Network Coverage Information- With our Medicare Advantage Health Maintenance Organization (HMO) plans you must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Health Plans for Self-Employed Individuals, Stay informed on vaccines, testing coverage and more. and check to see if your prescriptions are covered. Our nationwide network includes thousands of participating pharmacies. Gladys Gonzalez on March 1, 2022 at 6:54 pm thank you. Health plans that are seeing higher utilization of their OTC benefit program are also reporting improved member health, satisfaction, and reductions in costs of care, said Melissa Murray, Convey vice president of operations. Frequently Asked Questions and Helpful Resources, You may be able to join or switch plans under special circumstances that grant a Special Election Period. This product is not intended to diagnose, treat, cure, or prevent any disease. Preventive dental included in your plan with NO copay. Register now ! Once youre enrolled in Medicare, you can change your Medicare coverage during the Annual Election Period from October 15 to December 7. Forgot Password? Login Access To Your OTC Benefit Is Fast, Easy and Secure. You dont have to manage health conditions alone. Review your current health care coverage to see what options you have after you turn 65. When it comes to Medicare, sometimes you need to talk to someone face-to-face. At Convey, customer support and engagement are at the heart of our services and we have always put the best interests of our members first, Murray said. Why Should a Plan Offer an OTC Benefit Program? Every year, Medicare evaluates plans based on a 5-star rating system. Whether your looking for a plan on your own or would like help from an expert, we've got you covered. Non-Discrimination Notice and Language Assistance(PDF). www.conveyhealthsolutions.com 855-219-2578 BusinessSolutions@conveyhs.com THE CORNERSTONE OF MIRAMAR:BENEFITS CONVEY'S OVER-THE-COUNTER SOLUTION Convey Health Solutions ACCOMPLISH STRATEGIC SALES, CLINICAL, & MEMBER SATISFACTION GOALS WITH OTC CONVEY'S CMS-COMPLIANT OTC SOLUTION >Fully integrated mail, mobile, web & retail options available Along with urgent and emergency care when you travel. *Health plan members: Rather than submitting this form, we recommend you contact your health plan directly. Using Your Hearing Benefit. %PDF-1.6 % We are committed to providing high quality, timely service. .left-column
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Higher copays apply for medications on Tiers 1-4 if a standard pharmacy is utilized. When building the Medicare OTC card solution, we integrated member support services into every step of the process, just as we have for the other ordering channels. Save up to 33% on prescriptions when you use mail-order pharmacy. We provide everything needed to ensure the success of your supplemental OTC programs. Starting in 2023, all Univera Healthcare Medicare plans include preventive and comprehensive dental coverage at no cost. Examples of what can be purchased using your OTC account are Acetaminophen (Tylenol), antacids, and topical antibiotics. For Plans 002, 004, and 008, you will use your Wellcare By Fidelis Care Member ID card. Optimize your business processes for operational success from a strategic and financial perspective. Our local teamof doctors, nurses, dietitians and specialistsare here to supportyour wellbeing, including healthy eating, managing prescriptions, health conditions, and more. The point-of-sale Medicare OTC card is supported by Convey's Miramar technology and administrative services. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical costs and track your deductible and spending View and order your member card Sign In Sign in to access your over-the-counter benefit. Additionally, Univera Healthcare has contracts with pharmacies that equal or exceed the CMS requirements for pharmacy access in your area. otc-catalog. Each year, Medicare plans earn ratings on a one-to-five scale, with one star representing poor performance and five stars representing the highest quality rating a health plan can earn. Who is Convey Health Solutions? The Convey OTC benefit card solution is a focal point of our thoughtfully developed, member-centric OTC services. Our preventive health screenings, dedicated Medicare-only customer service department, and numerous health and wellness programs are just some ways in which we go above and beyond. Save money with lower copays on your Tiers 1-4 medications when you use one of our 35,000 preferred pharmacies. Medicare Advantage Over The Counter Benefits Administered By Fieldtex, Design and create your custom 2022 OTC Benefit Catalog Program. 306 0 obj <>/Filter/FlateDecode/ID[<06C8BB1311511A489E77D6F97AA2FE51>]/Index[284 34]/Info 283 0 R/Length 110/Prev 229651/Root 285 0 R/Size 318/Type/XRef/W[1 3 1]>>stream Need information in a different format? Take these important steps to learn about Medicare and see what you have to do now to prepare for enrollment. Chat is available from Mon. Enrollment in Univera Healthcare depends on contract renewal. 284 0 obj <> endobj How do I help a loved one find the right Medicare plan? Our local experts can guide you through the Medicare basics and answer any questions you have. They also benefit from one award-winning customer service center to coordinate it all. Questions? Learn More Dedicated to Solving Healthcare Challenges 9 of the Top 10 Health Plans are Convey Clients 20 Years in Business 3,000 Employees 19% MA Lives Served 2.2+ Billion Transactions Use of this site indicates your acceptance of our Terms of Use. Paying Your Monthly Premium Pay Your Bill The Univera Healthcare Advantage Our network of doctors and hospitals Partnering with a leading provider of supplemental OTC benefit administration services can deliver your plan and members with solutions that are genuinely appreciated, and help to ensure your health plans success. Language AssistanceandNon-Discrimination Notice, English|Espaol||P|Kreyl Ayisyen||Italiano|||Polski||Franais||Tagalog||shqiptar, *From April 1 to September 30, representatives are available Monday-Friday from 8 a.m. - 8 p.m.* (TTY: 711). Understand your options and learn more about your coverage. Consulting services to health plans, health systems, specialty health organizations, and healthcare investors throughout the country, with exceptional expertise in the government-markets. OTC benefit card, mail order, and flex wallet programs for over-the-counter benefits administration. View our Privacy Policy for information on how we protect your privacy. You will be responsible for the balance. LEADING INDUSTRY ADVISORY Y0028_8829_M. Any unused dollars at the end of your benefit period are not rolled over and cannot be used in following periods. Learn about Medicare Advantage and ask questions about plans and benefits from a Medicare expert. Whether your looking for a plan on your own or would like help from an expert, we've got you covered. By clicking on these links, you will leave the Fidelis Care website. As a focal point of Conveys thoughtfully developed member-centric OTC services, Conveys Medicare OTC card is a solution that will do just that. Submit a Comment. **For Plans 001 and 003, Convey provides mail order service. OTC Benefit Solutions: Supplemental Over The Counter Programs Over-the-Counter Benefit Program Administration Design and create your custom 2022 OTC Benefit Catalog Program Create Your 2022 Program Add more to your Health Plan with a Custom Over The Counter Benefit Catalog Program. Advisors are also available weekends 8 a.m. to 8 p.m. Enrollment in Univera Healthcare depends on contract renewal. See our Privacy Policy for how we use information. Choose from retail, home delivery, long-term care, specialty, home infusion, or Indian/Tribal/Urban pharmacies. For the best experience on our site, be sure to turn on Javascript in your browser. Big data analytics and technology solutions to achieve complete and accurate revenue, communicate critical patient information, activate clinical and claims data, understand the impact of social determinants of health, and more. The intensity of competition within the MA marketplace commands health plans to consistently identify solutions that contribute to enrollment growth. OUTSOURCING SOLUTIONS Our technology + service solutions meet the specific challenges that you face when trying to provide an optimal member experience. To help your loved one choose the best plan for them, youll need to know the answers to a few important questions. Your account can be used to purchase over-the-counter (OTC) eligible items that help treat injuries or illness. As the market-leading provider of supplemental OTC benefit administration services, we deliver the OTC solutions that members genuinely appreciate. Log in to your member account 24/7 for your member card, coverage, claims, and more. How Can We Help You Elevate & Streamline Your MA/MAPD, PDP, EGWP Plan Operations? As health plans seek ways to expand and enhance their supplemental benefits, countless Medicare Advantage (MA) members are recognizing the value of their health plans OTC benefit as a highly useful and meaningful tool to help manage their health. .left-column
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Watch our Medicare Minute Videos to learn more about initial enrollment and working past 65. Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. TTY: 711. Helping a friend or family member as they navigate Medicare enrollment or switch plans can be overwhelming. 0 If you obtain routine care from Out-of-Network providers neither Medicare nor Univera Healthcare will be responsible for the costs. Our 5 Tier comprehensive formulary and searchable medication database will help you determine if your prescription drug is covered by the Plan or if any utilization edits apply, such as prior authorization or step therapy. Were here for you with helpful online tools and a support team that has your back. OTC items may only be purchased by you for your own personal use. Time-saving fitness tips for real people on the go. Univera Healthcare is an HMO plan and PPO plan with a Medicare contract. The Formulary, pharmacy network, and/or provider network may change at any time. Over-the-Counter Benefit Program Administration. For hours and additional contact information please visit the Contact Us page. You will receive notice when necessary. Part D Prescriptions: $100 deductible, $0 for Tier 1 preferred generic drugs and vaccines at preferred pharmacies. To find out how your prescriptions are covered, check our comprehensive list of covered prescription drugs (also known as the formulary). Eating healthy is easier than you think. $50 allowance every three months for items such as allergy medication, antacids, digestive aids, cold & flu medication, denture products, and more. This information is not a complete description of benefits. Univera SeniorChoice Advanced (HMO-POS) provides comprehensive coverage for the health care services you need, including: $360 copay (per day) for days 1-5, days 6+ are covered in full. .left-column
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Weve got you covered. ET. See how we can develop an OTC plan for you. 0 comments. The supplemental benefits landscape is booming, with OTC benefits as its mainstay. Find a Univera Healthcare Medicare plan that fits your needs and budget. Sign up for our e-mail for the latest news & updates. You can use this account to purchase non-prescription, over . %%EOF If you're turning 65, you can enroll in Medicare from the period that extends 3 months before to 3 months after the month of your 65th birthday. Tv~Ln``$;@ \P Your members leverage one debit card for access to all integrated benefits and merchants via in-store purchases, home delivery, curbside pickup, and in-office transactions. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical cost and track your deductible and spending Convey manages member experience, compliance, and . If you enroll during AEP, your coverage will begin January 1st of the following year. Find the best plan for you with Medicare, individual and family plan options. Use of this site indicates your acceptance of our Terms of Use. Find a Univera Healthcare Medicare plan that fits your needs and budget. membership & Offer an additional supplemental benefit plan for members that suffer from chronic illness or have more complex health needs. Western New York Deserves More from Medicare: Dont worry; were here to help every step of the way. Login | Members | Univera Healthcare Member COVID-19: Stay informed on vaccines, testing coverage and more Member Login Username Password Forgot Username? Optimize your business processes for operational success from a strategic and financial perspective. Benefit Overview. For example, if you turn 65 on July 4, you can enroll anytime between April 1 and October 31. Login | Medicare Members | Excellus BlueCross BlueShield COVID-19: Stay informed on vaccines, testing coverage and more Medicare Login Username Password Forgot Username? The Importance of Offering an OTC Benefit during the COVID-19 Crisis, CMS Implements Supplemental Benefits for Chronically Ill Medicare Advantage Enrollees, The Importance of Utilization Reporting in the Over-the-Counter Benefit. We support our point-of-sale OTC benefit card with Conveys Miramar technology and administrative services. All Rights Reserved. For information on how to request reimbursement for Out-of-Network claims from emergency, urgent or other services, or Coverage Determinations and Appealscall Customer Care at1-877-883-9577 (TTY 711), Monday - Friday, 8 a.m. to 8 p.m. From October 1 through March 31, 8 a.m. to 8 p.m., 7 days a week. Specifically built to manage and support the supplemental benefits program, Miramar easily exchanges member data, enforces compliance, and allows for varying benefit designs. Convenient ordering via mail, phone, or online makes getting products to your members easy. For the best experience on our site, be sure to turn on Javascript in your browser. Members receive an OTC benefit card with a pre-determined allowance for approved, health-related OTC products such as vitamins and minerals, diabetes care, and nutritional supplements. We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Convey Health Solutions is a specialized Medicare technology company committed to compliant member management software and service solutions. Copyright 2023, Univera Healthcare. to learn about Medicare in the comfort of your own home. Forgot Username Forgot Password Sign In Frequently Asked Questions Registration Not Registered? Yes! hbbd```b``+@$S4dEddeM`7`2L^ .u@q2qD*ls D I would like to receive emails from Univera Healthcare, such as Wellness and Health newsletters and more. Convey's integrated, end-to-end OTC benefit administration solution for mail order, benefit card, and flex wallet programs. Our experiences partnering with both regional and national programs have helped us develop an efficient systemthat allows us to create Custom Benefits Programs at any scale to meet and exceed the needs of both you and your members. View our Privacy Policy for information on how we protect your privacy. You are covered locally and nationally with our extensive network of 65,000 pharmacies. Working with our technology team to properly maintain our operations and IT systems (HIPAA, PHI, PCI, Privacy and Security), our compliance team focuses on upholding all regulatory requirements, Jonathan Starr, Executive Vice President for Convey Health Solutions. To use your OTC benefits, choose one of the following ordering methods: Online: Visit the OTC Benefits website (powered by Convey Health) - registration required. Beneficiaries receive white glove customer service from our dedicated teams.. Our extensive expertise, powerful technology, and robust data analytics deliver integrated, end-to-end healthcare solutions to achieve meaningful results. As the market-leading provider of supplemental OTC benefit administration services, Convey delivers the solutions your members genuinely appreciate while helping to ensure your health plan's success. See our Privacy Policy for how we use information. You have from 3 months before you turn 65 to 3 months after your birthday month to enroll. membership & Links marked with an (external site) icon indicate you're leaving UniveraHealthcare.com. For most plans, you pay 1 copayment for a 30-day supply and 2 copayments for a 90-day supply. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Wellcare ByFidelis Care offers members a pre-paid account that is automatically replenished on either a monthly or quarterly basis depending on your plan. Preventive dental included in ALL plans with. Please call your health plan for assistance. Your account can be used to purchase over-the-counter (OTC) eligible items that help treat injuries or illness. Your members receive our award-winning customer service every step of the way. Members receive an OTC debit card with a pre-determined allowance for approved, health-related OTC products. Enrollment in Univera Healthcare depends on contract renewal. Log in, register for an account, pay your bill, print ID cards, and more. Members receive an OTC benefit card with a pre-determined allowance for approved, health-related OTC products such as vitamins and minerals, diabetes care, and nutritional supplements. JavaScript seems to be disabled in your browser. Phone: Call 1-855-657-7545 (TTY 711 ), Monday - Friday, 8 a.m. to 11 p.m. To the extent of any discrepancy between this web site and the Evidence of Coverage, the Evidence of Coverage terms take priority. Share this, If youre a caregiver for a loved one, we have resources that can support you. Login Your Account Email/Customer ID Password Forgot Your Password? Y0028_8829_M. Visit our. Y0028_8791b_MDate Last Updated 12/08/2022. We designed the Convey OTC benefit card program to help your MA beneficiaries make the most of their OTC benefitsto achieve or maintain wellness. Your plan benefits from one account manager, one reporting suite, one set of service level agreements, and consolidated billing. Supported by both our Miramar technology and administrative services, we provide a proven OTC benefits program thatreduces the burden, and expense, from your team having to support the programallowing you to focus on your core competencies. Our supplemental benefits solutions (including our industry leading OTC program) increase competitiveness of your plan offering, create positive member experiences, and improve clinical outcomes for health plan beneficiaries. If you are encountering any difficulty accessing your account, please feel free to call our Customer Care Team at 877-627-4787 anytime from 6am - 5pm PST Monday - Friday, or email us directly at customercare@newunivera.com by Convey Team | Feb 17, 2021 | Articles, OTC, Medicare, Supplemental Benefits | Enrollment in Univera Healthcare depends on contract renewal. Here are some resources to simplify the process and guide you along the way. .left-column
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. Prescriptions filled at non-network pharmacies are covered only in certain situations. Convey manages member experience, compliance, and utilization, so you can focus on your core competencies. Forgot Password? Closed Thanksgiving Day, Christmas Eve, Christmas Day, New Years Eve, and New Years Day Please make sure your card is active by visiting mybenefitscenter.com if you haven't already. From October 1 to March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. A messaging system is used after hours, weekends and on federal holidays. Take advantage of exclusive rewards and perks to get more from your plan. Univera Healthcare is an HMO plan and PPO plan with a Medicare contract. The expertly designed Medicare OTC card by Convey is no exception. From Oct. 1 - March 31: If you have any questions or are having difficulty accessing the site please call 1-833-331-1573.We experience high call volume the first and last weeks of the month. $0 preventive care services, including annual wellness visit, cancer screenings, vaccines, and more. Did you know you can make a one-time switch into a 5 Star Medicare Plan. Yes! Copyright 2023 Univera Healthcare. Simply implementing an OTC debit card for your member to use is not enough in this competitive market. 10+ Years Administering the OTC Benefits Program. Our technology + service solutions meet the specific challenges that you face when trying to provide an optimal member experience. This collaboration should allow you as the payer to have a say in the OTC benefit card program design: the product selection that is available to your membership, the variety of benefit configurations you would like to implement, any disease-states that your organization would like to target and tailor to, and more.