Thank you for coming!
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Transcript of Thank you for coming!
Thank you for coming!
Before we start:– Who is currently on Medicare? Who is on a Medicare
Advantage program?– Who has heard of Optimum HealthCare?– Who would like more benefits for less money?– Who wants the freedom to choose your own plan
and/or your own physician?– Who wants to work with a company that really
understands your healthcare needs and really cares about customer service?
What We Will Discuss Today
Discuss Your Current Coverage
Compare Medicare Advantage to Medicare
Introduce Optimum HealthCare
Explain The Benefits of a Optimum Health Plan
Help You Decide The Best Optimum Health Plan For You
Answer Questions and Show You How to Enroll Today!
Please hold questions until the end of the presentation.
Your Current Coverage
• What do you have now in addition to Medicare Parts A and B?
• Is there a cost to your plan?
• What do you like about your plan? What would you like to change about your plan?
• What type of plan would you prefer?– Comprehensive coverage with more benefits– A plan that will reduce your out-of-pocket expenses– Unique services outside traditional Medicare
SupplementalPlan
Medicare Advantage Plan with Prescription
Drug Coverage
Medicare Advantage programs often have
more benefits at less cost to you.
Original Medicare
Medicare Part D
Medicare Advantage Programs
Companies like Optimum
HealthCare offered to assist the government with Medicare
Optimum HealthCare
basically became a new and improved
‘Medicare’ for you.
Medicare pays Optimum
HealthCare to provide benefits
and customer service.
By developing a network, Optimum
HealthCare provides lower premiums and more benefits.
Medicare Advantage programs often have more benefits at less cost to you.
Medicare Advantage Programs
Extra benefits beyond original Medicare*• No Monthly Plan Premiums• For Part B Reimbursement Plans: (Refunds vary by county)• No Medicare Deductibles• Brand & Generic Rx Coverage• World Wide Coverage• Extra Benefits for Dental, Vision and Hearing• Health Club Membership & Fitness Programs• No Medicare supplement Needed• Over the Counter Benefits
*Limitations & Co pays may apply; Details vary by plan and plans are available by county; the social Security Administration reduces your Part B Premium on Part B payback plans{
Benefits of Medicare Advantage
Government Funds
Original Medicare Medicare Advantage• Limited coverage
• Limited preventive care benefits
• Deductibles
• Coinsurance
• Supplement needed• Join a Prescription Drug Plan (PDP) for Part D coverage
• Covers all benefits of Original Medicare + No Medicare deductibles
• Part D included
• No supplement needed
• Additional Benefits
Medicare Beneficiary* One of the plans available under the annually renewable Medicare Advantage contract.{
Benefits of Medicare Advantage
How a Medicare Advantage Plan is Reimbursed
Medicare Part B
Additional BenefitsOther health
care providers
Medicare Part AFinanced in part by payroll taxes paid by workers and employers
Financed in part by deductions from your monthly Social Securitycheck.
US Government Medicare Funds
Hospitals PharmacyDoctors
Optimum HealthCare
Do you have Medicare Parts A & B?
Is your permanent residence here in this county?
Do you live here at least six months out of the year?
Do you have end stage renal disease?
Are You Eligible?
• Optimum HealthCare was started by and still managed by doctors. These doctors care about developing better Medicare Advantage programs and providing customers with excellent service.
Introducing Optimum HealthCare
• Physician Managed & Operated• Corporate HQ in Tampa, FL • Member Services located in
Tampa, FL• Incorporated in 2004• Started in 2 counties for 2007,
grown to 5 counties in 2008• Expanding to a total of 29 Florida
Counties for 2009• We are locally operated to ensure
that we understand your healthcare concerns
• We are committed to excellence
Introducing Optimum HealthCare
Optimum HealthCare is committed to
EXCELLENT CUSTOMER SERVICEwith local claim centers, a concierge department and consistently friendly
and very knowledgeable service.
In fact, Optimum HealthCare is one of the fastest growing companies because of referrals by satisfied customers. In addition, out of 150 Medicare Health plans in 80 cities, Optimum HealthCare won the Senior Choice Gold Award in 2007.{
Excellent Customer Service
Concierge ServicesStellar service to our members is a matter we take quite seriously. You can now receive Concierge Service at each one of our local offices.
• A concierge desk at each office to expedite your Member Service needs. (i.e. replacement cards, PCP changes, address changes and more).
• Friendly trained staff who would like to meet you to learn more about what you need from your health
plan.• Information on scheduled Events and Health related
issues.
• A one hour resolution time.• Licensed Agents available to assist with benefit
information.
Awards
• National Committee for Quality Assurance-Toughest Quality Accreditationfor Managed Care Organizations-3 Year Accreditation (2007 - 2010)
• HealthMetrix Research Inc. (Medicare News Watch)
- An independent managed careresearch firm in Columbus, Ohio
(Independent Industry Analyst)-Awarded Optimum HealthCare their Senior Choice Gold Award For Excellence in Benefit Value (cost comparisons for over 150 Medicare health
plans in 80 cities, November 1, 2006)
Awards
Plans Offered by Optimum HealthCare?
• Gold• Platinum• Emerald
Compare Your Health Care Options
This table is a brief overview comparing Original Medicare, a popular Medicare supplement and Optimum Health Medicare Advantage plans. The Summary of Benefits will go into more detail about benefits.
Original MedicareOffice visits when you are sick
Hospitalization
* Limitations and co-payments may apply. May not be available on all plans.* You may be required to continue to pay your Medicare Part B premium
A common Medicaresupplement - Plan CCoverage for all Medicare
deductibles and co-insurance
Optimum Medicare Advantage Plan *Original Medicare benefits plus no Medicare deductibles. Additional benefits for prescriptions, extra coverage for dental, vision and hearing. No Medigap supplementneeded.
Using The Plan
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Important note: Statement of Understanding
Starting on the date your coverage begins with Optimum HealthCare, you must receive all of your health care from Optimum HealthCare
providers with the exception of emergency or urgently needed services or temporary out of
area renal dialysis.
Can I Choose My Doctor?
We have formed a very large network ofdoctors, specialists and hospitals that you can
choose from.
You must stay within our network of services while with
Optimum HealthCare.
You Are In Control
Primary Care PhysicianYour Choice
SpecialistHospital
Your PCP will refer you to a Participating Hospital
Emergency coverage at any hospital
Urgent care coverage at any health care provider
Other ProvidersWell woman visits
Dental, Vision, Hearing
*Limitations & copays may apply*See evidence of Coverage for details*You must receive all routine care from Plan Providers*Varies by county{
This Year’s Benefits With Optimum HealthCare
Your Optimum HealthCare Representative will present
the specifics of your Optimum HealthCare
Medicare Advantage plan benefits, using the Summary of Benefits booklet and drug
formulary.
Optimum Fitness Program
• The Freedom Fitness program combines free access to Fitness Centers with multiple programs directed at improving the health and welfare of our members
• Group Exercise Programs
• A local company run by doctors who wanted to make Medicare better
• Consistently voted to provide excellent customer service by industry experts and, more importantly, our customers
• Freedom to choose your own plan to fit your needs
• No monthly plan premiums
• No Medicare supplement needed
• For plans with Part B reimbursement: Refunds vary by county
• Worldwide Emergency, urgent and temporary out-of-area renal dialysis coverage
*Limitations & Co pays may apply; Details vary by plan and plans are available by county; the social Security Administration reduces your Part B Premium on Part B payback plans{
Top Reasons To Join Optimum HealthCare*
• Part D coverage included
• Preventive care, including physical exams
• Brand and generic prescriptive coverage
• Extra coverage for dental, vision and hearing
• Freedom fitness health club and fitness membership
• Predictable costs for easier budgeting
• Low out of pocket maximums
* Limitations & Co-payments may apply; Varies by County{
Top Reasons To Join Optimum HealthCare*
Enrollment
• Complete your enrollment form.
• You will receive a welcome packet, Evidence of Coverage and ID card.
Enrollment
• During the 2008 Annual Enrollment Period (AEP), MA eligible individuals may enroll in or disenroll from an MA plan. The AEP occurs November 15 through December 31 of every year.
• The last election made, determined by the application date, will be the election that takes effect
• Enrollments submitted during the 2008 AEP will have an effective date of 1st January, 2009.
New Member Orientation
• We will go over your welcome packet
• Show you how to: – set up your prescriptions by mail
– set up your over the counter benefits
– set up your dental benefits
– set up your fitness membership
• Review membership benefits
• Go over member services contact numbers
• Answer any questions you may have
Extra HelpMedicare Subsidy Information
You may be able to get extra help to pay for your prescriptiondrug premiums and costs. To see if you qualify for gettingextra help, call:
• 1-800-MEDICARE (1-800-633-4227). TTY/TTD users should call 1-877-486-2048, 24 hours a day, 7days a week
• The Social Security Administration at 1-800-772-1213 between 7.00 AM and 7.00 PM Monday through Friday. TTY/TTD users should call 1-800-325-0778
• Your State Medicaid Office
• Florida SHINE (1-800-963-5337, TTY 1-800-955-8771)
We would love to help give you peace of mind with your health care!
Are there any questions?
Before we finish……
Many of our members have been referred by their friends. Who do you know that could benefit from Optimum HealthCare’s Medicare
Advantage Plan?Carepath of PinellasCall: 727-565-4655
Monday thru Sunday 8:00 am – 5:00 pm
www.carepathins.comwww.youroptimumhealthcare.com
Thank You And Share The Good News