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Fraud Alert: COVID-19 Scams

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 02:23 PM

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Tags: Medicare Advantage, Medicare, Medicare Supplement, COVID-19

Over 1 Million MA Enrollees Are in Plans Offering New Benefits for the Chronically Ill in 2020

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 02:02 PM

Over 1 Million MA Enrollees Are in Plans Offering New Benefits for the Chronically Ill

Over 1 Million MA Enrollees Are in Plans Offering New Benefits for the Chronically Ill in 2020

Summary

Medicare Advantage plans are using new flexibilities to provide additional supplemental benefits to beneficiaries with chronic illnesses.

New analysis from Avalere finds that in 2020 239 MA plans offered by 23 parent organizations are providing special supplemental benefits for the chronically ill (SSBCI). Those plans represent 6% of all non-employer group waiver plans (EGWPs). More than half (56%) of the total Medicare beneficiary population lives in counties with at least 1 MA plan that offers at least 1 type of SSBCI.

Background

Supplemental benefits are additional services offered by MA plans that are not covered under Medicare Part A, Part B, or Part D. Until 2020, the CMS required that supplemental benefits be “primarily health-related,” meaning they needed to be intended to “diagnose, prevent, or treat an illness or injury, compensate for physical impairments, act to ameliorate the functional/psychological impact of injuries or health conditions, or reduce avoidable emergency and healthcare utilization” (see Avalere’s analysis of primarily health-related supplemental benefit offerings for 2020, including vision, dental, and hearing benefits).

Starting in 2020, the CHRONIC Care Act of 2018 permits plans to also target non-primarily health-related supplemental benefits to beneficiaries with chronic illnesses. By allowing SSBCI, policymakers are giving MA plans more flexibility to address social and environmental factors that may impact beneficiary health.

2020 SSBCI Plan Offerings

Among the plans offering SSBCI, the most commonly offered benefits are pest control (49% of plans), food and produce (41%), and transportation for non-medical needs (35%). While plans may choose to offer SSBCI other than the 10 benefits specifically outlined by CMS (see Table 1), few plans are doing so in 2020. The only SSBCI outside of these specified categories is a service dog support benefit, offered by 51 plans from the same parent organization.

Enrollment in Plans Offering SSBCI

While only a relatively small percent of plans are offering SSBCI for 2020, more may consider providing these services in future years as they gain more insight into the impact on beneficiary health outcomes, cost, and plan selection. Notably, 11% of special needs plan (SNP) enrollees—compared to 5% of non-SNP enrollees—are in plans that offer SSBCI (not including beneficiaries enrolled in EGWPs). As plans gain more experience with these benefits, those with a higher proportion of chronically ill beneficiaries may be faster to adopt these new benefits as a strategy to better manage care and impact social determinants of health.

CMS Proposes to Expand Eligibility for SSBCI for 2021

The list of chronic conditions CMS is currently using to define which enrollees may receive SSBCI is the same list of conditions CMS uses to determine if an enrollee is eligible to enroll in a chronic care special needs plan. Starting in 2021, however, CMS is proposing to allow MA plans to offer SSBCI to beneficiaries who do not have one of these conditions, provided they have a chronic condition that is life threatening or significantly limits their overall health or function. As plans consider expanding their provision of SSBCI, they will need to evaluate which populations could most benefit from services that address social needs.

Methodology

Avalere analyzed CMS’s Q2 2020 Plan Benefit Package files and the February 2020 Public Use enrollment file. The assessment of SSBCI reflects all MA plans with enrollment of at least 11, regardless of a plan type, in all 50 states and the territories.

Source: https://avalere.com/insights/over-1-million-ma-enrollees-are-in-plans-offering-new-benefits-for-the-chronically-ill-in-2020

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Tags: Medicare Advantage, DSNP

While the challenges are great, so are the opportunities

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 01:53 PM

While the challenges are great, so are the opportunities

While the challenges are great, so are the opportunities

The current times that we are all facing have brought each of us to realize how precious our families, our friends, our communities and, most importantly, our health is. At this time we have come to a realization that in the next few weeks we will be challenged to keep productive and prosperous. With that in mind, the present situation provides each of us an opportunity to focus on several items that we may have taken for granted in the past. Take some time to think about these alternatives:

Reassure your clients - For each and every one of your fixed annuity clients, take the opportunity to call them and give them some peace of mind knowing that their fixed annuities are protected from the current market volatility.

Focus on training - If you need to complete any type of continuing education or product certification, do not delay in taking the time to complete that during the present.

Expand your future opportunities - If you have considered obtaining a new license or designation, now is the perfect time to study and prepare yourself for that growth. Not only will the license or designation be useful to your production, but it also allows you to become more holistic in your services.

Invest in yourself - Take some time to work on what you do best, which is finding solutions for the problems that your clients face. Sales training can help with productivity and positivity. During these times, we all need positive influences, so take it upon yourself to improve.

Related:

For agent use only, not for use with consumers. Not affiliated with the United States government or the federal Medicare program. B03242006

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Tags: Sales Strategies, cross selling, online sales, COVID-19, Remote Sales, sales ideas

Mutual of Omaha: Med Supp Broker Bonus Program - 2020 - Q2

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 01:46 PM

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Tags: Mutual of Omaha Medicare Supplement, Bonus Program

Alternate Sales Ideas For Agents

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 01:26 PM

Alternate Sales Ideas For Agents

Agents, we are in unprecedented and uncertain times. Many of your clients are feeling unsafe and insecure. Now is a great time to reach out to them to answer questions and provide them with some alternate sales ideas they can use to preserve their assets and settle their worries during these trying times.

Your most valuable assets are the alternate insurance options and policy evaluations that you can provide for your clients at this time. As always - please use our expansive network of carrier partners as a resource for yourself and your client. You, the agent (along with our assistance on the backend) are here to help navigate your clients through these difficult times and provide added value where you can.

Short-term Care - If clients do not have coverage, or loses coverage because they lost their jobs, they can potentially get coverage for 3,6,12 months. If they haven’t tested positive for Covid19, it should be a covered expense if contracted after coverage starts.
Policy Loans - Many clients with a life insurance policy may have significant value secured in their policy if it is needed during this time of financial crisis. As an agent, you can work with your marketer and review specific carriers to dissect policy loan details and see what options your clients may have if they need the assistance. You can help guide those clients through the process to receiving that assistance.
Late Premium Payments - Many of the carriers will be making provisions regarding late premium payments for clients affected by COVID-19. Your marketer is constantly getting updated information from the carriers and can help you find the best options available for your clients.
Policy Conversions - There are currently no restrictions on converting a term insurance policy into another more permanent coverage type. If you have a client interested in exploring this option, contact your marketer. They can run illustrations to assist with finding the best options available.
Accelerated Underwriting and Simplified Issue - Many carriers offer accelerated underwriting and simplified issue for their products to help your clients get fast coverage. This is a great option as some clients may not want to be visited by a paramedic and/or yourself at the current time, many of these transactions can be done telephonically and by email.
Travel Restrictions - Many carriers may have travel restrictions in place, particularly on new applications for foreign national coverage. If you have a client that has concerns about this, your marketer can review specific carriers your client have coverage with, to dissect policy restrictions to see what options are available to them, if they need to travel.
New Policy Applications - As of today, there are no carriers – that we are aware of – that are not accepting applications. This information may change, but rest assured, your marketer gets updated information daily from the carriers and will be happy to research any concerns you and your clients have.
Positive COVID -19 Tests - Let us help you navigate how the carriers are evaluating and handling new, prospective clients who test positive for COVID-19 and any effects this may have on getting or keeping their coverage.

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For agent use only, not for use with consumers. Not affiliated with the United States government or the federal Medicare program. B03232007

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Tags: Sales Strategies, cross selling, online sales, COVID-19, Remote Sales, sales ideas

Update on Humana's Agent Technology Tools

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 01:03 PM

In these unique times, Humana has provided guidance to their agents to avoid face-to-face meetings and appointments with our consumers. Last week, we sent a communication outlining our request to reduce paper applications. Today we want to reiterate that Humana has an approved telephonic sales presentation process and electronic tools that will enable you to continue to sell and service consumers, which will further reduce our reliance on paper.

For career and field-based external partners, you should be leveraging Enrollment Hub now more than ever! This tool offers streamlined enrollment applications that allow electronic signatures, so the need to meet face-to-face can be alleviated, and links to Med Supp and IDV are also available within this tool.
Agents can also leverage Direct Marketing Materials (DMM) for Medicare and Agent Online Application (AOA) for Medicare and IDV applications when working virtually.
We also want to take this opportunity to remind you of the important steps you must follow to conduct a compliant telephonic sales presentation. Click here to learn more.
For English speaking consumers that do not have email addresses or want to enroll in a CarePlus plan, agents may now leverage IVR signature within FastApp.
- On Step 8 of the application, career agents should select Affinity ID “Field Agent IVR” and that will offer the correct signature types. External Agents should select the Affinity Code based on the partner you are aligned with. If your agency is not listed, please select “Field Agent IVR”
- Agents should elect to be notified about abandoned or successful IVRs via the checkbox under Agent Email Address. You can also look for these applications in VANTAGE Business Center 24-72 hours after submission.
- Job Aid with More Details: FastAPP IVR Process for Career and Partner Agents
Beginning at 9am EST on 3/24/20, for Spanish speaking consumers, please leverage the assisted telephonic signature (T-sig) process via Direct Marketing Services (DMS). The field agent will complete the electronic application, save it, and then call DMS to do the telephonic signature. Below are the steps that will take place:
- Field agent makes sales presentation over the phone.
- If consumer consents to enroll, field agent fills out the application in FastApp through the link in Vantage, and then saves it.
- Field agent will call & conference with DMS via 1-800-833-6573 with the enrollee on the line. THIS NUMBER IS ONLY TO BE USED FOR SPANISH ENROLLEES.
- Once all three parties are on the line (field agent, DMS agent and the enrollee), DMS will complete the signature using T-sig, and drop from the call. The field agent will then complete the call.
- Compliance Reminder! Agents may not coach the enrollee through the T-sig process by telling them to "just say yes to everything", for example.

Humana is here for you! Please reach out to ASU at 800-309-3163 or your local Broker Relationship Manager if you have any questions or concerns.

Want to learn more about Telephonic Presentations, Digital Marketing Materials, Caring for your Book of Business, Enrollment HUB, or other helpful topics? Go to Humana MarketPoint University and click the Upcoming Events tile to register for a webinar!

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Tags: Humana, COVID-19

FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 12:33 PM

FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

More than 60 million people ages 65 and older and younger adults with long-term disabilities are covered by Medicare. Due to their older age and higher likelihood of having serious medical conditions than younger adults, virtually all Medicare beneficiaries are at greater risk of becoming seriously ill if they are infected with the new coronavirus that causes COVID-19. COVID-19 is an infectious respiratory disease, which currently has no vaccine or cure. Diagnosis of COVID-19 is confirmed through testing, and treatment varies based on the severity of illness.

These FAQs review current policies for Medicare coverage and costs associated with testing and treatment for COVID-19, including changes adopted in three recent bills: the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, enacted on March 6, 2020 (Public Law 116-123); the Families First Coronavirus Response Act, enacted on March 18, 2020 (Public Law 116-127); and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020 (Public Law 116-136).

Does Medicare cover testing for COVID-19?

Yes, testing for COVID-19 is covered under Medicare Part B when it is ordered by a doctor or another health care provider that accepts Medicare, and if the test was ordered after February 4, 2020. Medicare Advantage plans are required to cover all Medicare Part A and Part B services, including COVID-19 testing.

How much do Medicare beneficiaries pay for COVID-19 testing?

Medicare beneficiaries who get tested for COVID-19 are not required to pay the Part B deductible or any coinsurance for this test, because clinical diagnostic laboratory tests are covered under traditional Medicare at no cost sharing. (Under traditional Medicare, beneficiaries typically face a $198 deductible for Part B services and coinsurance of 20 percent.) A provision in the Families First Coronavirus Response Act also eliminates beneficiary cost sharing for COVID-19 testing-related services, including the associated physician visit or other outpatient visit (such as hospital observation, E-visit, or emergency department services). A testing-related service is a medical visit furnished during the emergency period that results in ordering or administering the test. The law also eliminates cost sharing for Medicare Advantage enrollees for both the COVID-19 test and testing-related services, and prohibits the use of prior authorization or other utilization management requirements for these services.

Does Medicare cover treatment for COVID-19?

Currently there is no known treatment for COVID-19 beyond treating the symptoms of the disease. Patients who get seriously ill from the virus may need a variety of inpatient and outpatient services. Medicare covers inpatient hospital stays, skilled nursing facility (SNF) stays, some home health visits, and hospice care under Part A, and outpatient services, including physician visits, emergency ambulance transportation, and emergency room visits, under Part B. If an inpatient hospitalization is required for treatment of COVID-19, this treatment will be covered for Medicare beneficiaries, including beneficiaries in traditional Medicare and those in Medicare Advantage plans. Beneficiaries who need post-acute care following a hospitalization have coverage of SNF stays, but Medicare does not cover long-term services and supports, such as extended stays in a nursing home.

How much do Medicare beneficiaries pay for COVID-19 treatment?

Beneficiaries who are admitted to a hospital for treatment would be subject to the Medicare Part A deductible of $1,408 per benefit period in 2020. Part A also requires daily copayments for extended inpatient hospital and SNF stays. For extended hospital stays, beneficiaries would pay a $352 copayment per day (days 61-90) and $704 per day for lifetime reserve days. If a patient is required to be quarantined in the hospital, even if they no longer meet the need for acute inpatient care and would otherwise by discharged, they would not be required to pay an additional deductible for quarantine in a hospital. Traditional Medicare beneficiaries who need post-acute care following a hospitalization would face copayments of $176 per day for extended days in a SNF (days 21-100). For COVID-19 treatment-related outpatient services covered under Part B, there is a $198 deductible in 2020 and 20 percent coinsurance that applies to most services, including physician visits and emergency ambulance transportation.

While most traditional Medicare beneficiaries (81% in 2016) have supplemental coverage (such as Medigap, retiree health benefits, or Medicaid) that covers some or all of their cost-sharing requirements, more than 6 million beneficiaries lacked supplemental coverage in 2016, which places them at greater risk of incurring high medical expenses or foregoing medical care due to costs. Medicare does not have an out-of-pocket limit for services covered under Medicare Parts A and B.

Cost-sharing requirements for beneficiaries in Medicare Advantage plans vary across plans. Medicare Advantage plans often charge daily copayments for inpatient hospital stays, emergency room services, and ambulance transportation. Medicare Advantage enrollees can be expected to face varying costs for a hospital stay depending on the length of stay and their plan’s cost-sharing amounts. According to CMS guidance, Medicare Advantage plans may waive or reduce cost sharing for COVID-19-related treatments, and some companies have announced that they plan to do so, but this is not required. Plans may also waive prior authorization requirements that would apply to services related to COVID-19.

If a vaccine is approved for COVID-19, would it be covered by Medicare?

Medicare Part B covers certain preventive vaccines (influenza, pneumococcal, and Hepatitis B), and these vaccines are not subject to Part B coinsurance and the deductible. Medicare Part B also covers vaccines related to medically necessary treatment. For traditional Medicare beneficiaries who need these medically necessary vaccines, the Part B deductible and 20 percent coinsurance would apply. Based on a provision in the CARES Act, if a vaccine becomes available for COVID-19, Medicare is required to cover this vaccine under Part B with no cost sharing for Medicare beneficiaries for the vaccine or its administration; this applies to beneficiaries in both traditional Medicare and Medicare Advantage plans.

What telehealth benefits are covered by Medicare, and how much do beneficiaries pay?

Based on new waiver authority included in the Coronavirus Preparedness and Response Supplemental Appropriations Act (and as amended by the CARES Act) the HHS Secretary has waived certain restrictions on Medicare coverage of telehealth services for traditional Medicare beneficiaries during the coronavirus public health emergency. The waiver, effective for services starting on March 6, 2020, allows beneficiaries in any geographic area to receive telehealth services; allows beneficiaries to remain in their homes for telehealth visits reimbursed by Medicare; allows telehealth visits to be delivered via smartphone with real-time audio/video interactive capabilities in lieu of other equipment; and removes the requirement that providers of telehealth services have treated the beneficiary receiving these services in the last three years. A separate provision in the CARES Act allows federally qualified health centers and rural health clinics to provide telehealth services to Medicare beneficiaries during the COVID-19 emergency period. Telehealth services are not limited to COVID-19 related services, and can include regular office visits, mental health counseling, and preventive health screenings.

Traditional Medicare also covers brief, “virtual check-ins” via telephone or captured video image, and E-visits, for all beneficiaries, regardless of whether they reside in a rural area. These visits are more limited in scope than a full telehealth visit, and there is no originating site requirement. Medicare covers all types of telehealth services under Part B, so beneficiaries in traditional Medicare who use these benefits are subject to the Part B deductible of $198 in 2020 and 20 percent coinsurance. However, the HHS Office of Inspector General is providing flexibility for providers to reduce or waive cost sharing for telehealth visits during the COVID-19 public health emergency.

Medicare Advantage plans are able to offer additional telehealth benefits not covered by traditional Medicare, including telehealth visits for beneficiaries provided to enrollees in their own homes, and services provided outside of rural areas. Medicare Advantage plans have flexibility to waive certain requirements with regard to coverage and cost sharing in cases of disaster or emergency, such as the COVID-19 outbreak. In response to the coronavirus pandemic, CMS has advised plans that they may waive or reduce cost sharing for telehealth services, as long as plans do this uniformly for all similarly situated enrollees.

Can Medicare beneficiaries get extended supplies of medication?

The Department of Homeland Security recommends that, in advance of a pandemic, people ensure they have a continuous supply of regular prescription drugs. In light of the coronavirus pandemic, a provision in the CARES Act requires Part D plans (both stand-alone drug plans and Medicare Advantage drug plans) to provide up to a 90-day (3 month) supply of covered Part D drugs to enrollees who request it. (Typically Medicare Part D plans place limits on the amount of medication people can receive at one time and the frequency with which patients can refill their medications.)

According to CMS, for drugs covered under Part B, Medicare and its contractors make decisions locally and on a case-by-case basis as to whether to provide and pay for a greater-than-30 day supply of drugs.

What happens if Medicare beneficiaries in private plans need to receive care from out-of-network providers?

Plans that provide Medicare-covered benefits to Medicare beneficiaries, including stand-alone prescription drug plans and Medicare Advantage plans, typically have provider networks and limit the ability of enrollees to receive Medicare-covered services from out-of-network providers, or charge enrollees more when they receive services from out-of-network providers or pharmacies. In light of the declaration of a public health emergency in response to the coronavirus pandemic, certain special requirements with regard to out-of-network services are in place. During the period of the declared emergency, Medicare Advantage plans are required to cover services at out-of-network facilities that participate in Medicare, and charge enrollees who are affected by the emergency and who receive care at out-of-network facilities no more than they would face if they had received care at an in-network facility.

Part D plan sponsors are also required to ensure that their enrollees have adequate access to covered Part D drugs at out-of-network pharmacies when enrollees cannot reasonably be expected to use in-network pharmacies. Part D plans may also relax restrictions they may have in place with regard to various methods of delivery, such as mail or home delivery, to ensure access to needed medications for enrollees who may be unable to get to a retail pharmacy.

Are there any special rules for Medicare coverage for skilled nursing facility or nursing home residents related to COVID-19?

In response to the national emergency declaration related to the coronavirus pandemic, CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) for those Medicare beneficiaries who need to be transferred as a result of the effect of a disaster or emergency. For beneficiaries who may have recently exhausted their SNF benefits, the waiver from CMS authorizes renewed SNF coverage without first having to start a new benefit period.

Nursing home residents who have Medicare coverage and who need inpatient hospital care, or other Part A, B, or D covered services related to testing and treatment of coronavirus disease, are entitled to those benefits in the same manner that community residents with Medicare are.

Medicare establishes quality and safety standards for nursing facilities with Medicare beds, and has issued guidance related to infection control and prevention for COVID-19 to limit the exposure of nursing home staff and patients. This guidance directs nursing homes to restrict visitation by all visitors and non-essential health care personnel (except in compassionate care situations such as end-of-life), cancel communal dining and other group activities, and actively screen residents and staff for symptoms of COVID-19. These new rules do not apply to assisted living facilities, which are regulated by states.

Source: https://www.kff.org/medicare/issue-brief/faqs-on-medicare-coverage-and-costs-related-to-covid-19-testing-and-treatment/

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Tags: Medicare, COVID-19

Medico: COVID-19 Tools and Helpful Resources

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 12:22 PM

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Tags: phone sales, COVID-19, Medico, Remote Sales

Aetna: COVID-19 updates | Member resources | Tools you can use

Posted by www.psmbrokerage.com Admin on Tue, Mar 31, 2020 @ 12:08 PM

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Tags: aetna, COVID-19

How This Crisis Will Change You

Posted by www.psmbrokerage.com Admin on Wed, Mar 25, 2020 @ 07:41 PM

How This Crisis Will Change You

More Committed

Great article by Anthony Iannarino from thesalesblog.

We are in the middle chapters of our continuing crisis. Pundits and prognosticators are suggesting that our lives will never be the same, that we will be changed, altered by the events of our time, as were our parents, grandparents, and our ancestors. If this is true, then we should decide for ourselves what those changes might be.

More Grateful

If you are going to be changed by this crisis, the right place to start is by being more grateful, especially for the things we take for granted. Losing something often causes one to be more thankful for what was lost.

You might be grateful for the freedom to go where you want to go when you want to without restrictions. Until you are deprived of that freedom, it’s easy to take that freedom for granted. You might also be grateful for the unbelievable options available to you for eating, entertainment, and things you buy.

You might not have been grateful for your job, your clients, or your work family until events beyond your control disrupt those things. You may even be thankful for the grouchy guy that works in your IT Department.

The ability to gather in small and large groups, to hug people when you see them instead of bumping elbows, the ability to sit next to someone, or fly across the country or the world are all worth your gratitude.

Better Health

There are dozens of conspiracy theories about this virus, something that the human mind conjures up when it tries to explain something it doesn’t understand by creating a narrative to make sense of things it doesn’t understand or refuses to believe. The best conspiracy theory I have found is that this was a plot to get us to wash our hands. I guess that while we are dealing with a new virus, the old ones will be significantly reduced.

If you are going to be changed by the events of 2020, after gratitude, there is no better place to start than your physical, psychological, and emotional health. The importance of things like sleep and recovery, hydration, exercise, and diet are all critical to health and well-being, including your immune system. It’s also crucial to take measures to reduce your stress level, whether that be through contemplative prayer, meditation, yoga, journaling, sitting in a hot bath, or simply taking a nap and resetting yourself. The Dali Lama has suggested that the best mediation is sleep.

Crisis and disruptive events can take a toll on you emotionally.

Deeper Relationships

The essential things in life are not things. They are not a “what’s,” but instead, they are “who’s.” While you might miss your car, your house, your first edition, signed copy of some book you treasured, none of these things will come before your people, your relationships.

Many of us are calling the people we love and care about to make sure that they are okay. Some of us are delivering things to the people in our lives who are not able to acquire the things they need or take care of themselves. When we are worried and concerned, we recognize what’s most important, taking actions we wouldn’t take under different circumstances.

Allow this event to change you positively by reminding you of what is important in your life. Let it cause you to continue to value your relationships and increase the time you spend with the people that matter most and to ensure that they feel they are what you truly appreciate.

More Prepared

In 2001, two buildings fell in New York City. In 2008 and 2009, we experienced the second deepest recession in our short history. Now, in 2020, we face a health crisis to match the intensity and destruction of these events, which seem to show up every decade or so, following a period where things are good and stable.

Experiencing these events can prepare you for the next disruption or crisis. Navigating through a crisis is how you learn to find your way when there is no playbook, and when there are more unknowns than knowns. Part of the experience is learning to live with the unknowns, something that makes it is easier to accept when faced with similar challenges. The other part of the experience is making decisions, right or wrong, and learning what works and what doesn’t.

The greatest of human attributes, the linchpin of all character traits, is resourcefulness, our creativity as applied to our problems, challenges, and obstacles, our ingenuity.

If there is a trait you find in all human beings, except for those plagued by learned helplessness, it is the ability to discover and create solutions to intractable problems. I’m referring to problems like polio, measles, mumps, smallpox, traveling through space, feeding a growing population with fewer resources, and miniaturizing supercomputers to fit in your pocket allowing you to have a television, movie theater, radio, video camera, calendar, communication hub, conference calls, email, books, newspapers, notebooks, habit trackers, and a zillion other apps. All of which is to say, “We’ve got this.”

The lessons you learn now will prepare you for the next crisis, even if only preparing you to operate in a world of unknowns.

More Committed

Your goals and dreams might not have been getting the time and the energy they deserved. You might have written them down at the end of last year, only to allow them to sit collecting dust, making little or no progress on what you profess to want. Let this be a time you increase your commitment to your goals and dreams.

A positive change from a disruptive event like the one we are experiencing now is to finally take action on your goals and dreams, giving them priority over other things, including your excuses, your distractions, and procrastination. There is magic in goals so big they scare you and even more magic in doing the work that brings them life.

You can be reborn in times of turmoil and tumult. You can decide to be changed by being more, doing more, having more, and contributing more in the face of the disruption. It’s an act of defiance to live a life of your choosing and your design under ordinary circumstances, and it’s a revolution to do so in a crisis.

If you are going to be changed by this crisis, be intentional about that change and allow it to make you stronger.

Source: https://thesalesblog.com/2020/03/23/how-this-crisis-will-change-you/

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Tags: Medicare Advantage, Medicare, Medicare Supplement, Medicare Part D, COVID-19

Foresters Opportunity: Meet your clients by phone or video

Posted by www.psmbrokerage.com Admin on Thu, Mar 19, 2020 @ 03:46 PM

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Tags: Foresters

CMS Guidance and Waivers for MA and Part D Plans Response to COVID-19

Posted by www.psmbrokerage.com Admin on Thu, Mar 19, 2020 @ 03:27 PM

CMS Guidance and Waivers for MA and Part D Plans Response to COVID-19

CMS Guidance and Waivers for MA and Part D Plans Response to COVID-19

Over the past week, the Centers for Medicare & Medicaid Services (CMS) has made a number of announcements related to Medicare coverage in connection with the Coronavirus (COVID-19) outbreak. Several of those announcements have been specific to Medicare Advantage and Part D.

IN DEPTH

Medicare Advantage Organizations

Regulations Disasters and Emergencies. Pursuant to 42 CFR § 422.100(m), “special requirements” go into effect for Part A/B and supplemental Part C benefit access during disasters and emergencies, including state declarations of emergency and a presidential declaration under the Stafford Act.

While in effect, these special requirements are that MA Plans must:

Cover Medicare Parts A and B services and supplemental Part C benefits at non-contracted facilities subject to § 422.204(b)(3)’s requirements that facilities have participation agreements with Medicare
Waive requirements for gatekeeper referrals
Provide the same cost-sharing for enrollees as if the service was furnished at a plan-contracted facility
Make changes that benefit enrollees effective immediately, without the 30-day notification requirement at § 422.111(d)(3).

Cost-Sharing Waivers and Telehealth. In a March 10 memo, CMS also advised Medicare Advantage Organizations (MAOs) of additional flexibilities for MAOs through the exercise of CMS’s enforcement discretion.

MAOs may waive or reduce enrollee cost-sharing for COVID-19-related services, such as laboratory tests, telehealth benefits or other services to address the outbreak, as long as they do so consistently for all affected enrollees.
MAOs may provide enrollees access to Medicare Part B services via telehealth in any geographic area and from beneficiaries’ homes. This flexibility is irrespective of the scope of the telehealth benefit the MA plan filed and CMS approved.
On March 17, 2020, CMS issued waivers and guidance to provide Medicare coverage of telehealth. These waivers appear to describe FFS Medicare coverage, and do not directly mention or address any requirements for Medicare Advantage plans.

CMS noted that it had consulted with the Office of Inspector General (OIG), and that plans that utilized these flexibilities would satisfy the safe harbor to the federal anti-kickback statute set forth at 42 CFR § 1001.952(l). Once the outbreak has subsided, CMS will notify MAOs and Part D sponsors through the Health Plan Management System that CMS is ending its enforcement discretion with respect to such measures.

Section 1135 Waivers. The Secretary issued a Section 1135 waiver providing that CMS may authorize Medicare administrative contractors to pay for Part C covered services and seek reimbursement from MAOs for those services retrospectively.

On March 13, CMS waived and modified requirements related to Medicare Advantage appeals and grievances.

Part D Sponsors

Expectations and Authorities. The March 10 memo also reminded Part D sponsors of provisions contained in the Prescription Drug Benefit Manual to ensure adequate emergency access for enrollees:

Part D sponsors are expected to relax their “refill-too-soon” edits if necessary to ensure access to covered Part D drugs.
If enrollees cannot reasonably be expected to obtain covered Part D drugs at a network pharmacy, sponsors must ensure that such enrollees have adequate access to covered Part D drugs dispensed at out-of-network pharmacies, although enrollees will remain responsible for any cost sharing and additional charges that exceed the plan allowance, as applicable.
For enrollees that cannot physically access a retail pharmacy (e.g., because of a quarantine), Part D sponsors may relax any plan-imposed policies that would discourage certain methods of delivery, such as mail or home delivery, for retail pharmacies that provide such services
In the event that Part D drugs are identified to treat or prevent COVID-19, Part D sponsors may waive prior authorization, as long as they do so consistently.
If a vaccine becomes available for COVID-19, Part D plans will be required to cover the vaccine if it is a Part D drug. Otherwise, it will be covered under Medicare Part B.

Source: https://www.natlawreview.com/article/cms-guidance-and-waivers-ma-and-part-d-plans-response-to-covid-19

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Tags: Medicare Advantage, Medicare, Medicare Supplement, Medicare Part D, COVID-19

Will Medicare Pay For The Coronavirus?

Posted by www.psmbrokerage.com Admin on Thu, Mar 19, 2020 @ 03:13 PM

Will Medicare Pay For The Coronavirus?

Will Medicare Pay For The Coronavirus

Toni King, author of the Medicare Survival Guide www.tonisays.com.

Beginning Tuesday, March 17th, all local Social Security offices nationwide were closed to in-person visits and have asked those who need assistance to call your local Social Security office or Social Security’s 800 number at 1-800-772-1213 for assistance by phone. There is not a specified re-open date for local Social Security offices currently.

Toni: I must have missed this when listening to the national media coverage of the Coronavirus, but no one has explained how Medicare is covering the testing, vaccinations or quarantined in a hospital if anyone in my family that is on Medicare becomes infected with the virus.

My husband and I have recently retired and are covered by Original Medicare with a Medicare Supplement and a stand-alone Medicare Part D plan. Our parent’s situations are different as they both are covered by Medicare Advantage plans. My parents are both Texas retired teachers covered by TRS Medicare Advantage plan and my husband’s parents are covered by his father’s employer retiree Medicare Advantage plan.

How will Medicare pay for these different situations? I’d like to know what to do if I must take one of my family members or myself to the doctor or hospital. Thanks, Sheila from Bellaire, TX.

Sheila: We are witnessing a healthcare crisis that no one can be sure if they are safe. Especially the 60+million Medicare beneficiaries frightened of COVID-19, the disease caused by Coronavirus.

Let me discuss the various ways that Medicare will cover the testing and medical care for the 2 different Medicare plans…Original Medicare and Medicare Advantage plans:

Original Medicare with Stand-alone Part D and COVID-19 (Coronavirus) testing began on or after February 4, 2020. You will pay nothing for Medicare covered clinical diagnostic laboratory testing provided. Your medical provider will have to wait until April 1, 2020, to be able to submit a claim to Medicare for this test. **it is very important to verify that your Medicare facility, provider or medical professional is accepting Medicare assignment for Medicare to pay for COVID-19. When a vaccine is available for the Coronavirus, then all Medicare Part D plans will carry the vaccine and copays may apply. Telehealth is offered with Original Medicare. Medicare Part A (In-patient Hospital) and Part B (Medical Benefit) deductibles and copays may apply.
Medicare Advantage plan with Medicare Part D and COVID-19: Medicare beneficiary will have access to the same Medicare benefits. Medicare allows Medicare Advantage plans to waive cost-sharing for COVID-19 lab tests. Check with your Medicare Advantage plans to verify your coverage and costs. Telehealth coverage and additional coverage maybe offered. Once a vaccine for COVID-19 is available, then Medicare Advantage Prescription Drug plan copays apply. It is advised that the medical provider or facility be in network to receive your lowest cost for medical and vaccine costs.

Toni: After April 1 when the medical community that is accepting Medicare assignment begin to file claims regarding COVID-19 (Coronavirus), then we will really know how claims will be paid. Remember accepting Medicare assignment and not just billing Medicare is the key to how a COVID-19 claim will be paid. Since you and your husband are covered by Original Medicare with a Medicare Supplement and stand-alone Medicare Part D, you may pay a certain amount for your claim and your parents which are both covered by a Medicare Advantage plan with Part D may pay a completely different amount or co pays because these are two different types of Medicare plans.

Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the Medicare Survival Guide® Advanced book to the Toni Says Medicare column readers at www.tonisays.com.

Source: https://www.canyon-news.com/will-medicare-pay-for-the-coronavirus/106437

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Tags: Medicare Advantage, Medicare, Medicare Supplement, COVID-19

OPPORTUNITY: Portfolio Based Selling

Posted by www.psmbrokerage.com Admin on Thu, Mar 19, 2020 @ 12:02 PM

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Tags: Sales Tips, Medicare Advantage, Medicare Supplement, tips on selling insurance to seniors

Selling Your Way Out of a Crisis

Posted by www.psmbrokerage.com Admin on Thu, Mar 19, 2020 @ 11:42 AM

Selling Your Way Out of a Crisis

Selling Your Way Out of a Crisis

The time for you to start climbing out of the hole that you find yourself in is now. There is no benefit from waiting to begin your recovery. It doesn’t help you to wait until things settle down, watching them get worse, feeling a sense of dread, allowing yourself to be disempowered by events.

Take Back Your Power

When events and circumstances beyond your control derail your goals and plans, the fact that you can do nothing about the root cause of the challenge can make you feel as if you have no power. Even though you feel as if you are powerless, you are not. While you may not control the root cause of a crisis, you can manage your response. You can determine what you believe, and you can manage your reaction.

There is every reason to maintain a mindset that is positive, optimistic, future-oriented, and empowered. Being confident doesn’t require that you pretend nothing is wrong in the face of overwhelming evidence to the contrary. Instead, it is the belief that you are going to succeed despite the challenges you face. An even more empowering belief system is one that believes adversity is a gift, one that stretches you, that causes you to grow, to improve yourself—and your company and your clients.

Your mindset is critical because it is what will determine your actions. Nothing gets better unless you make it so.

Build Your Plan of Action

In a time of great crisis, especially one that impacts your business, it doesn’t pay to treat extraordinary circumstances like things are business as usual. Instead, it’s business unusual, which means you need to do things differently. That starts with a plan of action.

When a crisis harms your sales, improving your results means more activity and greater effectiveness. Your plan needs to require massive action in response to the crisis that causes a loss or reduction of sales. There are only four ways to grow revenue, and you should use as many of them as possible, starting with selling more to your existing clients, communicating with them at a higher frequency, and making sure you retain them.

You also need to acquire new clients, ones who can give you new revenue—and potential growth. However much prospecting you were doing before the crisis, you need to double your effort and increase the number of opportunities you create. There are always clients who need help recovering from their own crisis, and identifying and helping them recover helps you recover.

When you have the power to do so, raising your prices increases your revenue. The last way to grow is to acquire a competitor. This sales strategy is useful for those with the resources to do so but denied to most sales organizations.
Not only will you feel better having made a plan to recover, taking action will provide you with a sense of direction, a sense of certainty that you are going to be able to rebuild.

Improving Your Effectiveness

When every opportunity counts, improving your effectiveness is critical. You want to do everything you can to ensure your win. Speeding up your recovery means slowing down, focusing on the fundamentals of effective selling, and doing the work necessary to ensure you win big deals.

You may not have built a territory and account plan, targeting your dream clients and developing a pursuit plan. Now is the time to be clear about who your dream clients are and tighten up your theory about why they should change and how you can help. Your sporadic approach to prospecting needs to be driven instead by a valid prospecting sequence. You might also have lost your discipline around creating new opportunities and building a pipeline. When new opportunities from existing and new clients are critical to your recovery, focusing on building a pipeline is the only way forward.

Under normal circumstances, you may have been lax in your pursuit of opportunities, going through the motions of sales activity without being intentional about the outcome of each interaction in the sales conversation through which you are leading your prospective clients. If you are going to sell your way out of a crisis, you need to treat every opportunity as if it is critical, planning your sales calls, following your sales process, and using the methodologies that are proven to increase your results.

The key to improving your win rate, in good times and bad, is to improve your effectiveness. If you want better results, you have to improve your ability to produce better results, something that is as true for sales managers as it is for their sales reps. Better sales leaders get better results from their sales teams. Better salespeople win more—and better deals.

It has been said that one should never waste a crisis. Use this one to improve your effectiveness, taking more action, and improving your efficiency in the fundamentals of good sales.

Create a War Room

A war room is a place from which to plan, communicate, and adjust your approach as things change. Your competitor is not your enemy, and most of them won’t respond as aggressively as they might need to. Instead, your enemy is the poor results that come with an economic crisis.

In a crisis, more communication is necessary. Feedback as to what is working, what isn’t, and what adjustments you need to make is critical. When something is working, you want to do more of it, making sure everyone is aware and has access to strategies and tactics. When something isn’t working, you may need to find another way by making adjustments or making changes to your approach.

Most importantly, you want a visible place to keep score. Your progress will be slow if it isn’t significant enough to track and communicate. In complex B2B consultative sales, we tend to measure our results less frequently than we should, especially when sales cycles are long and decisions require building consensus. That won’t do as you sell your way out of a crisis. You are going to need to measure sales effectiveness more frequently in B2B sales.

The First Rule of Getting Out of a Hole

The first rule for getting out of a hole is to stop digging. Maybe you have been too lax about sales prospecting and sales effectiveness. You may have been able to grow because your vertical was increasing, a rising tide lifting all boats. When the water recedes, you can see the stumps, the companies that were only growing because their market was growing.

Increasing your revenue means selling more. You do not benefit from waiting for the crisis to end before you decide to improve your sales results. The way out of any crisis is always to sell your way out. Get moving.

Source: https://thesalesblog.com/2020/03/17/selling-your-way-out-of-a-crisis/

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Tags: Sales Tips, tips on selling insurance to seniors, phone tips, COVID-19

COVID-19 Selling Remotely and Helping Customers be Prepared

Posted by www.psmbrokerage.com Admin on Tue, Mar 17, 2020 @ 04:34 PM

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Tags: Sales Tips, tips on selling insurance to seniors, phone tips, COVID-19

Aetna: COVID-19 info | Telephonic enrollment (RATE) - Webinars | e-Kits

Posted by www.psmbrokerage.com Admin on Tue, Mar 17, 2020 @ 04:08 PM

Aetna: COVID-19 info | Telephonic enrollment (RATE) - Webinars | e-Kits

Keeping you informed about COVID-19

As we continue monitoring the outbreak of the coronavirus, also known as COVID-19, we remain focused on the health and safety of our members and agents. As an agent, you play an important role in keeping members informed. We encourage you to check our website frequently for updated information about the virus and tips for staying healthy, and to learn about the ways we're supporting members.

Webinar: Enroll by phone with the RATE tool

The Remote Agent Telephonic Enrollment (RATE) tool is a powerful feature that lets you enroll your clients by phone, after completing a compliant sales presentation with them. This is a convenient tool that can help you continue enrolling your clients telephonically in the event you can't meet with them in-person due to concerns about COVID-19.

Want to learn more? To register for an upcoming webinar, just click here and then search for trainings in your state.

Requirements to use the RATE tool

You must have access to the Ascend Virtual Sales Office app. To request access, fill out a quick request form on Producer World. Please note this can take up to 2-7 days to process your request.
You must have an iPad. This is required. RATE is not compatible with other tablet brands.
You must complete an online, self-paced compliance training and pass a quiz with a score of 90% in two tries or less.

After you successfully pass the quiz, we will initiate a RATE license for you. This can take 1-2 days to complete. Once completed your 1-800 telephone number will be communicated to you by email.

Stuck at home? E-kits are another great option

Do you have clients who want to move forward with enrollment, without risking COVID-19 infection? E-kits are another convenient enrollment tool available to you through the Ascend Virtual Sales Office app. With the e-kit option, you can enroll your clients via email and web.

No special set up or extra training is required to use it.
Plus, it works on any laptop or iPad mobile device.
Before using an e-Kit to enroll your client, you just need to complete a compliant sales presentation.

You must have the Ascend app to use e-kits. Click here to request access to the Ascend app on Producer World. Please note, it may take 2-7 business days to process your request.

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Tags: aetna, COVID-19

CMS Publishes FAQs to Ensure Individuals, Issuers and States have Clear Information on Coverage Benefits for COVID-19

Posted by www.psmbrokerage.com Admin on Tue, Mar 17, 2020 @ 03:24 PM

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Tags: CMS, COVID-19

WellCare: COVID-19 Response and Process Change

Posted by www.psmbrokerage.com Admin on Tue, Mar 17, 2020 @ 02:38 PM

WellCare: COVID-19 Response and
Process Change

wellcare header blog

COVID-19 Response and Process Change

Attention Valued Partner:

Thank you for all that you do to transform the health of our communities and your dedication to our underserved and vulnerable populations, particularly in this time of uncertainty.

Our teammates and partners are the heart and soul of this organization, and the health and safety of our employees, partners, members, and communities is our uncompromising priority. We are closely monitoring the coronavirus (COVID-19) situation and are engaging regularly with medical professionals, the Centers for Disease Control (CDC), the World Health Organization (WHO), and other government agencies as the situation evolves.

Company leadership, our business resilience teams, and representatives from across our businesses are engaging daily to monitor the situation as it evolves and are taking measures to keep employees and partners safe, minimize the risk of exposure to COVID-19, and ensure that we can continue to provide the services that our members rely on for their health and well-being.

Telephonic MAPD Marketing Presentation

Due to the current state of COVID-19 as of 3/16/2019, WellCare will allow agents to conduct telephonic MAPD sales appointments with beneficiaries!

Remember, when conducting telephonic MAPD marketing presentations to Medicare prospects seeking only MAPD information; all current CMS Medicare Marketing Guidelines, WellCare policies, etc. must be followed.

MAPD Telephonic Marketing Presentation Dos and Don'ts

After all CMS requirements are met including consent-to-contact and SOA, an agent may proceed with a telephonic MAPD marketing presentation and assist with a formulary/physician searches.

If the prospect agrees to enroll, the agent MAY:

Provide PURL information to the prospect; or
Send paper application (and all required documents) to be completed by the prospect

If the prospect agrees to enroll, the agent MAY NOT conduct telephonic enrollments on behalf of the prospect

Protecting our members, employees, and partners conducting home visits:

Centene is taking steps to cover COVID-19 testing and screening services for Medicaid, Medicare, and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening.
We will not require prior authorization, prior certification, prior notification, or step therapy protocols for COVID-19 testing and screening.
Enhanced protocols have also been created to ensure our pharmaceutical services continue to be available for members through supply chain management.
To lower the risk of transmission of illness we suggest taking precautions, such as reaching out by telephone prior to home visits to ensure that those being visited are not experiencing any symptoms related to COVID-19. As always, please ensure to adhere to all CMS guidelines.

Hours of Operation:

As of now, all call centers will be operating business as usual. As our country continues to prepare and execute safety measures, we will continue to evaluate business processes that will ensure the safety of all partners.

We encourage you to reference the Centers for Disease Control and Prevention (CDC) website as well as local government guidance for current updates.

Further, ensure to use the following precautionary measures to support a safe and healthy environment:

Thorough hand washing with soap and water for at least 20 seconds — hand hygiene is the most effective method to control the spread of many viral illnesses.
Using alcohol-based (containing at least 60 percent) hand sanitizer.
Covering your mouth when you cough or sneeze by coughing and sneezing into a tissue and then disposing of the tissue in a wastebasket.
Thoroughly cleaning surfaces that may be contaminated.
Avoiding shaking hands and close contact with people who are sick.

We appreciate your cooperation and support in serving our members and communities in this time of need and uncertainty. As the situation evolves, please know that additional measures will be taken with a local-oriented approach, and we will continue to ensure our employees and partners are supported and safe.

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Tags: WellCare, COVID-19

COVID-19: Agent Scripts & Tips

Posted by www.psmbrokerage.com Admin on Tue, Mar 17, 2020 @ 10:00 AM

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Tags: Sales Tips, tips on selling insurance to seniors, phone tips, COVID-19

2 New Med Supps - Hot Off the Press

Posted by www.psmbrokerage.com Admin on Fri, Mar 13, 2020 @ 02:09 PM

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Tags: Medicare Supplement, Accendo Medicare Supplement, Humana Achieve

What You Need to Know About Medicare Coverage and the Response to Coronavirus

Posted by www.psmbrokerage.com Admin on Fri, Mar 13, 2020 @ 02:04 PM

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Tags: Medicare, COVID-19

Coming Soon: CHLIC Launch in FL!

Posted by www.psmbrokerage.com Admin on Fri, Mar 13, 2020 @ 01:56 PM

EXCITING NEWS

We are Launching CHLIC in Florida!

We are excited to announce that on April 13th, we will be launching a new Medicare supplement product in Florida, insured by Cigna Health and Life Insurance Company (CHLIC).

CHLIC FL has great benefits for agents and their customers including:

Lower rates
3% Household Discount
Competitive Commissions
Cash incentives and leads
Access to the value added programs Active&Fit Direct^TM Program¹and our 24 Hour Nurse Line
View the Outlines of Coverage and Application

Find out more about our CHLIC plans in Florida:

Not contracted with Cigna? Request more information here.

1: Plus a $25 enrollment fee and applicable taxes. This is a discount program and is NOT insurance. This program is separate from medical plan benefits. Customer is required to pay the entire discounted charge. ASH is an independent company/entity and is solely responsible for the Active&Fit Direct program. ASH is not an affiliate of Cigna. Customer should consult a doctor prior to beginning a new exercise program. Participation in this program may be subject to program terms and conditions and is at customer's sole risk. The Active&Fit Direct program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Active&Fit Direct is a trademark of ASH and used with permission herein.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. CHLIC-1-0015-A © 2020 Cigna. Some content provided under license. For agent use only. 912277 08/18

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Tags: Cigna Medicare Supplement

Atlantic Coast Life Medicare Supplement Plans

Posted by www.psmbrokerage.com Admin on Fri, Mar 13, 2020 @ 01:44 PM

OFFERING OUTSTANDING OPPORTUNITIES

SINCE 1925

Introducing a new era of Medicare Supplement insurance, designed to transform the agent and customer experience.

With state-of-the-art product features and technologies, securing Medicare Supplement coverage for your clients has never been easier.

ASK US ABOUT THE APP BONUS PROGRAM!

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Give us a call today to learn how you can offer Atlantic Coast Life Medicare Supplement insurance plans to your clients!

Call today for details: 800-998-7715

or Request details here

For agent use only. Not for use with consumers. Certain contract exclusions and limitations may apply. All products are not available in all areas. Not affiliated with or endorsed by the United State government or federal Medicare program. B03092004

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Tags: atlantic coast life medicare supplement

CVS Health announces COVID-19 resources for Aetna members

Posted by www.psmbrokerage.com Admin on Fri, Mar 13, 2020 @ 01:35 PM

CVS Health announces COVID-19
resources for Aetna members

In response to the rapidly evolving COVID-19 outbreak, CVS Health announced a series of steps designed to support the health and well-being of Aetna members, ensure patient access to medication, and remove barriers to care.

Effective immediately:

Aetna will waive co-pays for all diagnostic testing related to COVID-19. This policy will cover the cost of physician-ordered testing for patients who meet CDC guidelines, which can be done in any approved laboratory location. Aetna will waive the member costs associated with diagnostic testing for all Commercial, Medicare and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason. Aetna members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices. Cost sharing will be waived for all virtual visits through Aetna-covered Teladoc® offerings and in-network providers delivering synchronous virtual care (live videoconferencing) for all Commercial plan designs. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
CVS Pharmacy will waive charges for home delivery of prescription medications. With the Centers for Disease Control and Prevention encouraging people at higher risk for COVID-19 complications to stay at home as much as possible, this is a convenient option to avoid coming to the pharmacy for refills or new prescriptions.
Aetna will now offer 90-day maintenance medication prescriptions for Commercial and Medicare members and is working with state governments to make the same option available to Medicaid members where allowable. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
Aetna will waive early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
Through Aetna's Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms. The package will also include personal and household cleaning supplies to help keep others in the home protected from potential exposure.
Through existing care management programs, Aetna will proactively reach out to members most at-risk for COVID-19. Care managers will walk members through what they can do to protect themselves, where to get information on the virus, and where to go to get tested.
Aetna is also offering its Medicare Advantage brief virtual check-in and remote evaluation benefits to all Aetna Commercial members and waiving the co-pay. These offerings will empower members with questions or concerns that are unrelated to a recent office visit and do not need immediate in-person follow-up to engage with providers without the concern of sitting in a physician’s office and risking potential exposure to COVID-19.

CVS Health is also implementing the following programs to educate members about COVID-19 and help address any associated anxiety and stress:

Opening Crisis Response Lines for all Aetna (Commercial, Medicare, Medicaid) and Caremark members who may be experiencing anxiety related to COVID-19.
Expanding 24x7 access to the Aetna Nurse Medical Line for all Aetna and Caremark members.
Providing Aetna plan sponsors with a Resources for Living toolkit with materials specifically developed for members experiencing anxiety related to COVID-19.

Containing the spread of this epidemic and equipping members with the information they need is a top priority we all share. Aetna has taken these actions in support of this objective, recognizing the need to act quickly. At the same time, it is important to us to work closely with you as a partner to bring the right solutions to our mutual customers as this very fluid situation evolves.

To follow CVS Health and Aetna news, visit the Newsroom and the frequently-updated COVID-19 resource center.