Rose’s life was impacted by Humana’s SeniorBridge.

Humana News

May 19, 2016

Humana Agent Support agentsupport@humana.com or 800-309-3163

Humana at Home: How Humana Helped Rose Stay in the Home Her Husband Built

There’s no place like home – and that home is where Rose and her husband made treasured memories while raising three loving and successful children.

After their father passed away, Rose’s children noticed she was less like herself. Her health declined and managing her life details became a challenge. They knew their mother wanted to remain home, but they would need help –so they called SeniorBridge, a private pay offering of Humana At Home that associates and their friends and family members can purchase at a discount.

SeniorBridge helped Rose get back into a routine, a healthy lifestyle, and a safe environment. Her team of care managers and homecare aides inspired Rose to get back to doing the activities that she loved and brought peace of mind to her children. The services Rose receives are services she purchases on an hourly basis and supplement any services provided through her insurance benefit.

Now when Rose’s children come to visit, they see the matriarch they remember. The smile is back on her face, she’s full of energy, her health is monitored by a team of professionals, and they still get to visit her in the house that means so much to all of them.

Select the image to learn more about Rose’s story – There’s no place like home.

Marketing Materials for Use Throughout the Year

Humana is pleased to provide our valued partners with a comprehensive suite of over 100 pre-approved customizable marketing materials that you can use outside the Annual Enrollment Period. You can preview the postcards, flyers, ads, letters, etc. in this link to the Humana Delegated Medicare Marketing Catalog or on the attached document by the same name.

These materials are designed to motivate prospects to switch to a Humana Medicare plan by focusing on Humana value propositions and solutions that certified agents are able to provide. The “How can I help you?” approach to these campaign materials emphasizes the tremendous value that a local agent relationship offers in making insurance decisions.

Each of the agent-focused campaigns offers a combination of pre-approved letters, post cards, flyers, ads and digital materials. Because the materials are CMS-approved, only the agent contact information may be altered. Throughout the catalog you will find best practices for use of the materials.

Marketing Resource Center

The marketing materials are now accessible to agents to customize and download via the Marketing Resource Center. You’ll see the materials relevant to the plans you’re contracted and certified to sell. Here’s how to access, customize and download the Medicare templates:

After signing into Humana.com Agent portal, click on the “Marketing & Products” tab at the top.
Select “Marketing Resource Center” (MRC) under the “Order Marketing Materials” header.
Click on “Individual” and then “Medicare”. Materials are categorized by type, such as $0 Premium or Age In/New to Medicare.
Each agent will see the materials relevant the plans they’re contracted, certified and appointed to sell in the states in which they’re contracted. Use the search functions in the left column to navigate or enter a document number or name into the search box at the top right

Agents who have never used the Marketing Resource Center before can click on the Quick Start Guide on the home page in the “Support” box for additional assistance.

Dual Eligible Auto Assignment Guidance

Per CMS regulations, MA organizations offering both MAPD and MA-only plans are required to have a process for automatic and facilitated enrollments for low income subsidy-eligible beneficiaries. All LIS-eligible individuals who elect an MA plan without Medicare prescription drug benefits (“MA-only plan”) will experience either an “automatic” or “facilitated” enrollment into an MAPD plan in the same organization to ensure they have PDP coverage wherever possible, unless the LIS-eligible individual declines the enrollment. Note: In the case of PFFS MA-only plans, MA organizations have the option of enrolling members onto either an MAPD plan or stand-alone PDP plan. These automatic and facilitated enrollment processes at Humana are called the Dual Eligible Auto Assignments (DEAA) and will occur monthly. Once a member declines the enrollment via an opt-out process, they should no longer be put through the process again.

Process Background

Members who are going to be moved may receive a prospective (future) or retroactive (past) effective date, and they have the opportunity to opt-out of the change. CMS breaks DEAA members down into two populations that help determine the rules around each.

Auto-Enrollees:

Members with full LIS (as identified by CMS).
Usually receive a retroactive (past) effective date equal to the later of A) their MA effective date with Humana or B) their LIS start date.
Have 10 days from the date we send a letter to opt-out before being moved in our systems, but the member can reverse that.
Have until the 15^th of the month following the date we send the letter to opt-out before the move is final.

Facilitated Enrollees:

Members with partial LIS (as identified by CMS).
Receive a prospective (future) effective date.
Have until the day before the effective date before being moved in our systems. Once moved, the member cannot reverse the move.

Regardless of which population a member falls into, CMS has no statute of limitations on when a member can opt-out. The opt-out timelines provided above are for the member to completely prevent and/or reverse any changes made. If the member opts-out after those deadlines, they can go back on the MA-only plan in the future, but cannot reverse the months of coverage they were moved onto the MAPD plan.

Member Impacts

Premiums – Changing from an MA-only plan to an MAPD plan often results in an increase of monthly premium. Members receiving a retroactive effective date would also be responsible for past-due premiums.

Existing PDP coverage – Humana checks to see if the member has PDP coverage through another carrier, but can’t check if the member has PDP coverage through a third party (such as TRICARE or VA). The member should contact the other carrier to determine the impacts the MAPD will have (which may include termination from that carrier) and to determine if the MAPD is duplicative (in which case the member would evaluate which plan to retain).

Please click on this link Dual Eligible Auto Assignment FAQs or reference the attachment by the same name for additional insights on the process.