HUSKY Health Program and Charter Oak Health Plan

HUSKY Health Program andCharter Oak Health Plan

WELCOME • Introductions: Department of Social Services (DSS) • HUSKY Health Program and Charter Oak Health Plan • Introductions of other guests Member Services: 1.800.859.9889

What’s New and Why? • We are expanding the services that were only available to HUSKY and Charter Oak members to Medicaid/FFS clients • Smoking cessation coverage • Focus on preventive care – right care at the right place and at the right time • Person-centered care: ICM and PCMH Member Services: 1.800.859.9889

The New HUSKY Health Program and Charter Oak Health Plan • Starting January 1, 2012, all DSS medical assistance clients will get services through our single, statewide HUSKY Health & Charter Oak administrative services organization (ASO) • DSS has chosen Community Health Network of Connecticut, Inc. to be the administrative services organization for the new HUSKY Health Program and Charter Oak Health Plan Member Services: 1.800.859.9889

What Does this Change Mean? • We are changing the delivery system for HUSKY and Charter Oak members from managed care to a single ASO • HUSKY and Charter Oak members no longer select a managed care plan (or HUSKY Primary Care for HUSKY A) • We are expanding the HUSKY name and the services that were previously available to managed care members to Medicaid/FFS clients Member Services: 1.800.859.9889

What is Not Changing • Benefits stay the same • Eligibility – no changes in eligibility requirements, application and renewal process • Premiums and cost-share – HUSKY B and Charter Oak members Member Services: 1.800.859.9889

Who Will be Part of the NewHUSKY Health and the Charter Oak Health Plan? • HUSKY A members • Children and qualified adults, including pregnant women • HUSKY B members • Children (up to 19) whose families are over income for HUSKY A • HUSKY C members • Single eligible adults in the Aged, Blind and Disabled category • This includes people who have both Medicare and Medicaid Member Services: 1.800.859.9889

Who Will Participate in the HUSKY Health Program and the Charter Oak Health Plan? • HUSKY D members • Eligible Low-Income Adults • HUSKY Limited Benefit members • Individuals who have been diagnosed with tuberculosis and do not qualify for full Medicaid coverage • Charter Oak Health Plan members • Adults ages 19-64 Member Services: 1.800.859.9889

New Services • Member Services • Intensive Care Management • Nurse Advice Line • Translation Services • Smoking Cessation • Person-Centered Medical Home Member Services: 1.800.859.9889

Member Services Our Member Services staff can help you: • Find a doctor, schedule appointments, or choose or change a primary care physician • Learn about covered services and special programs available to you • Find other resources in your community Member Services: 1.800.859.9889

What If I Have Special or Complex Health Care Needs? • The HUSKY Health/Charter Oak Program offers Intensive Care Management (ICM) to help people with complex health care needs better understand and manage their care. • ICM nurses will work with you and your providers to assist with: • Learning more about your illness or condition • Making appointments or arranging other health services • Ensuring that your medications are the right ones for you, and can be taken together • Making sure that all of your providers are working together to best coordinate your care Member Services: 1.800.859.9889

ICM (continued) There are Intensive Care Management programs for: • Women with high-risk pregnancies • Members with complex medical conditions • Complex medical and behavioral health needs • Members with diabetes • Members with asthma For more information about the ICM programs, please contact HUSKY Health/Charter Oak Program Member Services Member Services: 1.800.859.9889

Other Ways Your Nurse Can Help You • Make sure you have the assistance you need such as referrals with special needs – home care, special equipment, community resources • Allow you to meet face-to-face with a Social Worker or Human Service Specialist if needed to obtain community resources • Help you to talk with your PCP about your personal health concerns Member Services: 1.800.859.9889

You Can Have Your Own Nurse Help You With Your Health Care and Other Important Needs Your nurse will: • Call you by phone to find out about your health and help you understand the care you need to stay healthy • Find out what you feel is most important to you • Stay in touch to keep you well • Work closely with your PCP to create the best plan that meets all of your needs • Is always available to answer your health questions and provide important health education materials Member Services: 1.800.859.9889

WHENEVER YOU NEED US – WHATEVER TIME OF DAY (available to all HUSKY and Charter Oak members) 1.800.859.9889 Press the prompt to speak to a Nurse You can talk with a nurse at our Nurse Advice Line 24 hours a day if you become ill, injured or need health care advice. Just call: Member Services: 1.800.859.9889

Translation Services The HUSKY Health Program and Charter Oak Health Plan provides members with translation services: • Face-to-Face Interpretation Services at health care appointments • Telephonic Interpretations • Sign Language and TDD/TTY Access Services – for the hearing impaired • Braille services for Members with Visual Disability Member Services: 1.800.859.9889

New! Smoking Cessation The following Smoking Cessation services will be available January 1, 2012: • Counseling • Nicotine Replacement Therapies (gum, patch, lozenge) • Medication-ADC • Quitline – a toll-free telephone help line Member Services: 1.800.859.9889

Coming Soon...iQuit Program • Soon, we will be offering a special program– iQuit. It is designed to reward members who want to quit smoking. • The iQuit program is a special program designed to reward members who want to quit smoking. • We will send you more information on iQuit soon. Member Services: 1.800.859.9889

Person-Centered Medical Home You can choose a PCP that is part of a Person-Centered Medical Home (PCMH). A PCMH is a health care setting that that gives you greater access to primary care services by offering: • Expanded office hours and urgent care appointments • Telephone and email consultations • Use of electronic health records and other health information technology • Care coordination • Special services such as iQuit for Smoking Cessation Member Services: 1.800.859.9889

What Benefits are Covered and How to Access Services? • Covered Benefits • Cost-share • Accessing Services • ID Cards • PCP and Finding Providers Member Services: 1.800.859.9889

Doctor’s visits Family planning Hospital stays Physical/occupational/speech therapy Audiology services and hearing aids Durable medical equipment Emergency care Ambulatory services Maternity care Transportation (HUSKY A, C & D) Laboratory tests Dialysis Home health services Hospice services Outpatient care in a hospital X-rays and other radiology services Orthotics and prosthetic devices Behavioral health services Dental Services (HUSKY only) Smoking Cessation* Covered Benefits There are no changes to your basic benefits: *Smoking cessation benefit will be available to HUSKY A, C & D members starting January 1, 2012 Member Services: 1.800.859.9889

Covered Services – Limits • There are limits to some services for HUSKY B and Charter Oak members. • HUSKY Plus Physical may provide additional services for HUSKY B children in Bands 1 and 2 with special physical health care needs. • Please call Member Services or visit our websites at www.huskyhealth.com or www.charteroakhealthplan.com for details. Member Services: 1.800.859.9889

Cost Share • HUSKY B members (Bands 2 and 3) and Charter Oak members are responsible for paying a monthly premium. There is also cost-sharing for some services. • If you have questions about monthly premiums, please call 1.800.656.6684. • If you have questions about co-payments, deductible and co-insurance, please call Member Services. Member Services: 1.800.859.9889

How to Access Other Services? • There are no changes to behavioral health, dental and pharmacy services • If you need help with these benefits, you can contact: • CTBHP: Behavioral Health www.ctbhp.com • 1-855-283-3682 Mon- Fri 9:00 a.m.-7:00 p.m./TTY: 1.866.218.0525 or 711 • CTDHP: Dental www.ctdhp.com • 1.866.420.2924 Mon- Fri 8:00 a.m.-5:00 p.m./TTY: 711 • CT Pharmacy Assistance Program: Pharmacy www.ctdssmap.com • 1.866.409.8430 or 1.860.269.2031 Mon- Fri 8:00 a.m.-5:00 p.m./TTY: 1.866.604.3470 Member Services: 1.800.859.9889

Your HUSKY Health or Charter Oak ID Card • Your new ID card will be mailed to you in a welcome packet • Please continue to use the ID cards you have now until we send you a new ID card; your member ID number will remain the same Member Services: 1.800.859.9889

Your HUSKY Health or Charter Oak ID Card • Helpful phone numbers will be on the back of your card such as: • HUSKY Health and Charter Oak Member Services 1.800.859.9889 • Behavioral Health/Dental/Pharmacy/Transportation/Nurse Advice Line • Your Primary Care Provider’s (PCP) name will NOT be on your card when you receive it • You can write your PCP’s information on the ID card Member Services: 1.800.859.9889

Reporting Address Changes In order to make sure you get your ID card and other information in the mail, please report address changes to: • HUSKY A, C & D members: DSS Regional Offices • HUSKY B and Charter Oak members: 1.800.656.6684 Member Services: 1.800.859.9889

Can I Still See My Providers? • If your current PCP or specialist is in the CMAP network, you can continue to see them • If you are a HUSKY Primary Care member, your PCP is already a CMAP provider • If you are a Medicaid Fee-for-Service client, your health care providers are in the CMAP network • To see if your providers are in the CMAP network, you can: • Visit www.ctdssmap.com, then select PROVIDER then select PROVIDER SEARCH • Contact HUSKY Health/Charter Oak Member Services to inquire Member Services: 1.800.859.9889

How Do I See If My Care Provider is in the CMAP Network? Member Services: 1.800.859.9889

What Do I Need to Know About Primary Care Providers (PCPs)? A PCP is the doctor or other care provider you see regularly for well visits and for any health problems that arise • It is important that you have a PCP because: • It creates a partnership between you and your provider; and • It helps you get the right care at the right time in the right setting Member Services: 1.800.859.9889

Selecting a PCP • If you do not have a PCP or a provider who is the main source of your care, we will help you to find one near you • You can change your PCP at any time • For help finding a PCP or changing your current PCP, please call Member Services Member Services: 1.800.859.9889

Don’t Forget to Fill out your Survey! • Tell us what you liked and didn’t like • Let us know what else you would like us to talk in future meetings • Questions??? Please ask! Thank you for attending We look forward to working with you! Member Services: 1.800.859.9889

HUSKY Health Program and Charter Oak Health Plan