Category Archives: Enrollment

Making a Difference on Every Call

Vantage Point: Making a Difference

As our Annual Enrollment Period (AEP) came to an end, I sat back and thought of all of the work our team had done. Each year, prospective members call in to get information to determine if Health Alliance is the right fit for their needs.

Of course we go over the basics, like monthly premiums, copays, and out-of-pocket maximums, but that is all very black and white, and not every situation is the same or so simple.

At Health Alliance, the expectation is to go the extra mile for our members and prospects. Our potential members rely on our expertise to guide them in the right direction.

This past AEP, I had someone call in asking if our plan covers a certain medication that’s given at the doctor’s office. My immediate response to the caller was, “I don’t know, but let me research that for you.”

I wanted to make sure they were making the right choice by switching to our plan. After doing some research and calling our pharmacy department, I called them back and shared the details I’d gathered.

Later, I got the chance to meet the potential member to go over our plans in person. They could not thank me enough for gathering the information and told me my phone call back was a nice surprise. We gained credibility and their trust by taking the extra step to respond to their particular situation.

I was actually surprised because I didn’t feel like I had done that much, but after thinking about it for a while, I realized it really is the little things that count the most to our members. This is a perfect example of why our role as liaisons is so important for our community and what sets Health Alliance apart.

As liaisons, we go out of our way to give our members the most accurate information we can and to take away the pressure of those difficult and complex questions. Our job is to simplify and educate. We’re making a difference every day, no matter how big or small.

Jessica Arroyo, born and raised in Wenatchee Valley, is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off, she enjoys spending time with her husband and infant son.

HappyHappy, Healthy, Medicare New Year!

Long View & Vantage Point: Steps to a Happy Medicare New Year

Winter preparations are all done, and winter festivals and end-of-the-year holiday celebrations have ended. Just when you think you can sit back and relax, there is still one last item you may need to consider.

If you made any changes to your Medicare plan during the Annual Enrollment Period, here are some actions you can take to help you have a happy Medicare New Year:

  1. Make sure you’ve received your new plan’s member ID card.

If you joined a Medicare prescription drug plan (PDP) that works with Original Medicare, you’ll get a separate card to use when you fill your prescriptions, but you’ll still use your Medicare card for hospital and doctor services.

If you joined a Medicare Advantage plan, like a Health Alliance plan, you’ll get a new card to use when filling your prescriptions and for hospital and doctor visits.

If you need medical care or need to fill a prescription before you receive your ID card and your new coverage has already started, you may be able to use other documents as proof of coverage, like the welcome letter you got from the plan, or even your enrollment confirmation number and the plan’s name and phone number.

  1. Show your new member ID card to your doctor’s office and pharmacist on your first visit of the new year.

If you have stayed with the same insurance company, be sure to replace last year’s card with your new card. If you changed companies, be sure you’re always using your new card.

  1. If you chose to have your plan premium withheld from your Social Security check, don’t be alarmed if you don’t see it deducted right away. It can take up to 3 months from when you made this request to start seeing it withheld from your Social Security payment.
  1. Remember that your deductibles start over at the beginning of the year, so normal copayments won’t start until all applicable deductibles have been met for the year.
  1. Take advantage of your annual wellness visit. This free preventive benefit is designed to help you take charge of your health, learn about preventive services you might need in the future, and establish a baseline for personalized care.
  1. Take advantage of any gym membership benefits from your plan. Many plans offer gym memberships or access to fitness activities, at no cost to you. Our Be Fit benefit helps pay you back for your gym membership or fitness classes, so you can get fit at the gym of your choice.

Wishing you all a happy and healthy 2017!

Sherry Gordon-Harris is a community liaison at Health Alliance. She is a wife and mother of 2 boys and enjoys traveling, collecting dolls, and hosting princess parties and princess pageants.

Breck Obermeyer is a community liaison with Health Alliance, serving Yakima County. She is a homegrown girl from Naches and has a great husband who can fix anything and 2 kids who are her world. When not attending community events or providing Medicare education throughout the Valley, she can be found indulging in her hobbies of homesteading, pioneer cooking, and learning new survival techniques. She also has a strong love for all things Halloween.

AEP Medicare Shopping

Vantage Point: Let’s Shop

I’d seen all the cell phone carrier TV ads and billboards. I’d received offers to change in the mail and had friends and family share better coverage experiences, but I was stubborn. I convinced myself I was just being loyal, but the truth was, after 20 years with the same carrier, I was resisting change.

Entering the ultra-busy cell carrier’s store, I was approached right away by a super professional greeter. “How may I help you?” he asked, keeping eye contact while also using a hand-held tablet to address my needs.

As I waited for a sales agent, the greeter invited me to look around and told me I would be helped shortly. Not even 2 minutes later, while browsing phone choices and tapping along to the upbeat music, Marco introduced himself with an outstretched hand. I told him I had moved to a remote canyon, where my old cell carrier didn’t have good enough service. He offered me a solution and set my new plan up, right on the spot.

My new carrier’s bills are easy to read, and the website to manage my account is so user-friendly that I can now better understand my usage. Because of that, I’ve changed my plan 3 more times, saving me tons of money. Best yet, I never miss a call. I am now a big fan of comparison shopping.

October 15 to December 7 is the Annual Enrollment Period (AEP), when Medicare beneficiaries also get a seasonal opportunity to comparison shop. During the AEP, Medicare-eligible people can change from supplement plans, also called Medigap, to a Medicare Advantage plan, can change prescription drug plans, and can compare all the Medicare plans available in their county. They can and should check their current plan to see if anything new was added or, if due to health changes, it’s still the right fit.

Medicare beneficiaries get bombarded with ads. Some of it’s confusing, and some of it’s scary. Insurance is a very serious and important choice. We can’t compare all plans against each other, but at our customer service office at 316 5th St. in Wenatchee, we can sit down with someone in person and give them all the time and help they need to better understand. Whether they choose us or not, it’s a good feeling to know the personalized value we gave helped them to pick the right Medicare plan to fit their health needs.

Shannon Sims was a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. During her time off she enjoys spending time with her family and riding horses.

October, and Its Chores, Return

Long View: It’s That Time Again

There are a lot of reminders for folks to check their smoke detector batteries when daylight saving time is over. It does make sense to tie that chore to something that occurs on a regular basis. (Why not Valentine’s Day?) But, I almost always forget to do it.

It seems there are always other, more pressing things on the to-do list, like finishing up in the yard, switching out those summer clothes, or putting up the storm windows, if you’re unlucky enough to still have storm windows.

Just like these yearly chores, Medicare-eligible people need to review their healthcare coverage every year to see if their current plan still meets their needs. The days of one-size fits all are over thanks to the options-obsessed baby boomers. (I am including myself, so you know.)

If you’re a caregiver, a change in your loved one’s situation may show the need for different coverage. Have they started traveling more or less? Did their medication needs change because of things like new prescriptions or treatments for a chronic illness? Did their primary care provider retire or move? Did their current plan change? Does it still meet their needs? It’s time to explore your options.

We know you’re busy, so let’s look at a few resources:

Medicare.gov

A great one is Medicare’s website. This site is relatively easy to navigate and packed with information. You can check your plan’s Star Rating while you’re at it.

Department on Aging

Another good resource is your state’s Department on Aging. They have independent counseling services for people who are Medicare-eligible.

Area Agency on Aging

Your local Area Agency on Aging is a gold mine. Find one near you.

HealthAllianceMedicare.org

Our website is easy to navigate and gives you a nice overview of the options we have in your county.

The Annual Enrollment Period for Medicare is once again from October 15 until December 7. Sign up then for a plan that starts on January 1, 2017. The sooner you review your needs and gather information, the better you’ll be able to make an informed choice. When you’re done, you can move onto something really important, like cleaning out the junk drawer in the kitchen. Like that’s ever going to happen.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

 

Finding Doctors & Personalized Care

Finding Doctors Made Easy

Finding doctors and care that’s covered on your plan, like from a Primary Care Physician (PCP) or a clinic in your service area, is key to helping us pay for the care you get.

For some plans, like HMOs, you must go to a doctor in your provider network. And for some plans, like PPOs, although you can go to out-of-network doctors, going to doctors in your plan’s network can help you save.

Log In

The best way to find doctors in your network is to log in to Your Health Alliance, our one-stop member website. If you’ve never used Your Health Alliance before, you’ll have to register for an account first.

On Your Health Alliance, when you choose Find a Doctor or Hospital from the very top menu on your dashboard, you’ll see a list of all the providers you can use on your plan. From there, you can filter these or search by doctor or hospital name to find what you’re looking for.

Plan Details Search

If you can’t log in to Your Health Alliance, you can also find a doctor by looking at your plan’s network through our Plan Details Search.

You can find this feature by choosing learn how to use your benefits on HealthAlliance.org’s home page. This takes you to our Member Benefits & Forms page. The first bullet under Using Your Benefits, What Your Plan Covers, will take you to the search.

On the search, you just need to enter your member number from your ID card to see a list of all your plan’s documents, which will include your network of doctors. You can find your member number here:

Finding Your Member Number

Finding Doctors

You can also search for doctors on HealthAlliance.org. Choose Find a Doctor from the top menu to start your search.

Once you’re here, you can search for your network or by a doctor’s name, or you can look at a list of all our directories.

The best way to find your network is to search with your member number from your ID card. (The above image can help you find your member number.)

Or you can find your network by choosing your state and plan type and directory. If you have our insurance through your employer, you’ll choose employer groups. If you’re on a Medicare plan, you’ll choose that. If you shopped for and bought our insurance for yourself (and it’s not a Medicare plan), you’ll choose individual and families from the list.

Then you’ll choose your directory. Your directory is based on what type of plan you have. If you or your employer bought your plan from a public exchange, like Healthcare.gov or a state exchange, it will say public in your directory name. If you bought it directly from us, it will say direct.

It will also say your plan type, like HMO, PPO, or POS. If you bought a plan in a specific market, like Riverside or Methodist, it might say that, too. Your plan policy or plan documents can tell you what the name of your plan is to help you know which plan type you have.

Once you’ve chosen one of these, you can also add filters, like doctor or location info, to find certain providers.

Now that you’ve searched and found your network, you’ll see details for each of the doctors in your plan’s network, like address, if they’re taking new patients, and more. You can also add filters at this point to narrow your search.

And if you’re shopping for a new plan, we’ve made it easy to find doctors on those plans by connecting you to their networks while you’re shopping.

Still need help finding doctors or have questions about our providers? It’s no problem! Our Customer Service is here to help! Just contact us.

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Finding Medicare During the Annual Enrollment Period

Vantage Point: The Season for Informed Choices

It’s October, and folks living in North Central Washington are looking forward to beautiful fall colors and freshly picked apples. For those on Medicare, it’s also the start of the Annual Enrollment Period (AEP), when beneficiaries can shop for their 2016 coverage. It runs October 15 to December 7. But because of confusing plan changes and choices, some dread the AEP rather than looking forward to it.

But there are people who can help make these decisions easier. A trusted resource for Medicare eligibility throughout the year is the Statewide Health Insurance Benefits Advisors (SHIBA) program. The SHIBA program was formed to help consumers understand Medicare and their options for supplementing it. SHIBA counselors keep client information 100% confidential, and their main mission is to help clients see Medicare plan comparisons so that the client can choose using unbiased and accurate information.

At educational presentations in the past, I’d learned a lot from Dick Anderson, a certified SHIBA counselor, and recently had the pleasure of meeting with him one-on-one. Hearing Dick describe some of his stories captured what a valuable service he and other advisors provide. Counseling to help others by these trained volunteers truly comes from the heart.

Dick says there’s no Medicare plan that’s right for everyone, so instead he tries to get his clients to talk about their individual needs. This helps him determine what’s most important to them, so they can make a measured choice that meets their personal needs.

The rewards for this work are illustrated by Dick’s powerful stories of people from all different backgrounds, incomes, and educational levels who have come to him heavy with feelings of helplessness and confusion and after meeting with him, left with their cloud of anxiety lifted.

At Health Alliance, we strive to have quality, sustainable Medicare plans, but we agree with Dick that there’s no perfect plan for every person’s needs. Therefore, we value and respect the work SHIBA volunteers do to help people make informed choices.

For current Health Alliance members, we’re holding special meetings the first week of October in Wenatchee, Moses Lake, and Omak about our 2016 benefits and to answer any questions.

If you want to meet with a SHIBA counselor, you can make an appointment by calling Community Choice at 1-888-452-0731 or Aging and Adult Care at 509-886-0700.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant and Okanogan counties in Washington. She has four adult sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.

Composing for Medicare Annual Enrollment Period

Long View: It’s Annual Enrollment Time

The Medicare Annual Enrollment Period starts on October 15. It’s the time of year when you can make changes to your Medicare Advantage plan. Plans can change premiums, copays, and formularies every year, so it’s important to review your coverage and see if it still suits your needs.

Medicare.gov is a great resource, as is your local senior center. You can also call Health Alliance at 1-888-382-9771 or TTY 711 (8 a.m. to 8 p.m. daily from October 1 to February 14 and weekdays the rest of the year) or go to HealthAllianceMedicare.org for insight. Because I know this subject can be a little dry, I turned it into a poem from our vantage point. I hope you enjoy!

The chaos starts in mid-October.
Medicare says, “Think it over.”
The plan choice that you made last year,
It may be time to change and steer.

You stay at home most all the year.
Your children want you safe and near.
You dislike the awful weather.
HMOs might suit you better.

Maybe you’d like a PPO.
The freedom helps the snowbirds go,
To warmer climes away from ice.
So bon voyage! (It must be nice!)

Supplements can come in handy.
If you’re mobile, they are dandy.
Great if you like to get away,
If you are active day by day.

We brace for those who wait ‘til later.
Here’s our next procrastinator,
Frantic, stricken, and full of fear.
(Showing up late year after year.)

My co-workers have lost their voices.
December 7 ends your choices.
(And why’d they pick Pearl Harbor day?
It’s odd, I know, I just can’t say.)

We’re done, all is signed and dated.
You now feel somewhat elated.
No need to worry and have no fear,
We will be back again next year.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

 

Health Alliance Medicare is an HMO and PPO plan with a Medicare contract. Enrollment in Health Alliance Medicare depends on contract renewal.

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