Along with urgent and emergency care when you travel. 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. Improve your quality of life with our support. 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. Were here for you with helpful online tools and a support team that has your back. When it comes to Medicare, sometimes you need to talk to someone face-to-face. Who is Convey Health Solutions? 8 a.m. to 8 p.m. FIDELIS and FIDELIS CARE are trademarks of Centene Corporation, Non-Discrimination Notice and Language Assistance, Transparency in Coverage Machine Readable Files. The supplemental benefits landscape is booming, with OTC benefits as its mainstay. Questions about products or company? For Coverage January 1, 2023 to December 31, 2023, $0 Routine Eye Exam and $150Annual Eyewear Allowance, Annual Routine Hearing Exam $0 copay, Hearing Aids $499 & $799 per unit. Share this, If youre a caregiver for a loved one, we have resources that can support you. Did you know you can make a one-time switch into a 5 Star Medicare Plan. Please call your health plan for assistance. (In-network), Outpatient Hospital Coverage (In-network), Tier 1 Preferred Generic Drugs (Includes select vaccines). Get care from the people and places you know and trust using our robust network of doctors, hospitals, and pharmacies. To find out how your prescriptions are covered, check our comprehensive list of covered prescription drugs (also known as the formulary). The over the counter benefit provides Medicare members the opportunity to purchase over the counter items from a select catalog using an allowance that is given to them each quarter. View our. Whether your looking for a plan on your own or would like help from an expert, we've got you covered. Login | Members | Univera Healthcare Member COVID-19: Stay informed on vaccines, testing coverage and more Member Login Username Password Forgot Username? 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. Y0028_8791b_MDate Last Updated 12/08/2022. 2023 Convey Health Solutions. Why Should a Plan Offer an OTC Benefit Program? You are covered locally and nationally with our extensive network of 65,000 pharmacies. This page last updated 10-01-2022. 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. - Thurs. We're here for you. 0 comments. Call: Submit a Comment. TTY: 711. For out-of-network providers, we will pay 100% of the allowance or dentist charges, whichever is less. How do I help a loved one find the right Medicare plan? Eating healthy is easier than you think. 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. Copyright 2023, Univera Healthcare. Telehealth for care by telephone, email or chat. Star Ratings are released annually and are based on member satisfaction, plan details, and overall performance. View our Privacy Policy for information on how we protect your privacy. Our Star Rating is a testament to how hard we work to help support your health and wellness. Enrollment in Univera Healthcare depends on contract renewal.Submit a complaint about your Medicare plan atwww.Medicare.govor learn about filing a complaint by contacting the Medicare Ombudsman. 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. Get mental health support via in-person and telehealth visits, with a participating licensed therapist (20% coinsurance) and/or psychiatrist (specialist copay applies). $0 preventive care services, including annual wellness visit, cancer screenings, vaccines, and more. OTC items may only be purchased by you for your own personal use. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical costs and track your deductible and spending View and order your member card Let's get started! This page last updated 10-01-2022. This product is not intended to diagnose, treat, cure, or prevent any disease. Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. 1 Comment. As the market-leading provider of supplemental OTC benefit administration services, we deliver the OTC solutions that members genuinely appreciate. Wellcare By Fidelis Care offers members a pre-paid account that is automatically replenished on either a monthly or quarterly basis depending on your plan. hb``` eapI]u/AR_GPJ[~AGF$i+biH #; L,1a^2dyf8~u|snDHlD@nb``3`pH20b0 2P Submit a complaint about your Medicare plan at www.Medicare.gov or learn about filing a complaint by contacting the Medicare Ombudsman. 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. Copyright 2023, Univera Healthcare. The intensity of competition within the MA marketplace commands health plans to consistently identify solutions that contribute to enrollment growth. Through our experience serving 3.5+ million plan members, we have the expertise needed to provide comprehensive, member-centric OTC services. financial reconciliation, Compliant Debit Card & Flex Card Solutions, Specifically built to manage and support the, Personal emergency response systems (PERS). The Convey OTC benefit card solution is a focal point of our thoughtfully developed, member-centric OTC services. See how we can develop an OTC plan for you. financial reconciliation, Specifically built to manage and support the, Integrated retail, debit card solution with strong focus on compliance, HITRUST certification for information security, Integrated OTC benefits: A Prescription for Customer Satisfaction. .left-column
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Enrollment in our plans depends on contract renewal. Also, consider your travel habits, prescription drug needs, and calculate your annual health care budget. Enrollment in Univera Healthcare depends on contract renewal. The Star Rating is based on information collected from actual members like you, clinicians, and Medicares comprehensive monitoring process. Please make sure your card is active by visiting mybenefitscenter.com if you haven't already. Simply implementing an OTC debit card for your member to use is not enough in this competitive market. .left-column
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. Use of this site indicates your acceptance of our Terms of Use. Annual Election Period for 2020 Coverage: October 15 December 7, including $0 premium plans andvision coverage without copays and, on most plans including 50+ frequently prescribed medications, like hearing aids, gym memberships, and no-cost preventive screenings, from Jamestown to Rochester and every Buffalo neighborhood in between, in network just choose the one closest to you, to urgent care, emergency care, and telemedicine visits by video conference or phone. Specifically built to manage and support the supplemental benefits program, Miramar easily exchanges member data, enforces compliance, and allows for varying benefit designs. This benefit covers 100% of preventive dental services, like cleanings, x-rays, and bitewings, as well as more extensive services like restorative care or major procedures up to a $1,000 annual allowance. Offer an additional supplemental benefit plan for members that suffer from chronic illness or have more complex health needs. Over-the-Counter Benefit Program Administration. Frequently Asked Questions and Helpful Resources, You may be able to join or switch plans under special circumstances that grant a Special Election Period. and get answers to the most common questions we hear about Medicare. We use cookies and other technologies to optimize site functionality, analyze website traffic, and share information with social media, advertising, and analytics partners. Preventive dental included in your plan with NO copay. Sign up to receive your monthly Medicare milestones, showing what you should do now and next, straight to your email inbox. Terms of Use | Web Privacy Policy | Accessibility Statement. Login Access To Your OTC Benefit Is Fast, Easy and Secure. Select Your CountySelect your County - Select Your County -AlleganyCattaraugusChautauqua CentralNorthSouth GeneseeNiagaraOrleansWyoming, Speak with one of our dedicated Medicare Sales Advisors. Here are some resources to simplify the process and guide you along the way. Our extensive expertise, powerful technology, and robust data analytics deliver integrated, end-to-end healthcare solutions to achieve meaningful results. Out-of-network/non-contracted providers are under no obligation to treat Univera Healthcare members, except in emergency situations. Time-saving fitness tips for real people on the go. For additional savings, ask your doctor for a 90-day supply of your medication and fill the prescription at a local pharmacy or through home delivery. Univera Healthcare is an HMO and PPO plan with a Medicare contract. Members receive an OTC debit card with a pre-determined allowance for approved, health-related OTC products. For most plans, you pay 1 copayment for a 30-day supply and 2 copayments for a 90-day supply. Western New York Deserves More from Medicare: Dont worry; were here to help every step of the way. Review your current health care coverage to see what options you have after you turn 65. To use your OTC benefits, choose one of the following ordering methods: Online: Visit the OTC Benefits website (powered by Convey Health) - registration required. Convey's integrated, end-to-end OTC benefit administration solution for mail order, benefit card, and flex wallet programs. Closed Thanksgiving Day, Christmas Eve, Christmas Day, New Years Eve, and New Years Day Choose from retail, home delivery, long-term care, specialty, home infusion, or Indian/Tribal/Urban pharmacies. Convey manages member experience, compliance, and . Medicare Advantage Over The Counter Benefits Administered By Fieldtex, Design and create your custom 2022 OTC Benefit Catalog Program. by Convey Team | Feb 17, 2021 | Articles, OTC, Medicare, Supplemental Benefits | For information on how to request reimbursement for Out-of-Network claims from emergency, urgent or other services, or Coverage Determinations and Appeals call Customer Care at 1-877-883-9577 (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. By clicking on these links, you will leave the Fidelis Care website. You will be responsible for the balance. View our Privacy Policy for information on how we protect your privacy. Put more money in your pocket. Your plan benefits from one account manager, one reporting suite, one set of service level agreements, and consolidated billing. View our Privacy Policy for information on how we protect your privacy. 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. Examples of what can be purchased using your OTC account are Acetaminophen (Tylenol), antacids, and topical antibiotics. 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 Prescriptions filled at non-network pharmacies are covered only in certain situations. membership & We designed the Convey OTC benefit card program to help your MA beneficiaries make the most of their OTC benefitsto achieve or maintain wellness. 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. Enrollment in Univera Healthcare depends on contract renewal. Login | Medicare Members | Excellus BlueCross BlueShield COVID-19: Stay informed on vaccines, testing coverage and more Medicare Login Username Password Forgot Username? Login Your Account Email/Customer ID Password Forgot Your Password? Advisors are also available weekends 8 a.m. to 8 p.m. CMS-Compliant OTC Services As the market-leading provider of supplemental OTC benefit administration services, we deliver the OTC solutions that members genuinely appreciate. OTC benefit card, mail order, and flex wallet programs for over-the-counter benefits administration. Using Your Hearing Benefit. Tv~Ln``$;@ \P For hours and additional contact information please visit the Contact Us page. I would like to receive emails from Univera Healthcare, such as Wellness and Health newsletters and more. Explore our mail order, benefit card, mobile, and web solution. 317 0 obj <>stream Forgot Password? Contact us today to speak with our Medicare Advantage experts. Phone: Call 1-855-657-7545 (TTY 711 ), Monday - Friday, 8 a.m. to 11 p.m. The Convey OTC benefit card solution is a focal point of our thoughtfully developed, member-centric OTC services. In OTC form, these drugs are FDA approved and often equally effective as prescription drugs at 2023 Convey Health Solutions. View our Medicare Advantage Timeline to learn more. With the Silver&Fit Fitness Benefits Program you can join a participating fitness center for a $0 annual fee, workout from home with a home fit kit (1 kit / $0 annual fee), and access online digital workouts. From Oct. 1 to Dec. 31, representatives also are available weekends from 8 a.m. to 8 p.m. Join us for a Medicare Seminar to learn more and let us help you choose the right plan. View Benefits & Coverage (Requires login) Disenrollment Rights & Responsibilities Give permission to access your health information Univera Healthcare is an HMO plan and PPO plan with a Medicare contract. 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. 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 plans success. To learn more about Conveys Medicare OTC card and our complete suite of supplemental benefits programs from a solution expert, hbspt.cta._relativeUrls=true;hbspt.cta.load(4332662, '11d72886-3898-4181-bcdb-162cb1a375da', {"useNewLoader":"true","region":"na1"}); Implement a Valuable Medicare OTC Card Program, A fully compliant and configurable multi-channel OTC solution to meet health plans requirements, A choice for members from five integrated purchasing methods for ease of access: online, phone, mobile app, mail-in form, and in-store OTC product purchasing, Expanded service offerings that include seamless benefits management, transaction activity and account balance assistance, and enhanced mobile and web capabilities, Support from the #1 VISA global payments processor for secure, real-time updates, Access to retail locations within an average of 10 miles from members homes, A solution that is part of larger concierge supplemental benefits and flex wallet programs. Currently partnered with numerous Plans, weve successfully distributed over 1,000,000 packages of over-the-counter supplies to Medicare members nationwide. 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. View preventive health checklist for older adults. Choose to enroll online, by mail when you order an enrollment kit, or by phone. Call Customer Service toll-free at 1-877-883-9577 (TTY 711) 8 a.m. to 8 p.m. Monday - Friday. Once youre enrolled in Medicare, you can change your Medicare coverage during the Annual Election Period from October 15 to December 7. You can even request a 1-on-1 appointment with a Medicare expert to get your questions answered. Your account can be used to purchase over-the-counter (OTC) eligible items that help treat injuries or illness. *Health plan members: Rather than submitting this form, we recommend you contact your health plan directly. Create an Account View your Summary of Benefits and Coverage Find a doctor, estimate medical cost and track your deductible and spending preventive health checklist for older adults, comprehensive formulary and searchable medication database, Summary of Benefits with Multi-Language Flyer, $5/$30 Benefit Overview. Please contact us! For the best experience on our site, be sure to turn on Javascript in your browser. As a focal point of Conveys thoughtfully developed member-centric OTC services, Conveys Medicare OTC card is a solution that will do just that. To see which stores participate, check withyour OTC partner. And with integration into our flex wallet program, members can have simplified access to more benefits than ever before! The information you're accessing may not be Medicare-specific and/or provided by Univera Healthcare. Conveys integrated, end-to-end OTC benefit administration solution for mail order, benefit card, and flex wallet programs. Every year, Medicare evaluates plans based on a 5-star rating system. How Can We Help You Elevate & Streamline Your MA/MAPD, PDP, EGWP Plan Operations? **Free shipping can only be fulfilled within the 48 contiguous United States (excludes recipients of Alaska, Hawaii, and other US territories). .left-column
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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. Y0028_8829_C. Specifically built to manage and support the supplemental benefits program, Miramar:OTC easily exchanges member data with client interfaces, empowering both advocates and members to navigate the OTC program with ease. and check to see if your prescriptions are covered. They also benefit from one award-winning customer service center to coordinate it all. Or, see the Evidence of Coverage using the link above. This information is not a complete description of benefits. All Rights Reserved. See our Privacy Policy for how we use information. From Oct. 1 - March 31: Optimize your business processes for operational success from a strategic and financial perspective. Non-Discrimination Notice and Language Assistance(PDF). Take advantage of exclusive rewards and perks to get more from your plan. You have from 3 months before you turn 65 to 3 months after your birthday month to enroll. You dont have to manage health conditions alone. Questions? Log into your account, view patient information, and more. Conveys purpose-built solution and services support the OTC benefit card platform in concert with our other ordering channelsin place since we began administering this program in 2008. Your members receive our award-winning customer service every step of the way. Convey Health Solutions is the vendor that Univera Healthcare is using to administer the Over the Counter Benefit. Links marked with an (external site) icon indicate you're leaving UniveraHealthcare.com. If you obtain routine care from Out-of-Network providers neither Medicare nor Univera Healthcare will be responsible for the costs. by Convey Team | Feb 20, 2018 | 1 comment. 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. Enrollment in Univera Healthcare depends on contract renewal. 0 With our expertly designed program, we track utilization accurately so that you only pay for what the members use. endstream endobj 285 0 obj <.