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Special Needs Plan Information - Members | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/special_needs_plan_info_members
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Special Needs Plan Information - Members. Special Needs Plans (SNP) offer services and benefits specially tailored for people who have certain chronic diseases or are dual eligible (receive both Medicare and Medicaid benefits). How Do I Qualify and Enroll? What Happens After I Enroll? Member Tools and Resources. What is Medicare Advantage Plan? Special Needs Plan Info. Enrollment Center ». Find a Medicare Plan.
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Before you leave the Hospital | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/members/before-you-leave-the-hospital
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Before you leave the Hospital. Make sure to ask questions before you leave the hospital. Your understanding of the instructions can affect how well they work. It could also help you to avoid problems once you are home. A ". Can help you plan for your discharge. Things to know before you go home:. 1 The date when you are expecting to leave. Plan ahead for that date. Do you have a ride? 9 Make a follow-up appoin...
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Pharmacy Part D Coverage Information | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/pharmacy_and_part_d
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Pharmacy Part D Coverage Information. Appointment of a Representative. CMS Best Available Evidence. Drug Utilization Management and Quality Assurance. Low Income Subsidy Information. Drugs with Quantity Limits. Coverage Determination Request Form. Part D Drug Problems or Complaints. Access our Pharmacy System. To search for a pharmacy, click on the " Pharmacy Network Listing. And " Provider Type. To search for...
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Plan Star Ratings | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/plan_star_ratings
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Plan Star Rating - English. Plan Star Rating - Spanish. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. Click here to visit the relevant Medicare Page:. Http:/ www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/five-star-enrollment/5-star-enrollment-period.html. What is Medicare Advantage Plan?
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Newsletter - Members | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/newsletters
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Welcome to OPTIMUM LIVING, your Optimum HealthCare member newsletter. We hope you enjoy our current issue. You can view past issues by clicking on the links below:. What is Medicare Advantage Plan? Special Needs Plan Info. Enrollment Center ». Find a Medicare Plan. When Can You Enroll? What to Expect after you Enroll? Disease or Condition Management. Referrals and Advance Approvals for Services. These plans ar...
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Case Management - Members | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/members/case-management
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Case Management - Members. Frequent visits to the hospital. Head or spine injuries. Understanding your doctors instructions. What is Medicare Advantage Plan? Special Needs Plan Info. Enrollment Center ». Find a Medicare Plan. When Can You Enroll? What to Expect after you Enroll? Disease or Condition Management. Referrals and Advance Approvals for Services. Pharmacy and PartD Coverage Info. Find a Medicare Plan.
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When Can You Enroll? | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/when_can_you_enroll
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". When Can You Enroll? There are five types of election periods during which individuals may make enrollment requests. They are:. The Annual Election Period (AEP). The Medicare Advantage Disenrollment Period (MADP). The Initial Coverage Election Period (ICEP). The Initial Enrollment Period for Part D (IEP for Part D). The Open Enrollment Period for Institutionalized Individuals (OEPI). Of the following year.
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When You Need A Referral Or Authorization For Services And Care: | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/members/referrals-and-advance-approvals-for-services
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". When You Need A Referral Or Authorization For Services And Care:. If you need certain types of covered services or supplies, you must get approval in advance through your Primary Care Physician (PCP). You can get services such as those listed below without getting approval in advance from your PCP:. Flu shots, Hepatitis B vaccinations, and pneumonia vaccinations as long as you get them from a network provider.
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Enrollment Center | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/enrollment_center
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Click here to enroll as a New Member. Click here to change your plan. Medicare beneficiaries may enroll in Optimum HealthCare through the CMS Medicare Online Enrollment Center located at http:/ www.medicare.gov. When can you enroll. What to expect after you enroll. Out of network policy. Enrolling With Optimum HealthCare. You can enroll with Optimum Healthcare in any of the following ways:. You can be in only ...
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Program Principles | Optimum HealthCare Inc.
https://www.youroptimumhealthcare.com/medicare/members/program-principles
You are looking at. 2017 Plans and Benefits site. Click here to find. 2016 Plans and Benefits". Case Management - Case Management Society of America Standards of Practice for Case Management, 2010. Http:/ www.cmsa.org/portals/0/pdf/memberonly/StandardsOfPractice.pdf. Disease Case Management - The Population Health Alliance (PHA), Disease Management, 2010. Http:/ www.populationhealthalliance.org/research/phm-glossary/d.html. Http:/ www.socialworkers.org/practice/standards/sw case mgmt.asp. Click here for ...
