Hello All,
I pray each and every one of you is doing well. I just wanted to let you know that Annual Open Enrollment (AEP) here (October 15th thru December 7th).
There are some changes that are going to take place for 2025. Starting with Good news!!! The Coverage Gap, or “Donut Hole”, has been eliminated and your out-of-pocket maximum cost is lower than ever. That means you’re more protected from high drug costs in 2025. There will be a deductible to meet if your prescriptions fall into the Tier 3,4 and 5 category. That means you will pay the full cost for your drugs in these tiers until your deductible is met. Then you will move to the Initial Coverage Stage. In the Initial Coverage Stage you will pay your plans copay or coinsurance. The plan pays the rest. Once you have paid a combined total of $2000, which includes the amount you paid towards your deductible amount, you move to the Catastrophic Coverage stage. In that stage, you won’t pay anything for your Medicare-covered Part D drugs for the rest of the plan year.
Please everyone review the formulary for next year by clicking on the QR code that is on second page at the bottom of the Enrollment Guide that your carrier has sent out to you. You can also go to the member portal website to make sure your prescriptions will be covered for next year. Also, contact your providers and or me if you want to make sure your doctors will still be in network for next year. If you are wanting a copy of your Evidence of Coverage (EOC) for the plan that you want to continue with for next year, in order to make sure you like the plan coverage, costs and benefits, then email me back your request and I will send it.
The plans are generally going to be the same, with the exception of a few increased costs in one plan’s premiums. Other plans do have lower copays, deductibles etc.. Ancillary benefits such as Over the Counter (OTC) have increased slightly in a few plans. Also, all the plans (HMO and PPO’s) do not require a referral. The HMO’s you still have to have a doctor within the network (but no referral is required) and the PPO’s you can go in and out of network (with a higher out-of-pocket cost out of network). Our Medicare Advantage PPO plan is still a National plan. To know more about the changes that are taking place, I can also send you the Benefit Highlights of the 2025 plan (at your request) that you will be automatically renewed in. If I don’t hear back from you before December 7th stating you would like to change your plan, you will automatically be renewed into the 2025 version of the plan you have currently. In other words, if you like your plan you don’t have to do anything and you will automatically be renewed in the same plan you are in now for 2025.
****There is one new plan that is coming in 2025 and two other plans that are being mapped. What mapped means is the plan is the same basically, but with a few changes including the number assignment of the plan, plan benefits and more counties it may cover. They are all Dual Complete Plans. The new one is the HMO (UHC Dual Complete CO-S4 (HMO POS D-SNP)) and the other two PPO’s (UHC Dual Complete CO-V001 and CO-S001 PPO D-SNP). These plans are for any individual who has full Medicaid benefits or is a Qualified Medicare Beneficiary (QMB). You will pay $0 for your Medicare-covered services. Also, Great News: The HMO plan has a $235 credit for food, OTC and utilities, which is quite an increase from the $185 credit that is given currently.
So everyone who is enrolled in a Dual Complete Plan, please contact me. ***Your plan that you are currently on may not auto renew based on which Dual Complete Plan you are on currently****. We have to get you enrolled into the new plan before December 7th.
I would also like to let everyone know that you may be receiving a new UCard, even if you received one last year. This is because of the new plans when it comes to the Dual Complete Plans. The new plan has to reflect/say what plan you’re on when you go to the hospital or pharmacy. Once you receive your Ucard, you’ll have to activate it for your ancillary benefits i.e. over the counter benefits (OTC), gym services, healthy food, utilities (for those on Dual Complete plans and UHC rewards), if you have changed your plan. If you haven’t changed your plan, you will still receive a new UCard, but will not have to reactivate your ancillary benefits. You also do not need to activate the card for doctor visits or to receive prescriptions, but most definitely for the ancillary benefits.
United Healthcare has a mobile app that you can download on your phone that will allow you to see what’s covered with things like OTC and Healthy Foods. It will allow you to see how much you have left to spend for these ancillary benefits, as well as a host of other great benefits that can save you time and answer many questions you may have about a particular subject. If you have any trouble with the mobile app, you can always go to the website uhc.com for the same service, or call me for assistance.
Attached below our eight documents that I would recommend you read. The first two documents are the Annual Notice of Change (ANOC) for the UHC Dual Complete CO-V001 & CO-S001 PPO D-DNP Plans. These documents let you know that there has been a change from this year’s Dual Complete CO-S001 & V001 PPO D-SNP plan benefits to next year’s Dual Complete CO-S001 & V001 PPO D-SNP plan benefits and lets you know what changes will occur. The second document is the 2025 Benefit Highlights for the new UHC Dual Complete CO-S4 HMO D-SNP plan. This is the plan with the $235 healthy benefits credit. Please review the plan. This document lets you see how your plan will look in 2025. The last few documents are the 2025 Complete Drug List (Formulary) for all the plans, including Dual Complete. Look at the plan name numbers you have on your UCard or Enrollment Guides currently and then choose which Drug List Formulary is for your plan.
If you need guidance, please let me know.
Take your time and please review these changes. Let me know if you would like to enroll in the new Dual Complete plan or continue with the coverage you currently have. For most who have a Dual Complete D-SNP HMO plan currently, you’ll need to switch your current 2024 HMO plan for the new 2025 HMO plan that will be starting in 2025. ****Once again, I want to say if you like the plan you’re currently on, you don’t have to do anything. Your plan will automatically renew, unless you need the UHC Dual Complete S4 HMO D-SNP.**** For those of you who just have some questions about your plan for next year, we definitely can speak. Please do not hesitate to give me a call at 720-975-5513, email: bluelytehealth@gmail.com or leave your contact information by clicking the contact tab at the top of the page. You will then be directed to the contact form that. Make sure you select the form for Medicare. Then leave your name, number, email address and phone number. I will get back to you and we can set up a time to go over your questions and concerns.
Just a reminder for everybody that I can send the Benefit Highlights through email, upon request. Especially for individuals who are currently on the PPO Dual Complete plan, as well as the Dual Complete HMO plan and need to see the changes happening for 2025. I can also send the Benefits Highlights for the new HMO plan in 2025. For those not on the plans, you’re more than welcome to request the Benefit Highlights also. Let me know if you want to change your plan before December 7th 2024.
It is truly my honor and pleasure to serve you all. Thank you so much for allowing me to be your broker.