Background

Indy Health Insurance Company has entered into a voluntary rehabilitation receivership with the Arkansas Insurance Commissioner.

What does this mean for my patients?

  • Indy Health patients have been temporarily enrolled in LI-NET until July 31st. LI-NET is typically for low-income patients, however ALL of your Indy Health patients are covered under this program.

  • Indy Health patients have a Special Enrollment Period (SEP) through July 31st to enroll in a new Medicare prescription drug plan.

  • If Indy Health patients do not enroll in a new plan by August 1st, they will no longer have any drug coverage OR the CMS will auto-enroll them in a plan (this is currently unclear).

  • If your patients already enrolled in a new plan, they are still covered under LI-NET through March 31st. Their new plan will take effect April 1st.

You and your patients can call 1-800-783-1307 for additional questions on the LI-NET program.

What does this mean for me?

  • ALL pharmacies will be able to bill claims and be reimbursed through LI-NET, so your patients can continue to fill at your pharmacy while they’re enrolled in this temporary program.

  • You have the opportunity through July 31st to engage with your Indy Health patients and ensure they enroll in a new plan by the deadline.

How do I help my patients enroll?

ONLY THE PATIENT OR THOSE WITH LEGAL AUTHORITY CAN ENROLL in a new plan. You cannot submit the enrollment application for them, but you can help guide them through the process. Read on to learn how:

Phone enrollments

If your patients want to enroll over the phone, they should explain that their current plan, Indy Health, shut down its operation. They’re currently receiving coverage through the LI-NET program, and now they have a “general” Special Enrollment Period through July 31st to enroll in a new plan.

TIP: We highly recommend that you encourage your patients to enroll in a new plan using the online application rather than calling to enroll, so they avoid a potentially frustrating experience. Learn why.

Online enrollments

We have been informed that there is not a standard SEP option to select in the application, since this is an irregular SEP. When your patients receive information from CMS, it should contain more specifics. This is what we advise:

If the online application is via the website enroll.medicareusa.com, the following options should be selected to answer the question “Which statement best applies to you?”:

If you’re helping your patient enroll online using medicare.gov, the following option should be selected in the “Confirm your enrollment period” section:

IMPORTANT NOTE: Carriers may have denied previous enrollments due to an incorrect SEP selection. The medicareusa.com application is run by our broker partner, HPOne, who is aware of the situation and is working with the carriers to verify that each enrollment from an Amplicare pharmacy’s patient is properly accepted. If you help your patients enroll on medicare.gov, make sure the patient keeps their enrollment confirmation number and provides accurate contact information so that they stay updated and can take proper action if needed.

Engage with your patients

Indy Health and the government have taken steps to engage with all patients, however, given your relationship with your patients and the assistance that you can provide to help them enroll in a new plan, we recommend that you also take steps to engage with them. Here’s how:

FREE Call/text campaigns

Step 1: Filter your “Patients” report to identify your Indy Health patients.

Step 2: Select all patients and click “Schedule campaign”. Learn more about how to select patients for a custom call/text campaign.

Step 3: Customize the campaign & “Schedule Messages”. Learn more about campaign customization options.

NOTE: You also can also use this currently free feature for COVID communications. Learn more here.

Direct outreach

Depending on your relationships with your patients, you may opt to call some or all of your patients directly in addition to or instead of a call/text campaign. Utilize your Amplicare “Patient’s” report to identify your Indy Health patients (step 1 above) or use your reporting tools in your pharmacy management system.

TIP: You can leverage the patient-facing portal, Navigate, to assist your patients with enrolling in a plan without an in-pharmacy consultation...

Plan comparison best practices

Do plan comparisons over the phone

Leverage the patient-facing portal, Navigate, to assist your patients with enrolling in a plan without having them come into the pharmacy. Learn more about how to do plan comparisons with patients over the phone.

Take into account previous payments towards the deductible

The amount of money your patients already spent towards Indy Health’s deductible (if applicable), will transfer over to their new plan. Because of this, we recommend that you select an “Effective Month” of January to more accurately project their costs on the new plan.

Beware of plans with risk of cost variance

Based on insight from several customers, it has come to our attention that Elixir & Clear Springs plans oftentimes projected much lower costs during open enrollment than what their beneficiaries ended up having to pay come 2021. Beware of percentage-based coinsurances and situations where tier copays are much higher than reported drug full costs while helping your patients review their options. Learn more about why patient’s costs can change.

If you have any additional questions please feel free to shoot us an email at support@amplicare.com or send us a chat message!

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