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Medicare

Medicare

Inpatient/Hospital Care Outpatient/not admitted to hospital

Medicare Part D= Prescreiption Drugs Medicare Part C= Medicare Part C/ HMO Health Maintenance Organization

Healthfirst Medicare Advantage Plan Name Plan Abbreviation Part A& B Part D Dual Eligible . / / /

For Dual Eligible Plan no payment needed . Life Improvement Plan = Healthfirst Handled only Medicare. Medicaid should be handled by other Insurance Services or State Medicare Will cover 80% and Medicaid will handle 20% 100% will be billed by Healthfirst . Completecare Plan= We both Handle Medicare and Medicaid . Connection Plan= HARP Health And Recovery Program = Members with Mental Health eligibility

Company Code 30 Healthfirst Medicare Advantage Member IDs Will start With 11,12,13

Knowlegde

Dual Eligibility Renewall Plan= for Life Improvement Plan/ Medicaid can Renew Every Year, Medicare is not renewable

Dual Eligible Plans- Renewal Responsobilities

	LOB					Agency Contact Information
				Provide the Direct phone number 1-844-500-9820 Mon-Fri 8:30AM- 8:00PM
				snd Transfer the number to retention Scheduling Department

LIP with On-Exchange Medicaid using the FF extension: . English

. Signature PPO= can see both in and out of network . Signature (HMO)= can only see in network providers . PPO =preferred provider organization

HARP= Health And Recovery Program

OOP Assistance for PArt D

New YOrk State EPIC Program= New York State (NYS) Supplemental prescription coverage that works with Medicare Part D Plans

Elderly Pharmaceutical Insurance Coverage (EPIC) / Low Income Subsidy (Extra Help)

5 Status of Enrollment . Enrolled . Dis Enrolled . Feature Enrolled . Pre Enrolled . Null Enrolled

Healthfirst Plan Sinature PPO Sinature HMO 65 plan = not eligible for OTC Increased benefits plan life improvement plan Complete care plan / handled by Medicaid and Medicare connection plan / handled only by Medicaid and HARP

MarketPlace Plan

Siganture PPO care or Flex Card

Complete care can recive monthly allowance

Medicaid is not eligible for OTC card

OTC card is eligible only for Medicare plan members only

For caller's RP and un authorized Caller HH - for RP 18 above check case history then view more it must be Valid RP Minor- Biztalk

Senior Health Partners don't Have PCP only long term services and Dual services, They may have PCP but handled by the State.

Dual eligibility . Life Improvement Plan . Completecare Plan . Connection Plan

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