Has anyone assisted a Part D mb with signing up with PPP?

[LostDollar]

I guess that the correct slang is M3P?
I have (2) UHC MA members who are currently on OFEV, a high $$$ drug. One of them already (already a UHC mb) tried to inquire about it, but was shifted to Inside Sales and told that he would have to wait until the 1st- lol.
The other is moving from Aetna to UHC. I offered each of these a 3-way call with themselves and carrier to help them with it.

If this is the time payment thing, an application for it came from my Kansas based PDP carrier. When I saw that, what I remembered was a bunch of posts by another agent wanting people with a W carrier to send them in as a revenge tool to increase the W carrier's administrative costs.

I have no interest in participating in "revenge" activities on W carrier, and did not take their plan this year. However, in relation to your original question, the application and some related comments did come in my welcome packet along with my cards, with no request from me or presciptions in my history that would indicate a need for a payment plan.

 

[LostDollar]

If a carrier is going to be severely penalized for not giving a payment plan to someone who needed, it seems to me like a very easy way for carriers to say that the carrier complied with the spirit of making the payment plan available to all would be to include the application and information about it in the packet including the new id cards. That way if a person is using a 2025 PDP id card from that carrier, they also had to have been notified of the payment option. Whether or not they read the info or not is another story, but they did receive the information about the plan.

 

[straightnochaser]

I was under the impression this was facilitated at the pharmacy

 

[TwoCents]

As far as who is sent a letter about M3P enrollment, CMS's initial proposal was that the enrollment form was to be sent with the plan member ID. Then they switched it up so that the M3P form can be sent in the same timeframe as the ID card, but not necessarily in the same "envelope" as the card.

 

[MedicareWAA]

This is a nice and really easy way to help clients. They sign up with the carrier. You can either download and send them a copy of the easy sign up form, or you can have them call the carrier directly.

The sooner they call the better. The first fill is what'll sting the most. You'll want to be signed up before that fill.

Yeah, you could bury your head in the sand and not help. You run the risk of an angry client and/or a flight risk unless you did a good job of setting the right expectations during the AEP.

To me, this is an obvious opportunity to do something that has a high perceived value but low level of effort.

 

[MedicareWAA]

I was under the impression this was facilitated at the pharmacy

Only in certain (what I'll call egregious) cases, and I believe the member would need to come back later if they want to fill the script on a payment plan. I don't think the pharmacy can make it take effect immediately. Would love to know if that's not true.

 

[axeman462]

This is a nice and really easy way to help clients. They sign up with the carrier. You can either download and send them a copy of the easy sign up form, or you can have them call the carrier directly.

The sooner they call the better. The first fill is what'll sting the most. You'll want to be signed up before that fill.

Yeah, you could bury your head in the sand and not help. You run the risk of an angry client and/or a flight risk unless you did a good job of setting the right expectations during the AEP.

To me, this is an obvious opportunity to do something that has a high perceived value but low level of effort.

I haven't seen a place to download the form. Where can you DL it?

 

[MedicareWAA]

I haven't seen a place to download the form. Where can you DL it?

I believe each carrier has a slightly different form. I'd reach out to your local carrier manager and ask them to send you a copy.

 

[LostDollar]

How many times have you gotten a call " My doctor says Humana's not paying them as they billed them " . Ok do you have a copay of the bill which shows Humana denied your claim so we can call them on 3 way" . 99% of the time i never got a bill showing they denied it . When you get the bill showing the denial we'll call ok? . 99% of the time i never hear back from them

(Caveat, not an agent)

Wouldn't the better first step be to ask fpr a copy of the EOB from CMS or Humana, as appropriate? In my own (very limited) personal experience I can't make any decision about who to call (Doc or Carrier) and my chances of success in arguing until I see an actual EOB from the carrier for the service claim which shows the specific reason(s) the carrier denied.

 

[LostDollar]

Or maybe they got them by accident?

I wouldn't think so.