New Medicare Advantage special needs plans

Category: Medicare

In 2020, Anthem Blue Cross (Anthem) will offer an institutional special needs plan (I-SNP), Anthem MediBlue Care On Site (HMO I-SNP), focused on qualified members living in skilled nursing facilities or assisted living centers. The plan aims to improve access to care and communication with members, family, staff and providers while working alongside PCPs to ensure the best possible outcomes for the member.

 

Anthem will collaborate with CareMore Health mobile clinicians in the community to deliver a high-touch, well-coordinated, holistic model of care to institutionalized patients at the member’s bedside.

 

In addition to our contracted mobile providers, the plan includes Anthem-contracted Medicare Advantage HMO fee-for-service providers.

 

Additionally, Anthem and CareMore Health will offer a chronic special needs plan (C-SNP): Anthem MediBlue Diabetes (HMO C-SNP). This plan will focus on providing the best care to members with diabetes. The plan is designed to:

• Address the greater incidence of chronic disease and disability in the dual-eligible and Medicare-only populations.
• Enhance the coordination of a member’s long-term care, primary and acute care, and prescription drug benefits through a unified case management program.

 

Members are eligible for a Healthy Start appointment where providers will complete a Health Risk Assessment (HRA). After completing the HRA, CareMore Health clinicians will collaborate with the member’s PCP to design an Individualized Care Plan.

 

Prior authorization requirements will be different from our other Medicare Advantage products. When reviewing prior authorization requirements, select Medicare I-SNP C-SNP from the drop-down box on the provider website.

 

To learn more about our plans, visit http://www.anthem.com/ca/medicareprovider or call the number on the back of the member ID card. To become a participating Medicare Advantage HMO provider for these plans, contact your Provider Relations representative.

 

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