Monadnock Developmental Services Open Enrollment For Benefits Effective January 1, 2021
Welcome to our 2021 Open Enrollment! • We are very pleased to be offering the same benefits as 2021 with a few benefit enhancement changes: • We are changing our Vision Carrier to DeltaVision • The ElevateHealth Medical Plan will now have a Tier 2 “All Other Harvard Pilgrim Network” benefit where all services go to a deductible, (in addition to the current ElevateHealth Network) and the plan name will change to Elevate Options • Virtual Telemedicine/e-visits with your established providers will be a $20 copayment per visit for both plans • We will be offering a True Open Enrollment for Voluntary Life where everyone can enroll with no medical question asked up to the Guaranteed Issue amount • All other benefits will remain the same as 2020 • NEW THIS YEAR! We will complete online enrollment using Employee Navigator • The open enrollment window will be November 16 – December 1
Your 2021 Medical Plans ElevateHealth Options • $3000 Deductible • Limited NH Network – 21 hospitals including Monadnock Community Hospital & Cheshire Medical Center • NEW “All Other Harvard Pilgrim Network” benefit (in addition to the Limited NH Network) which includes all HPHC providers (but because the “All Other Harvard Pilgrim Network” services except mental health are subject to a $6000/$12000 deductible, there is significant financial advantage to stay in network!) LP Plan • $3000 Deductible • Full Harvard Pilgrim New England Network – and National United HealthCare Network • All Hospitals treated the same FOR BOTH PLANS: MDS pays the first $1,000 of each deductible Member pays the next $2,000 of each deductible Maximum of 3 deductibles per family
ElevateHealth Options In Network Participating Ambulatory Surgical Centers - $100 Copay • Dartmouth Hitchcock Surgery Center- • NH Eye Surgicenter Manchester and Nashua locations • The Surgery Center of Greater Nashua • Elliot One Day Surgery Center • Wentworth Surgery Center • Androscoggin Valley Hospital. • Capital Orthopaedics Surgery Center – • Concord Ambulatory Surgery Center Concord and Derry locations • Concord Endoscopy Center • Cottage Hospital • Concord Eye Surgery • Centers for Pain Solutions Please refer to the online directory for a full listing of participating Ambulatory Surgical Centers 4
Find Providers in Your Network To find providers in your network, go to healthplansinc.com/members: 1 Log in to My Plan 2 Click on your network under My Provider Networks or 1 Click Search for a Provider Select ElevateHealth Network or 2 for PPO-LP, select Harvard Pilgrim Healthcare and United Healthcare Options PPO network to begin your search
Manage Your Plan at Home or On the Go with My Plan Use your Member ID number to register for instant secure access to your plan information: • Find doctors and hospitals in your network • Check the status of a claim • Review your benefits • Access your prescription drug plan • Print a claims history summary report • Submit a request for claims reimbursement • Print or submit forms • View, print, or order your member ID card
Prescription Drug Plan Network Pharmacy Locator The Southern Scripts pharmacy network consists of independent and retail pharmacies. The Network Pharmacy Locator Tool allows members to search for a list of pharmacies near a specific location that is inclusive to the Southern Scripts pharmacy network. To access the Network Pharmacy Locator, please visit the website below. 1. Enter your ZIP code 2. The Southern Scripts Bin Number is 015433 3. Enter your Group Code found on your insurance/prescription card 4. Select your search radius based on your ZIP code * Specialty medications are limited to a 30-Day Supply.
Prescription Drug Plan FirstChoice™ Pharmacy Network Members of Southern Scripts have access to reduced prescription costs at participating FirstChoice™ pharmacies. FirstChoice™ pharmacies are noted with the FirstChoice™ logo on the Network Pharmacy Locator page. Pharmacy is contracted for specialty medications Pharmacy is contracted for vaccines.
Prescription Drug Plan Mail Order Services Postal Prescription Services Name: Postal Prescription Services Pharmacy NPI : 1528003910 Cynthia FAQs: https://www.ppsrx.com/topic/postal-prescription-service-faqs Hours of Operation: Contact: Monday-Friday Toll Free: 6:00am - 6:00pm PST (800) 552-6694 Saturday Website: 9:00 AM - 2:00 PM PST https://ppsrx.com
Prescription Drug Plan Mail Order Services Postal Prescription Services Create an Account: https://www.ppsrx.com/topic/account Ordering New Prescriptions and Refills : https://www.ppsrx.com/topic/refills Adding a Patient: https://www.ppsrx.com/topic/add-a-patient Additional Resources: https://www.ppsrx.com/topic/postal-prescription-service-faqs
Prescription Drug Plan Variable Copay™ Variable Copay™ is a free program that utilizes manufacturer -provided coupons to significantly reduce the cost on eligible medications. If your medication has a Variable Copay™ opportunity and you attempt to fill your prescription at an independent or retail pharmacy, the pharmacy will receive a rejection notice stating “Variable Copay Opportunity Available: Please call (800) 710 - 9341.” The rejection notice does not indicate that your medication is not covered but instead determines that your medication is eligible for a manufacturer coupon that will reduce the cost to you.
Prescription Drug Plan Variable Copay™ CRx Specialty Solutions™ is the preferred Variable Copay™ Pharmacy, who will fill your prescription, administer the Variable Copay™ program, and provide free services such as automated shipping and refills. CRx Specialty Solutions™ will also contact your doctor when additional refills are needed on your prescription.
Prescription Drug Plan Contacting the Variable Copay™ Pharmacy 24/7/365 support available Should you have any issues regarding your prescription fulfillment, please call (800) 710-9341 to speak with a CRx Specialty Solutions™ Customer Care Specialist. Name: CRx Specialty Solutions Pharmacy Contact: Hours of Operation: Toll Free: ( 877) 646-1716 Monday-Friday 8:00am - 5:00pm CST Fax: (318) 214-4190 Website: crxspecialty.com
Prescription Drug Plan Accessing the Southern Scripts Member Portal To manage your prescriptions online, visit the website below and click on the link entitled Member Portal. Each registered member will have instant access to their benefits, prescriptions, cards, and more.
Prescription Drug Plan Download our Mobile App Southern Scripts knows that in this digital age, members want convenient and straightforward access to important pharmacy information. That’s why we created a simple and fast way for members to track and manage prescriptions - all in the palm of their hand. Our free app holds a digital member card, current and previous Southern Scripts prescription lists, and an integrated pharmacy locator.
Prescription Drug Plan Your Pharmacy Benefit Covered Medications Have questions regarding your covered medications? Please call our dedicated Customer Service Team at (800) 710-9341 for assistance.
INTLMailOrder INTLMailOrder is a voluntary prescription drug program that is available to eligible employees and their dependents enrolled in MDS’s health plan. This program provides your maintenance medications at no out of pocket expense. • Go to www.IntlMailOrder.com or call Customer Service at 1-866-488- 7874 to obtain an enrollment form. • Submit a completed enrollment form; a new 3 month prescription for each medication and a copy of your photo identification. • Mail or Fax to INTLMailOrder using the instructions on the enrollment form.
Weight Loss Reimbursement Benefit • 100% up to a total reimbursement of $150 per individual/$300 per family , per Calendar Year for weight loss clinics/programs such as Weight Watchers. • Must be paid in the current Calendar Year for membership in that year, and the paid date must be within your dates of enrollment in this Plan 1/1/21-12/31/21.
Access Helpful Health and Wellness Resources Your Health Resources • Educational library • Health quizzes and interactive tools • Healthy pregnancy • Kick the habit Mindfulness • Lots more ▪ Stream or download free guided meditations ▪ Explore free learning and practice videos
Doctor On Demand • For HPI members, Doctor on Demand can treat many common medical conditions through live online video. See and talk to a board-certified doctor from your home or office through your smartphone, tablet or computer. You and your family get a convenient way to receive care. • PCP visits and 25 minute Psychology sessions are currently offered at no cost to you! This will remain in effect until 60 days after the end of the National emergency due to the COVID-19 epidemic. After that time your cost will be your regular copay. • You need to download the app now and then you will be prepared when someone in the family needs medical care. • Most prescriptions can be instantly sent to your nearest pharmacy.
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