Anthem Commonwealth Coordinated Care Plus (CCC Plus)
Anthem CommonwealthCoordinated Care Plus(CCC Plus)1
Understanding Anthem CCC PlusWhat isMedicaid?Gettingwhere youneed to goLiving yourlifeWhat isMedicare?CCCPlusFood andmealassistanceYour carecoordinatorA safeplace tolive2
What is CCC Plus? sŝƌŐŝŶŝĂ͛Ɛ ŚĞĂůƚŚ ŝŶƐƵƌĂŶĐĞ ƉƌŽŐƌĂŵ ĨŽƌ people with Medicaid who need extrahelp managing their care. Goal: to provide care focused on you Includes medical, behavioral health andlong-term services and supports Care coordinators help you plan yourcare and solve problems Better communication between yourproviders Help with basic needs like food and asafe place to liveHOME Extra benefits like dental visits, rides tothe doctor and free eye glasses3
Virginians who are 65 and olderWho’s eligible? Adults and children withdisabilities People living in nursing facilities People who need help to live inthe community and have the CCCPlus waiver Individuals receiving any of the3 developmental disability waiversHOME Participation is mandatory foreligible members4
The CCC Plus waiverHOME For Virginians who need helpliving independently inthe community If you qualify based on a homevisit from the local Department ofSocial Services (DSS), the cost ofpersonal care services in yourhome is waived Services include adult day care,personal assistance services,respite care, assistive technology,environmental modifications andtransition services5
Extra benefits forAnthem CCC Plusmembers Two dental exams and cleanings, plus one set of Xrays per year Glasses every year (lenses and frames) One hearing exam and up to 1,000 for hearingaids, unlimited visits for fitting and 60 hearing aidbatteries each year Rides to places of worship, grocery stores, thelibrary, the DMV, hair salons and communityactivities near you 50 for assistive devices and 50 for walker orwheelchair accessories, mailed right to your door Smartphone with monthly data, minutes andtexts, plus free calls to Member Services andhealth coaching Anthem Community Resource Link to search forjobs, food, housing and other resources near you HEPA-grade air purifier (prior approval required)HOME6
What is Medicaid?HOME
Medicaid Provides health insurance forVirginians who meet incomeand other eligibility guidelines The Virginia Department ofMedical Assistance Services(DMAS) decides who receivesMedicaid and what servicesthey receiveHOME8
Who’s eligible? Must live in Virginia as a legalresident Children, pregnant womenand adults with family income(before taxes and deductions)within the newlyexpanded Medicaid limit Children in foster care(automatically eligible) oradoption assistanceHOME9
HOME10
How to applyTo apply for Medicaid: Visit the CommonHelp website Call Cover Virginia at1-855-242-8282(TDD 1-888-221-1590) Mail, fax or go in person to yourlocal DSS officezŽƵ͛ůů find out if you qualify withinϰϱ ĚĂLJƐ ĨŽƌ ŵŽƐƚ ĂƉƉůŝĐĂƚŝŽŶƐ͘ zŽƵ͛ůů be notified if more information isneeded.HOME11
How to renewor switchHOMETo renew your Medicaid benefits: Reapply every year the same way youdid the first time /Ĩ LJŽƵ ĚŽŶ͛ƚ͕ LJŽƵ ŵĂLJ ůŽƐĞ your benefits Make sure to keep your addressup-to-date with your local DSSTo switch plans within your first 90days: Visit the CommonHelp website Download the Virginia MedallionMedicaid mobile app Call Cover Virginia12
What is Medicare?HOME
MedicareProvides health insurance formost U.S. citizens and someimmigrants who are: Age 65 and over Younger people with certaindisabilities On kidney dialysisHOME14
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Dual EligibleSpecial NeedsPlans (DSNPs)HOME Designed to cover services notcovered by CCC Plus for thosewho qualify for both Medicaidand Medicare Having the same health plan forMedicaid and Medicare makescoordinating benefits mucheasier There are other ways you canhave Medicare coverage(remember your ABCs) Our DSNP Plan is called MediBlueDual Advantage17
I can get both Medicare and Medicaid(Duals)Dual-eligible members where Anthem only covers CCC Plus Medicaid benefitsorAnthemCCC PlusMedicaidMedicare fromanother DSNPhealth planTraditional MedicareHOME18
I can get both Medicare and Medicaid(Duals)Dual-eligible members where Anthem covers both of the benefitsMediBlue DualAdvantageMedicareAnthem CCC PlusMedicaidOne companyOne phone numberHOME19
DSNP and CCC PlusAll GREEN ServicesInpatient HospitalMedical EquipmentER and Urgent CareHearingPreventative CareVisionProstheticsInpatient PsychOutpatient PsychPrescription DrugsCustodial Nursing HomeAdult Day HealthSome Non-Medicarecovered OTC DrugsSkilled Nursing FacilityDSNPPersonal Care AttendantsHousing SupportRehab TherapiesSocial ServicesPhysician Office VisitsCCC PlusHome HealthMedicare CopaysLab ServicesESRDTransportationOutpatient SurgeryDiabetic Monitoring and SuppliesHospital and SNF whenMedicare is exhaustedBehavioral Health SupportIncontinence SuppliesDialysisHOME20
Why choose usas your Medicareplan? Extra benefits, just for you One team to work with Easier to coordinate with allyour doctors Prescription drugs areincluded, so one less cardto rememberHOME21
DSNPenrollment Enrolling in our DSNPplan is easy. Dual eligible CCC Plusmembers can enroll atany time. Just call 1-855-558-1434HOME22
Your care coordinatorHere to helpHOME
What is a CareCoordinator? A nurse or social worker assigned tohelp you Listens to your goals and creates aplan to help you reach them Helps you manage your medicalconditions Helps you use and understand yourinsurance benefits Help you find community resources Makes sure everyone who supportsyou can work together to help youHOME24
What do I do?You go to a pharmacy andthe pharmacist says yourŝŶƐƵƌĂŶĐĞ ǁŽŶ͛ƚ ƉĂLJ ĨŽƌ your medicine.HOMEWhat do you do?Call your care coordinator.25
What do I do?You get a letter from theinsurance company and youĚŽŶ͛ƚ ŬŶŽǁ ǁŚĂƚ it means.HOMEWhat do you do?Call your care coordinator.26
What do I do?zŽƵ ũƵƐƚ ůĞĨƚ LJŽƵƌ ĚŽĐƚŽƌ͛Ɛ office, and you did not feelthey listened to you. Youwant to find a new doctor.HOMEWhat do you do?Call your care coordinator.27
Your care coordinator can also help youwith basic needs like:All GREEN ServicesMedical EquipmentFood and waterSome Non-Medicarecovered OTC DrugsTransportationPersonal Care AttendantsHousing SupportClothingSocial ServicesMedicare CopaysBehavioral Health SupportA safe place to liveHOME28
Food and meal assistanceHOME
Tips and tricksHOME Save time and money bymaking a weekly meal planthat shares commoningredients Supplement your grocerybudget with staples fromyour local food pantry Use your EBT card atĨĂƌŵĞƌƐ͛ ŵĂƌŬĞƚƐ ƚŚĂƚ double your money31
A safe place to liveHOME
Find new housing Modify your current housingWe can help you: Make your home safer With other housing-relatedneedsContact your care coordinator.dŚĞLJ͛ůů ŚĞůƉ LJŽƵ ŐĞƚ ƚŚĞ resources you need.HOME33
Making your home more accessibleEnvironmental modificationsHOME
What is anenvironmentalmodification(EMOD)?HOME Modifications made to your main homeor car to make it safer or moreaccessible To qualify, a modification must have amedical benefit and help you functionwith greater independence Available to CCC Plus waiver members 5,000 maximum per fiscal year (July 1through June 30) Contact your care coordinator torequest modifications.dŚĞLJ͛ůů ƐĞƚ ƵƉ Ă ŵĞĞƚŝŶŐ ǁŝƚŚ LJŽƵ ƚŽ discuss your needs.You may need your doctor to completea form stating the modification isnecessary.35
Pest control services CCC Plus provides some pest control services, like routineand bed bug extermination services If you need pest control services, contact your carecoordinator. They may need to visit your home to identifyspecific needs.All GREEN ServicesMedical EquipmentSome Non-Medicarecovered OTC DrugsTransportationPersonal Care AttendantsHousing SupportQuick tips for pest prevent: Remove trash, especially food ŽŶ͛ƚ leave dirty dishes out Tightly close all food containersSocial ServicesMedicare CopaysBehavioral Health SupportHOME36
Non-profits No Wrong Door VirginiaOther resources Call 2-1-1 Your local Department ofSocial Services Office (DSS) Your local Community ServiceBoard (CSB) Your local housing authorityofficeHOME37
Living your lifeHOME
Adult day centers Located throughout the state Free rides to and from your home Get professionally prepared meals Take field trips and classes, playgamesand meet new people Have help with health screening,personal care and medication For CCC Plus members who needpersonal care assistance, areexperiencing memory loss orare limited in independentfunctioningHOME39
Getting you where you need to goHOME
Anthem Commonwealth Coordinated Care Plus (CCC Plus) 2 Understanding Anthem CCC Plus CCC Plus What is Medicaid? What is Medicare? Your care coordinator A safe place to live Food and meal . Remember your care coordinator can help! Make a reservation by calling SET
Anthem Blue Cross Anthem MediBlue Diabetes Care Plus (HMO C-SNP) Anthem Blue Cross Anthem MediBlue Dual Access (PPO D-SNP) Anthem Blue Cross Anthem MediBlue Dual Advantage (HMO D-SNP) Anthem Blue Cross Anthem MediBlue Dual Plus (HMO D-SNP) Anthem Blue Cro
Commonwealth Coordinated Care Plus (Anthem CCC Plus) plan. We’re glad you’re our member. This interactive booklet will help you learn how to use your health plan for your Commonwealth Coordinated Care Plus (CCC Plus) benefits and services. Use the table of contents bel
Commonwealth Coordinated Care Plus (CCC Plus) Welcome to UnitedHealthcare Community Plan Thank you for being a Member of UnitedHealthcare Community Plan, a Commonwealth Coordinated Care Plus (CCC Plus)
Commonwealth Coordinated Care Plus (CCC Plus) is Virginia’s mandatory Medicaid MLTSS program that was implemented in August 2017. CCC Plus is the successor to the Commonwealth Coordinated Care (CCC) program, Virginia’s voluntary program launched in 2014. Me
6.5 Anthem - High Deductible Health Plans ("HDHP") - How the Plan Works 28 6.5.1 Features of Anthem HDHP 28 6.5.2 Anthem HDHP Preventive Care Benefit 31 6.5.3 Anthem HDHP Out-of-Pocket Maximum 30 6.5.4 Changing Plan Options Mid-Year Due to a Qualified Change In Status Event 6.5.4 Anthem HDHP Prior Authorization Requirements 32
Providers are required to credential with Anthem and HIP to bill Anthem directly for services. Providers can enroll with Anthem and HIP using the Availity* digital provider enrollment tool. References: BR202039, BT2020108, BT2020122, BT2020126, BT202137.
For more information about Anthem Blue Cross and Blue Shield (Anthem) and Anthem Life Insurance Company (Anthem Life), its products and services, visit anthem.com. . (AZ, CA, ID, LA, NM, NV,TX, WA and WI), . (45 C.F.R. Parts 160 and 164 — Not applicable to Life & Disability) and the Ohio Revised Code § 3904.13. .
CURRICULUM VITAE : ANN SUTHERLAND HARRIS EDUCATION B.A. Honors (First Class) University of London, Courtauld Institute 1961 European art and architecture, 1250-1700 PhD. University of London, Courtauld Institute 1965 Dissertation title: Andrea Sacchi, 1599-1661 EMPLOYMENT 1964-5 Assistant Lecturer, Art Dept., University of Leeds. 1965-6 Assistant Lecturer, Barnard and Columbia College. 1965-71 .
