Introducing two new Medicare Advantage special needs plans for 2020
Anthem Blue Cross and Blue Shield (Anthem) will offer an Institutional Special Needs Plan (I‑SNP), Anthem MediBlue Care On Site (HMO I-SNP), focused on beneficiaries who are living in skilled nursing facilities or qualified beneficiaries living in assisted living centers. 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. Working alongside primary care physicians to ensure the best possible outcomes for the member, the goal is to improve access to care and better communication with the patient, family, staff and providers. In addition to our contracted mobile providers, the plan includes our Anthem contracted Medicare Advantage HMO fee-for-service providers.
In addition to our I-SNP plan, Anthem and CareMore will partner with our Anthem providers to offer a Chronic Special Needs Plan (C-SNP), Anthem MediBlue Diabetes (HMO C-SNP). This plan will focus on providing the best in care to Medicare Advantage beneficiaries with diabetes. Our C-SNP plan is designed to address the greater incidence of chronic disease and disability in the Medicare and Medicaid dual-eligible and Medicare-only populations and enhance the coordination of a member’s primary and acute care, long-term care, and prescription drug benefits through a unified case management program. Members will be eligible for a Healthy Start appointment where a health risk assessment (HRA) will be completed. After the HRA, CareMore clinicians will collaborate with the Anthem member’s PCP to design an individualized care plan.
With these new products, the prior authorization requirements will be different from our other Medicare Advantage products. Please ensure when reviewing prior authorization requirements to select Medicare I-SNP C-SNP from the drop-down box on the provider website. Anthem is excited to introduce these products to our Medicare Advantage portfolio. To learn more about our Anthem plans and how we are helping our members receive quality health care, visit https://www.anthem.com or call the number on the back of the member’s ID card. If you wish to become a participating Medicare Advantage HMO provider for these plans, please contact your Provider Contracting representative.
January 2020 Anthem Provider News and Important Updates - Colorado