollment request.

· Because the MA-OEP is higher on the CMS hierarchy of enrollments, we would use the election for qualifying individuals prior to using SEP-L.

· Individuals must submit their enrollment or disenrollment request between January 1 – March 31^st.

Individuals must be actively enrolled in an MA or MA-PD plan on or before January 1^st.

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Plan Information

Eligibility Verification Process

Please always verify prospect’s Medicaid and Medicare eligibility before you submit the application by calling our Broker Support at 1-855-241-3647 to avoid the application to be denied.

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2021 OTC Catalog

We are mailing 2021 OTC catalog to our existing members. For new members, the catalog should be including in their welcome kits. If your clients have not received the catalog, they can call our Member Services at 1-800-450-1166 (TTY 711), seven days a week, 8 a.m. to 8 p.m. to order the catalog over the phone.

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COVID-19 pandemic contingency plan

Telephonic Enrollment Process

Keystone First VIP Choice have implemented a temporary telephonic enrollment process for our agents to support their production during COVID-19 pandemic:

1. Complete presentation over the phone.

2. Check if prospect’s providers are in network and medications covered by the plan using the plan website online directory. Make sure the information is noted in Customer Relationship Management (CRM) system.

3. Check the prospect’s Medicaid and Medicare eligibility by calling Broker Support at 1-855-241-3647. They can also assist with step 2.

Call our telephonic enrollment support line (1-877-703-9102) with the prospect to complete enrollment over the phone. Agents can also transfer to the enrollment line after the eligibility verification call.

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		Please be safe and take all precautionary measures recommended by the Centers for Disease Control and Prevention.

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AmeriHealth Caritas VIP Care (HMO-SNP) is a Medicare Advantage special needs plan for individuals enrolled in Medicare and Medicaid (dual eligibles) who live in one of the 62 counties in Pennsylvania (Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bradford, Butler, Cambria, Cameron, Carbon, Centre, Clarion, Clearfield, Clinton, Columbia, Crawford, Cumberland, Dauphin, Elk, Erie, Fayette, Forest, Franklin, Fulton, Greene, Huntingdon, Indiana, Jefferson, Juniata, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, McKean, Mercer, Mifflin, Monroe, Montour, Northampton, Northumberland, Perry, Pike, Potter, Schuylkill, Snyder, Somerset, Sullivan, Susquehanna, Tioga, Union, Venango, Warren, Washington, Wayne, Westmoreland, Wyoming, and York).

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