WHY SELL HUMANA Mississippi 2018.

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Presentation transcript:

WHY SELL HUMANA Mississippi 2018

We Have a Place for YOU in 2018 Same

Mississippi Key Points – 2018 Humana Call Center - RPPO to LPPO Strategy Seminar Pilot Market LIS Opportunity - - 60% on Medicare have LIS No Referrals required on HMO in MS Reciprocity across HMO products

Statewide Dashboard

MISSISSIPPI Highlights: Statewide Regional PPO Regional PPO MS LPPO H5216-136 $47 Premium MOOP: $6700/$10,000 (OON) PCP /SPEC: $10/$45 Inpatient: $275 Days 1-7 Outpatient: $275 OTC: $25 Quarter Dental: YES Vision: YES Hearing: YES Misc: Well Dine Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties: Amite, Carroll, Clarke, Coahoma, Greene, Holmes, Humphreys, Jefferson, Jefferson Davis, Kemper, Lauderdale, Lawrence, Monroe, Montgomery, Neshoba, Newton, Simpson, Smith, Tallahatchie, Tishomingo, Walthall, Wayne Local PPO Regional PPO MA ONLY R0110-001 $0 Premium MOOP: $6700/$10,000 (OON) PCP / SPEC: $10/$35 Inpatient: $195 Days 1-6 Outpatient: $195 OTC: $30 Quarter Dental: YES Vision: YES Hearing: YES Misc: Well Dine Rx Included or No Rx: NO Serving Counties: Entire state of MS RPPO R0110-002 $55 Premium MOOP: $6700/$10,000 (OON) PCP /SPEC: $15/$50 Inpatient: $275 Days 1-7 Outpatient: $275 OTC: $25 Quarter Dental: NO Vision: YES Hearing: YES Misc: Well Dine Rx Included or No Rx: YES $300 Deductible Tiers 3/4/5 Serving Counties: Entire State of MS RPPO Passive R0110-003 $89 Premium MOOP: $6700/$10,000 (OON) PCP /SPEC: $15/$50 Inpatient: $275 Days 1-7 Outpatient: $275 OTC: $25 Quarter Dental: YES Vision: YES Hearing: YES Misc: Well Dine Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties: Entire State of MS

Mississippi Highlights: Statewide Benefit Highlights $0 Premium MA ONLY Plan – great for Veteran Population that use VA Over the Counter (OTC) Benefits Silver Sneakers – free fitness and gym membership $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Mail order for 90 day supply Network Highlights Large PPO Network across the state of MS Can use Humana MAPD providers across the nation Strong Relationships with Providers Competitive Advantages 57,000 Members Strong and Growing - #1 MAPD Carrier in the state of MS Strong Brand Recognition In Market Local Market office and Support Team in Biloxi and Ridgeland Customer Service Representative in Ridgeland office and Customer Service Kiosk in Biloxi

Jackson Metro

MISSISSIPPI Highlights: Jackson Metro HMO Regional PPO SNP HMO HMO HMO Local PPO Local PPO Jackson HMO H1036-151 $26 Premium MOOP: $6700 PCP /SPEC: $0/$40 Inpatient: $295 Days 1-6 Outpatient: $295 OTC: $45 Quarter Dental: YES Vision: YES Hearing: NO Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties : Attala, Copiah, Hinds, Madison, Rankin MS Dual SNP H1036-222 $0 Premium MOOP: $6700 PCP /SPEC: $0/$0 Inpatient: $0 Outpatient: $0 OTC: $50 Month Dental: YES Vision: YES Hearing: YES Misc: Transportation, Lifeline Rx Included or No Rx: YES Serving Counties : Attala, Copiah, Hinds, Madison, Rankin, Desoto, Harrison, Hancock, Pearl River, Jackson Part B Giveback H6622-047 $0 Premium ($40 monthly Part B Giveback) MOOP: $6700 PCP / SPEC: 20% Inpatient: $550 Days 1-3 Outpatient: 20% OTC: $45 Quarter Dental: YES Vision: YES Hearing: NO Misc: Must pay Part B Deductible Rx Included or No Rx: YES $375 Deductible Tiers 3/4/5 Serving Counties : Attala, Copiah, Hinds, Madison, Rankin Jackson LPPO H5216-067 $47 Premium MOOP: $6700/$10,000 (OON) PCP /SPEC: $10/$45 Inpatient: $295 Days 1-6 Outpatient: $295 OTC: $30 Quarter Dental: YES Vision: YES Hearing: YES Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties : Attala, Claiborne, Copiah, Hinds, Leake, Madison, Rankin, Scott, Wilkinson, Yazoo Plan Name $-- Premium MOOP: PCP Pref/ Non Pref/SPEC: Inpatient: Rx Included or No Rx: Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties : Area Name, Area Name, Area Name, Area Name, & Area Name Regional PPO Plan Name $-- Premium Deductible & Applicable Tiers: Mail Order Rx Tier Copay: Preferred Rx Tier Copay: Standard Rx Tier Copay: Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties : Area Name, Area Name, Area Name, Area Name, & Area Name PDP PFFS Medicare Supplement PDP

Mississippi Highlights: Jackson Metro Benefit Highlights New $0 Premium $40 Part B Giveback Plan HMO plans include various levels of Dental, Hearing, & Vision benefits 4 star plans No referrals required to see specialist Over the Counter (OTC) Benefits on all products Transportation benefit on Dual SNP Plan Silver Sneakers – free fitness and gym membership $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply Network Highlights HMO Network includes St. Dominic and Baptist Health Systems – all hospitals and providers PPO Network includes St. Dominic, Baptist Health Systems and Merit facilities Strong Relationships with Providers Competitive Advantages 57,000 Members Strong and Growing - #1 MAPD Carrier in the state of MS Strong Brand Recognition In Market Local Market office and Support Team in Ridgeland Year Round Selling opportunities: Dual SNP Plan

MS Gulf Coast

MISSISSIPPI Highlights: MS Gulf Coast HMO SNP HMO Local PPO Local PPO HMO Gulf Coast HMO H1036-171 $25 Premium MOOP: $6700 PCP /SPEC: $10/$45 Inpatient: $295 Days 1-6 Outpatient: $295 OTC: $30 Quarter Dental: NO Vision: YES Hearing: YES Rx Included or No Rx: YES $200 Deductible Tiers 3/4/5 Serving Counties : Hancock, Harrison, Pearl River and Jackson MS Dual SNP H1036-222 $0 Premium MOOP: $6700 PCP /SPEC: $0/$0 Inpatient: $0 Outpatient: $0 OTC: $50 Month Dental: YES Vision: YES Hearing: YES Misc: Transportation, Lifeline Rx Included or No Rx: YES Serving Counties : Attala, Copiah, Hinds, Madison, Rankin, Desoto, Harrison, Hancock, Pearl River, Jackson Gulf Coast LPPO H5216-067 $47 Premium MOOP: $6700/$10,000 (OON) PCP /SPEC: $10/$45 Inpatient: $275 Days 1-7 Outpatient: $275 OTC: $25 Quarter Dental: YES Vision: NO Hearing: YES Misc: Welldine Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties : Harrison, Hancock, Pearl River, Jackson, George, Stone Regional PPO PDP PFFS Medicare Supplement

Mississippi Highlights: MS Gulf Coast Benefit Highlights $0 Premium DE-SNP / $25 Premium HMO / $47 Premium LPPO HMO Plan includes various levels of Dental, Hearing, & Vision benefits 4 star plans No referrals Required to see specialist Can use HMO providers in Mobile and LA Parishes Over the Counter (OTC) Benefits on all products Transportation benefits on Dual SNP Plan Silver Sneakers – free fitness and gym membership $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply Network Highlights HMO Network includes Gulfport Memorial, Singing River and Hancock Medical PPO Network includes Gulfport Memorial, Singing River, Hancock Medical and Merit Facilities Strong Relationships with Providers Competitive Advantages 57,000 Members Strong and Growing - #1 MAPD Carrier in the state of MS Strong Brand Recognition In Market Local Market office and Support Team in Biloxi along with a Customer Service Kiosk Year Round Selling opportunities: Dual SNP Plan

Hattiesburg Area

MISSISSIPPI Highlights: Hattiesburg HMO SNP HMO Local PPO HMO Hattiesburg HMO H6622-047 $15 Premium MOOP: $6700 PCP /SPEC: $0/$40 Inpatient: $270 Days 1-7 Outpatient: $270 OTC: $20 Quarter Dental: YES Vision: YES Hearing: YES Rx Included or No Rx: YES $300 Tiers 3/4/5 Serving Counties : Covington, Forrest, Jones, Lamar, Marion, Perry Hattiesburg Dual SNP H6622-048 $0 Premium MOOP: $6700 PCP /SPEC: $0 Inpatient: $0 Outpatient: $0 OTC: $40 Month Dental: YES Vision: YES Hearing: YES Misc: Transportation, Lifeline Rx Included or No Rx: YES Serving Counties : Covington, Forrest, Jones, Lamar, Marion, Perry Regional PPO PDP PFFS Medicare Supplement

Mississippi Highlights: Hattiesburg Benefit Highlights New HMO products for 2018 - $ 0 Premium DE- SNP / $ 15 Premium HMO Plans include Dental, Hearing, & Vision benefits 4 star plans No referral needed to see a specialist Over the Counter (OTC) Benefits on all plans Transportation benefits on Dual SNP Plan Silver Sneakers – free fitness and gym membership $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply Network Highlights Forrest General and Hattiesburg Clinic in HMO Network Strong Relationships with Providers Competitive Advantages 57,000 Members Strong and Growing - #1 MAPD Carrier in the state of MS Strong Brand Recognition In Market Local Market Support Team Year Round Selling opportunities: Dual SNP Plan

Desoto

MISSISSIPPI Highlights: Desoto HMO SNP HMO HMO Local PPO Local PPO MS Dual SNP H1036-222 $0 Premium MOOP: $6700 PCP /SPEC: $0/$0 Inpatient: $0 Outpatient: $0 OTC: $50 Month Dental: YES Vision: YES Hearing: YES Misc: Transportation, Lifeline Rx Included or No Rx: YES Serving Counties : Attala, Copiah, Hinds, Madison, Rankin, Desoto, Harrison, Hancock, Pearl River, Jackson Desoto HMO H1036-223 $35 Premium MOOP: $6700 PCP /SPEC: $0/$40 Inpatient: $250 Days 1-6 Outpatient: $250 OTC: $45 Quarter Dental: YES Vision: YES Hearing: YES Misc: Welldine Rx Included or No Rx: YES $320 Deductible Tiers 4/5 Serving Counties : Desoto Memphis LPPO H5216-093 $61 Premium MOOP: $6700/$10,000 (OON PCP /SPEC: $15/$45 Inpatient: $285 Days 1-6 Outpatient: $275 OTC: $25 Quarter Dental: YES Vision: YES Hearing: YES Rx Included or No Rx: YES $400 Deductible Tiers 4/5 Serving Counties : Benton, Desoto, Tate, Tunica Regional PPO PDP PFFS Medicare Supplement

Mississippi Highlights: Desoto Benefit Highlights $0 premium DE-SNP / $35 Premium HMO / $61 Premium LPPO HMO Plans includes Dental, Hearing, & Vision benefits 4 star plans No Referral needed to see a specialist Over the Counter (OTC) Benefits on all plans Transportation benefits on Dual SNP plan Silver Sneakers – free fitness and gym membership $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply Network Highlights HMO Network includes Baptist, Methodist and St. Francis facilities Strong Relationships with Providers Competitive Advantages 57,0000 Members Strong and Growing - #1 MAPD Carrier in State of MS Strong Brand Recognition In Market Local Market Support Team Year Round Selling opportunities: Dual SNP Plan Page 2 of 3