Open + Enrollment Your comprehensive guide to key Medicare and health insurance decisions Advertising supplement to The Denver Post
November 15, 2020
Inside: Learn about Colorado’s health insurance marketplace.
Staying Connected Boosts Mental and Physical Health By: Denver Health Medical Plan
Social connections are crucial to every aspect of our lives. And as we age, it’s even more important to maintain them. Besides reducing loneliness, social contact can actually improve our mental and physical well-being in a number of ways: It reduces stress: A support system of family and friends provides us with emotional support as we navigate life’s challenges — enhancing our self-confidence, reducing stress, and lowering our risk for cardiovascular disease. It makes us happier: Scheduling a phone call, dinner, or a stroll in the park adds variety to our day and gives us something to look forward to. It keeps us active: Planning activities with others, like walking, volunteering, or playing with the grandkids, is a great way to keep moving, which improves mental and physical health. It helps prevent dementia: Connecting with
others helps increase brain health and reduce the risk of cognitive decline.
Creative Ways to Stay Connected For many families, the challenges of social distancing have made it hard to maintain a close connection with loved ones. When inperson get-togethers aren’t possible, here are some other creative things you can do: Turn video calls into an activity: Enlist a relative or friend to help you set up a call. Then, plan an activity — perhaps a video chat storytime with the grandkids, a cooking class, or a game of Bingo. Get creative with letters: Start a story and pass it back and forth to someone until you have a finished masterpiece created together. Start a movie club: Once a week, pick out a movie to watch with family or friends at the same time and then talk about it on your next phone call or video chat.
Set up an interview: Have young family members write down anything they’ve ever been curious about the family and ask away — what was life like growing up? What was your craziest family vacation? What was mom (or dad) like as a kid? Be a guest teacher: If your grandchildren are homeschooling, what better way to illustrate a historical event than to recount the story from personal experience? Teaching is a fun way to learn together. To ensure you communicate regularly, it’s a good idea to schedule a block of time for video chats, calls, or visits. If there are days you can’t stick to your regular schedule, even short check-ins throughout the day are enough to stay connected with the ones you love. Learn about Denver Health Medical Plan Medicare Advantage plans by calling 303-602-4912.
794 PROVIDERS. 3,615 SPECIALISTS. 9 HOSPITALS. TONS OF EXTRA BENEFITS. A large provider network is just one of the many benefits of our Medicare Advantage plans. In addition to all the benefits you would expect from original Medicare, Denver Health Medicare Advantage plans also provide:
Provider network includes:
Even More benefits:
» » » »
» 35 round-trip rides to the doctor’s office » Up to $200 in Eyewear every year » Up to $1,500 in hearing aid coverage every 3 years » Dental, vision and hearing
Denver Health SCL (Denver Metro Area) UCHealth (Denver Metro Area) Stride Community
Low copays: » $0 PCP copay » $25 specialist copay » $25 urgent care copay
CONTACT A LICENSED SALES AGENT TO ENROLL TODAY 303-602-4912 (TTY 711) 8 a.m. to 5 p.m. | Monday through Friday denverhealthmedicalplan.org
Denver Health Medical Plan, Inc. is a Medicare-approved HMO plan. Enrollment in Denver Health Medical Plan depends on contract renewal. The Plan also has a written agreement with the Colorado Medicaid Program to coordinate your Medicaid benefits. ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-877-956-2111 (TTY 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Para obtener más información llame al 1-877-956-2111. (Los usuarios de TTY deben llamar al 711). H5608_NwsPprPrntAdV2_21_M
What Value-Based Care Is and Why It Matters to Your Health
By: Mark Iorio, Central West Region President, Humana As important as scientific and medical breakthroughs are to healthcare, they’re only part of the equation. What’s the other part? People. From doctors to nurses, health coaches to behavioral specialists, people determine the healthcare experience. To have a better healthcare experience, you need people who can connect the dots between your lifestyle, genetics, environment, and health. You need a new kind of care.
What Value-Based Care Is. Value-based programs, developed by The Centers for Medicare and Medicaid Services (CMS), the federal government agency that manages Medicare and Medicaid, aim to deliver better care for individuals, better health for populations, and lower costs.[1] Value-based programs reward providers for the quality of care they provide, not the quantity of services performed. Value-based care works to improve health outcomes.
Why Value-Based Care Matters. More Collaboration, Increased Transparency. Value-based care encourages providers and payers to collaborate, which can lead to greater transparency. A coordinated effort creates a unified approach to improve your health outcomes.[2] With value-based care, in addition to a doctor, you may have access to other support through a health coach, nutritionist, and/or behavioral health specialist. More than Medicine. Value-based care providers may recognize that social and environmental factors such as food security, social connections, and transportation contribute to your overall health. In fact, these factors may be “at the root of why patients aren’t achieving the best health outcomes.” Valuebased providers may use lifestyle adjustments as a medicine—not just procedures and pills— to help you lead a healthier, happier life. Coordinated Care for Complex Conditions. Humana’s Value-Based Care Report shows 1
Sources
2 3
that 90.5 percent of Humana members have at least one chronic condition, and 82.6 percent have at least two. Chronic conditions such as diabetes, hypertension, and heart disease may present ongoing physical, emotional, and social demands that take a toll on both you and your family.[3] Humana found that patients in a value-based setting were more likely to adhere to hypertension and diabetes medications than those of non-value-based doctors. Value-based care providers may offer increased care coordination and support. Better Health. Humana members in value-based care settings receive higher rates of preventative screenings, fewer emergency room and hospital admissions, and greater adherence to medications than those in non-value-based care settings, all of which contribute to lower medical costs. Humana found a 20.1 percent savings in value-based care programs and expenses compared to Original Medicare. Happier Life. When you’re healthier, you enjoy a better quality of life. You can be more active whether that’s cultivating your garden, learning how to paint, taking a yoga class with friends, or marking travel destinations off your bucket list. You can be more engaged with your friends and family, celebrate the simple joys and major milestones alike. Better health and greater happiness are within your reach. It’s up to you to reach for it. Ready to get started with value-based care?
Visit healththatcares.com or contact your local licensed Humana Sales Agent at 1-844-2248993 (TTY: 711). ¿En español? Llame gratis al 1-844-357-9121 (TTY: 711). Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.
h ttps://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs https://valuebasedcare.humana.com/wp-content/uploads/2019/11/docs2019_VBC_GCHKMZNEN.pdf https://www.healthaffairs.org/doi/10.1377/hlthaff.20.6.64
Preparing for Open Enrollment During COVID-19 Healthcare coverage is needed now more than ever. Having a plan that can support you during the COVID-19 pandemic can be of great help, especially with the expenses involved in treating the disease. The pandemic has strained the workings of various industries, including the health insurance field. As everyone adjusts to a “new normal”, one might encounter challenges when registering for insurance. It’s essential to know how you can prepare for the changes in healthcare applications prior to open enrollment.
How to Prepare for Open Enrollment During the New Normal Delaying your healthcare application isn’t an option, especially with the current crisis that the country is facing. The question is, how can you ensure an efficient and safe way of registering for healthcare? To get started, here are some tips that will help you have a hassle-free open enrollment during the pandemic:
Don’t Panic As businesses close and lay off employees, it’s inevitable for many to worry about their insurance coverage. While this is a valid feeling, panicking won’t solve anything. It’s important to stay level-headed when preparing for open enrollment, so you can explore and understand your insurance options clearly. The Center for Medicare & Medicaid Services (CMS) is doing their best to make sure every citizen has access to the benefits of government health insurance. They are finding ways to provide equitable relief, like application extensions and waiving late registration fees.
Learn More About Contactless Registrations Since everyone is encouraged to practice social distancing measures, it’s important to know you can complete your healthcare registration online. For online transactions, go to www.ssa.gov/ onlineservices. You may also send documents through airmail or fax.
Are you satisfied with your Medicare plan? Could you do better? Compare comprehensive Medicare Advantage plans.
Could you get more? Find out how your current plan compares.
Could you pay less?
$0/month plans may be available.
Currently, local social security offices are not allowed to render in-person services but they can still process applications that are sent to them in the channels mentioned.
Know Colorado’s Open Enrollment Period Colorado’s open enrollment period runs from November 1 to December 15. Only a qualifying life event can make you eligible to apply throughout the rest of the year until the next exchange. To learn more about Colorado’s Open Enrollment Period, go to connectforhealthco.com.
Medicare’s Annual Election Period is here (10/15 - 12/7). Have your new Medicare Advantage plan ready to protect you on January 1, 2021.
“This is Medicare Advantage, the easy way.” Meredith Vieira
Compensated spokesperson
Go to myHealthPolicy.com to find out.
Our local network of licensed insurance agents can also help you find the right Medicare Advantage plan or a standalone Part D Prescription Drug Plan that works with Original Medicare! Call us at 1-800-GO-START (1-800-467-8278), TTY 711. myHealthPolicy.com is operated by K.F. Agency, Inc., which is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in these plans depends on contract renewal. myHealthPolicy,com and K.F. Agency are not connected with or endorsed by the United States government or the federal Medicare program. CA residents: We collect personal information from you in order to offer products, services and information we think will be of interest to you. As a California consumer, you have the right to opt out of the sale of your information. Please see myhealthpolicy.com/home/ privacy-center to learn more about the information we collect, how we use it, and exercising your rights.
High-Deductible Healthcare Plans 101
In the early 2000s, health insurance prices saw an increase owing to higher healthcare costs at the beginning of the decade. Businesses picked up on this trend and began looking for ways to balance their employees’ benefits with the company’s expenditures. Some of them sought out high-deductible health plans (HDHP) on the belief that this would give everyone the best of both worlds.
What Are High-Deductible Health Plans? An HDHP is an insurance policy with a high minimum deductible that the insured must first payout of their pockets before the coverage kicks in. The portion of the bill that one has to pay will depend on their contract, while the rest is then mostly covered by the provider.
How Do High-Deductible Health Plans Work? An HDHP works and can be used just like any other healthcare plan. Several factors will determine your specific rate, including your age, location, number of dependents, and tobacco usage. If you opt for your insurance company’s innetwork providers, 100% of your preventative care costs will be covered by your plan. For other services, you will first have to meet the minimum deductible for the year. Your insurer will then cover the rest of your expenses, while you’ll only need to pay for coinsurance. And once you’ve reached your out-of-pocket limit,
which is set by the IRS, your insurance provider will cover the rest of your healthcare costs for that year.
Should You Opt for High-Deductible Health Plans? Depending on your health situation, being covered by an HDHP can have a wide variety of pros and cons for you. It’s best to consider these first before making your final decision so you can have a better understanding of what you’ll be signing up for.
Advantages of HDHPs HDHPs are often better suited for individuals or wealthy families who do not mind paying for higher deductibles. However, if your company provides HDHPs as one of the multiple plans that employees can opt for, here are some of the benefits that you can enjoy: •H DHPs entitle you to lower premiums than if you opted for POS or PPO. •Y ou have access to a wider network of providers compared to HMOs. •Y ou can open a health savings account (HSA) to help cover out-of-pocket expenditures. •M onthly expenses for medical care may be lower, especially if you do not have expensive maintenance medication. • I f you rarely use your health benefits, you may end up saving money instead
with this plan • Since preventative care costs are 100% covered by your HDHP, you can afford to come in for regular checkups with an innetwork provider.
Disadvantages of HDHPs As with all insurance policies, HDHPs can also have a few cons that are worth learning about. This will help you better prepare for all scenarios. Keep the following in mind before you fully opt-in for an HDHP: • If you have a chronic illness, out-of-pocket expenses can be a little higher than other plans. • You will also have to cover costs for office visits, diagnostic tests, prescriptions, and surgeries until they meet your minimum deductible. • You can’t take full advantage of your HSA if you have high monthly out-of-pocket expenditures. • Deductibles for HDHPs are high for many people, especially if they opt for family plans.
Learn More about Healthcare Plans There’s more to healthcare plans, including HDHPs, than just the basics. For you to make the right decision, it’s also best to consider and read more about the different categories of insurance policies.
Questions to Ask Yourself Before Selecting a Healthcare Plan Having a Medicare plan has a multitude of advantages. It can help cover medical expenses, provide access to healthcare services, and give peace of mind to its beneficiary. As the open enrollment season draws near, you might be considering getting a plan for yourself or a loved one. Whatever your motivation is, it’s important to think things through and plan carefully. This way, you can get the coverage that suits your needs best.
4 Important Questions to Ask When Selecting Medicare Coverage For first-timers, it can be quite a challenge to choose healthcare coverage. But when one knows the right questions to ask, it will be easy to get the details you need and make informed decisions. If you’re new to Medicare, here are some questions that can help you understand the different plans, their benefits, and how to apply for them:
What’s Covered by My Chosen Plan? ach type of plan covers varying healthcare E expenses. Part A is for in-hospital costs, while Part B is for outpatient services like doctor’s appointments, diagnostic tests, therapy, and durable medical equipment. But if you want comprehensive coverage, a Medicare Advantage (MA) plan may be the right one for you. edicare Advantage policies cover healthcare M services under Part A and Part B plans. Unlike the original Medicare, most MA insurances include Part D or prescription drug coverage. They may also have other extra benefits like vision, hearing, dental, or health and wellness programs. efore applying for any of these plans, it’s vital B to evaluate where you’ll need assistance the most. Is it for in-patient services, medicines, or preventative care? This way, you can find coverage that is inclusive of the solutions you need.
H ow Much Do Plans Cost? Healthcare coverage can be pricey. You’ll need to pay monthly premiums, annual deductibles, coinsurances, and possible late enrollment penalties. So before you apply for any Medicare plan, make sure you understand the costs involved.
tart by browsing online resources or asking S local social security officers about Medicare rates and payment schemes. This will help you find a plan that covers most of your medical expenses and doesn’t exceed your budget.
W hich Doctors Can I Consult? If you’re enrolled in a Part A plan, you can receive care from doctors and institutions which are accredited by Medicare. You may want to check with the Centers for Medicare and Medicaid’s (CMS) Physician Compare site. This is the online database of the healthcare workers and hospitals which provide services for Medicare beneficiaries. owever, if you have an MA policy, you may H need to contact your insurance provider to ask them about their network. They will be the ones who will connect you with their partner healthcare facilities and physicians.
When Can You Enroll for Medicare? The initial enrollment period (IEP) for a
Medicare plan begins three months before one’s 65th birthday and ends three months later. If you weren’t able to sign up during the IEP, you can still do so during the general application season. However, applications made after you were first eligible might require you to pay penalties. So if you wish to avoid the additional charges, it’s best to register for coverage as early as possible Applying for coverage doesn’t have to be difficult. When you’ve equipped yourself with the needed information, you can go through the application process without any hassle. If you want to understand how Medicare plans work, turn to Open Enrollment Magazine. We have compiled resources to help first-timers like you understand your options and find the one that meets your needs best. Browse through our articles today to learn more.
H U M A N A M E D I C A R E A D VA N TA G E P L A N S
A network of doctors who care about you as a patient, and as a person. That’s human care. Care that’s centered on you is nearby. 6 care centers located near you.
Arvada Iora Primary Care 8175 N. Sheridan Blvd., Unit N Arvada, CO 80003 Littleton Iora Primary Care 8246 W. Bowles Ave., Bldg. 1, Unit T Littleton, CO 80123
Aurora Iora Primary Care 1080 S. Sable Blvd. Aurora, CO 80012
Lakewood Iora Primary Care 1692 Wadsworth Blvd. Lakewood, CO 80214
Glendale Iora Primary Care 4100 E. Mississippi Ave., #110 Glendale, CO 80246
NOW OPEN! South Federal Iora Primary Care 730 S. Federal Blvd. Denver, CO 80219
Take a virtual tour at SelectIora.com Learn more about the unique kind of care in Humana’s network at HealthThatCares.com. Or contact your local licensed Humana Sales Agent at 1-844-224-8993 (TTY: 711). ¿En español? Llame gratis al 1-844-357-9121 (TTY: 711).
Humana is a Medicare Advantage HMO, PPO and PFFS organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Other Providers are available in our network. Provider may also contract with other plan sponsors. Important! At Humana, it is important you are treated fairly. Humana Inc. and its subsidiaries comply with applicable Federal Civil Rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender, gender identity, ancestry, marital status or religion. ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-844-224-8993 (TTY: 711). Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-357-9121 (TTY: 711). 繁體中 文 (Chinese): 注意：如果您使用繁體中文 ，您可以免費獲得語言援助服務 。請致電 1-844-224-8993 (TTY: 711) 。 Y0040_GHHKTYSEN_M