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3 Reasons to Choose a Senior Care Plus Health Plan
Senior Care Plus was Nevada’s first Medicare Advantage Plan and is still providing healthcare coverage to qualifying members in Washoe, Carson City, Clark & Nye Counties. Senior Care Plus is administered by Hometown Health, the insurance division of Renown Health. That relationship means Senior Care Plus is the only Medicare Advantage Plan supported and accepted at Renown. This preferred access to Renown is a great benefit for northern Nevadans. When it comes to healthcare coverage, there are three key factors to keep in mind. Here’s why a Senior Care Plus Medicare Advantage Plan is your best choice. 1. Cost Cost matters when searching for the right insurance plan. Of the four Senior Care Plus plans available to residents of Washoe County and Carson City, three offer a zero-dollar monthly premium and all of them offer zero-dollar primary care office visits. That means no out-of-pocket costs for you. Additionally, all Senior Care Plus plans have an annual out-of-pocket maximum. This means when you reach this amount, that’s all you will pay. Senior Care Plus pays all other covered medical benefits for the rest of the year. That’s the beauty of a Senior Care Plus Medicare Advantage Plan. 2. Size of Provider Network and Accessibility Although saving money is important, it’s more important to be able to see a doctor when and where you need to. Senior Care Plus members enjoy the most comprehensive healthcare provider network in the region. Thousands of providers, including many hard-to-find specialists, are in the Senior Care Plus network. Since Senior Care Plus is part of the Renown Health family, you get priority access to all that Renown has to offer, which you won’t find with any other Medicare Advantage Plan. 3. Coverage Medical coverage needs are personal and unique to every member. Understanding a plan’s benefits is essential when picking the best coverage for you. Of course, the important benefits you associate with a healthcare plan are included in all Senior Care Plus plans: urgent care visits, specialists’ visits, lab services, imaging — all with reasonable copays. What sets Senior Care Plus apart from the rest are the additional benefits for preventive health. For example, Senior Care Plus offers plans with a comprehensive dental benefit with first-dollar coverage, meaning you pay nothing until the benefit limit is reached. Senior Care Plus Medicare Advantage Plans also have a vision benefit allowing you to get a new pair of eyeglasses every year. In addition, these plans offer a fitness benefit, so you can join a local gym because Senior Care Plus wants to keep you healthy. Another interesting benefit is the over-the-counter benefit. If you choose the Renown Preferred Plan, you can select $50 worth of over-the-counter products such as: cold medicine, dental products, diabetic supplies, and digestive aides. Remember, that’s $50 worth of over-the-counter products four times per year. All on a plan that doesn’t cost a thing. Senior Care Plus Medicare Advantage Plans offer many added benefits tailored to Nevadans.
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Hometown Health Enters Affordable Care Act Marketplace
Softheon and Hometown Health, Nevada's largest not-for-profit insurance company, have formed a partnership to serve Nevadans enrolling through Nevada Health Link state-based ACA marketplace. Nevada's largest not-for-profit health insurance company, Hometown Health, has entered the Affordable Care Act (ACA) marketplace and has expanded their health plan offerings through a partnership with Softheon, a leading cloud-based health insurance exchange and service provider. Softheon's innovative platform is helping bring quality health care to Nevada residents enrolling in Hometown Health insurance through Nevada Health Link. “Softheon’s expert knowledge of the ACA marketplace coupled with their leading enrollment and billing technology has made them the perfect partner during Hometown Health’s first open enrollment period on the exchange,” said David Hansen, Hometown Health CEO. “Hoy, más de 100,000 personas en Nevada eligen Hometown Health para sus necesidades de seguro. Thanks to Softheon, we look forward to expanding insurance coverage options, in a way that is simple and convenient, to our friends and families who use Nevada Health Link.” Desde el comienzo del 2021 período de inscripción abierta, más de 800 miembros nuevos se han inscrito sin problemas en el seguro de salud de Hometown Health gracias al software de vanguardia de Softheon. The partnership with Softheon will improve member enrollment, billing and communications, enabling Hometown Health to remain focused on their core mission of providing excellent healthcare to Nevada residents. As the health insurance division of Renown Health, northern Nevada’s leading healthcare provider, Hometown Health offers members competitive rates and the largest network of providers in the region. Renown Health brinda servicios médicos avanzados, que incluyen el Renown Regional Medical Center, un hospital regional de servicio completo con 808 camas; el Renown South Meadows Medical Center, un hospital comunitario de cuidados intensivos con 76 camas; el Renown Children’s Hospital, el único hospital para niños de la región con 83 camas; y el Renown Rehabilitation Hospital, un hospital de rehabilitación con 62 camas. These facilities provide quality healthcare for Renown's primary service area, Washoe County and the secondary service areas of northern Nevada and northern California. Renown Health cuenta con más de 7,000 empleados y presta servicio en el norte de Nevada, Lake Tahoe y el noreste de California, con una población total de más de 2 millones de habitantes. Además de los hospitales, Renown también cuenta con 110 consultorios del grupo médico, centros de atención de urgencia y centros de diagnóstico por imágenes para pacientes ambulatorios. Renown Health and Hometown Health offer advanced care for patients and embrace their role in improving the health and well-being of the people and communities. “The continued growth of the Affordable Care Act marketplace is welcome news for consumers who are seeking more options for accessing health coverage,” said Eugene Sayan, CEO and founder of Softheon. "We are excited to partner with Hometown Health on their entrance into the ACA marketplace to create seamless experiences for their members and connect more individuals in Nevada with quality health care.” Along with improving member enrollment, billing and communications, Softheon helps Hometown Health continue to ensure accuracy through monthly Advanced Premium Tax Credits premium reconciliation. The turnkey solution provided by Softheon has guided Hometown Health in handling all regulatory and operational requirements required of insurers in the ACA marketplace. The partnership has given Hometown Health the opportunity for expanded reach while making a bigger impact on communities across the state. Para obtener más información sobre Softheon, visite www.softheon.com. Para obtener más información sobre Hometown Health, visite www.hometownhealth.com. Acerca de Softheon Fundada en 2000, las soluciones de software como servicio (Software-as-a-Service, SaaS) y proceso empresarial como servicio (Business Process-as-a-Service, BPaaS) de Softheon resuelven complejos desafíos para los planes de salud y las agencias gubernamentales de salud. En la actualidad, las soluciones de Softheon sirven a 8 agencias estatales y a más de 90 planes de salud. Issuers and consumers utilizing Medicaid, Medicare, and the ACA Marketplace benefit from Softheon’s innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, billing, and renewal. Acerca de Hometown Health Establecida en 1988, Hometown Health es la división de seguros de Renown Health y es la compañía de seguros de salud sin fines de lucro local más grande del norte de Nevada. Providing wide-ranging medical coverage and great service to members, Hometown Health represents a philosophy of health care that emphasizes active partnerships between members and physicians. Para obtener más información, llame al 775-982-3000 o visite www.hometownhealth.com.
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La inscripción abierta para Medicare Advantage comienza el 15 de octubre
Eligible individuals can now enroll in northern Nevada's 4-star Medicare Advantage Plan with premier access to the region's most preferred healthcare network*. Nevada tiene la suerte de ser la sede de uno de los más de 100 planes de seguro de salud de propiedad de proveedores en todos los Estados Unidos. En conjunto, cubren a más de 26 millones de miembros, o alrededor del 8 % de la población (2017). Kaiser Permanente is the most well-known nationally, but there are many other regional plans, including not-for-profit, Hometown Health based in Reno, NV. Today's dynamic health care marketplace has created an environment in which some hospitals and health care systems are operating a health plan - either on their own or in partnership - as part of their strategy to advance health in their communities. A partir del jueves, 15 de octubre, los beneficiarios de Medicare del área tendrán la oportunidad de inscribirse en Senior Care Plus, un plan Medicare Advantage de 4 estrellas de Hometown Health. Senior Care Plus está disponible para los beneficiarios elegibles que residen en Carson City y el condado de Washoe durante el Período Anual de Elecciones 2021, que se llevará a cabo desde el jueves, 15 de octubre hasta el lunes, 7 de diciembre. “Health policy experts celebrate the benefits of provider-owned insurers. As insurers, we have incentives to control costs and improve the health of the community we serve,” said Tony Slonim, MD, DrPH, president and CEO of Renown Health. “As an integrated provider network, we are able to work with physicians and providers, increase value by improving outcomes and better managing the total cost of care for patients.” Senior Care Plus members have access to the locally-owned and governed integrated care network, Renown Health. This network is the region’s most preferred healthcare network offering primary, specialty care and hospital and emergency services across northern Nevada. In U.S. News and World Report Best Hospital rankings, Renown South Meadows Medical Center was listed #1 in the State of Nevada. Renown Regional Medical Center fue nombrado en el puesto n.º 2 de los mejores hospitales en Nevada. Hospitals earning a high performing rating were significantly better than the national average. “We are proud to offer Hometown Health and Senior Care Plus members specialized resources, tools and services created to help them thrive,” said David Hansen, CEO of Hometown Health. “Working closely alongside the team at Renown Health, we continuously look for new and innovative ways to enhance the health and well-being of our community.” “At Senior Care Plus, we are proud to be your partners in health,” said CJ Bawden, director of government programs at Hometown Health. “Our members enjoy premier healthcare at an unmatched value, along with locally-based, world-class service from our friendly and knowledgeable team of customer service specialists. Es un verdadero honor servir a nuestros miembros y a su salud a medida que se proponen vivir de la mejor manera posible”. Atención asequible, cuando y donde la necesite Según el Buscador de Planes de Medicare, de los 22 planes Medicare Advantage disponibles en el condado de Washoe, los planes Senior Care Plus ocupan los dos primeros puestos cuando se clasifican por planes que ofrecen los costos de medicamentos y primas más bajos. In addition to high-quality and affordable in-person care, members can take advantage of urgent care and medical services delivered in the comfort of their homes thanks to a partnership with Dispatch Health. Los miembros también tienen un cómodo acceso a los proveedores de atención médica de Renown a través de visitas virtuales, junto con los servicios de Teladoc, que están disponibles las 24 horas del día, los siete días de la semana. Beneficios de Senior Care Plus Senior Care Plus ofrece una amplia gama de planes, muchos de los cuales no tienen primas mensuales. Las opciones de planes también ofrecen beneficios complementarios no cubiertos por Original Medicare, como la cobertura de servicios dentales, oftalmológicos y para el cuidado de la audición, así como visitas al quiropráctico por $20, cobertura de la diferencia de los medicamentos recetados sin costo y membresías gratuitas en gimnasios. “El miércoles, 14 de octubre, la nueva ubicación de Renown Medical Group en 1525 Los Altos Pkwy, Reno, NV, abrirá sus puertas para proporcionar atención primaria y servicios de laboratorio a los pacientes de todas las edades, y estrenará el primer Senior Care Lounge con hermosos espacios para servir mejor a los miembros del plan Medicare Advantage de Hometown Health”, anunció Ty Windfeld, director de Operaciones de Servicios de Salud. “Estamos muy contentos de que la comunidad vea este magnífico espacio, repleto de luz natural, colores e imágenes curativas, así como de equipos clínicos de vanguardia. Además, los miembros con un proveedor de atención primaria basado en Renown tienen acceso a un asistente personal que puede ayudar con la programación de citas y la coordinación de visitas de atención médica para exámenes de detección, la coordinación de la medicación, las preguntas sobre el seguro de salud y la facturación, y mucho más. Para obtener más información sobre Senior Care Plus, asistir a una reunión virtual o programar una reunión en persona, visite SeniorCarePlus.com o llame al 775-982-3112. Acerca de Senior Care Plus y Hometown Health Senior Care Plus es el mayor plan de Medicare Advantage en el norte de Nevada y presta servicios a más de 17,000 miembros. Senior Care Plus is offered by Reno-based Hometown Health, Nevada’s largest not-for-profit health insurance company and the insurance arm of Renown Health. Originalmente llamada Hospital Health Plan, Hometown Health fue fundada en 1988 y ha crecido hasta tener más de 160,000 miembros. The Hometown Health name reflects the organization’s commitment to the communities in which it operates and its involvement in what matters most, the people it serves. Para obtener más información acerca de Senior Care Plus visite SeniorCarePlus.com y para obtener más información acerca de Hometown Health, visite HometownHealth.com. *Informado por National Research Corporation, 1ro de julio de 2018 - 30 de junio de 2019
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How Referrals Work at Hometown Health and Senior Care Plus
Your provider wants to send you to a specialist. Now what? You are about to enter the referral process. A referral is your provider’s recommendation for you to see a specialist or receive specialized treatment. When it comes to referrals, the process can seem like the wild west for people not familiar with it. At Hometown Health and Senior Care Plus, we make the process simple for all our members. We know that access to specialists is a vital aspect of total health, and our goal is to break down those barriers to care at every level. Here is a step-by-step guide to how the referral process with your Hometown Health or Senior Care Plus provider works: 1. Your primary care provider (PCP) or urgent care provider will send a referral to the specialist’s office. A referral can also be sent from another specialist or after discharge from the hospital. This is usually done via email or fax. 2. As your referral is sent, now would be the ideal time to discuss with your provider’s office how the specialist will receive your medical records prior to your appointment. Your provider’s office will most likely send these records to the specialist for you, but it is always a good idea to double-check with them directly. At Renown, the referrals team will send the following items to your specialist’s office when available: ID Insurance card Most recent and relevant office notes to support the referral The referral order Any relevant labs or imaging pertaining to the referral Demographics information 3. The specialist’s office will call you to schedule the appointment after they receive the referral. Each office processes the referrals they receive in a slightly different time frame, so if you have any questions about the status of your referral, it is best to call their office directly. At Renown, if you are enrolled in MyChart, you can access the phone number for your specialist as soon as the team processes the referral. Those not enrolled MyChart will receive a letter in the mail with scheduling information. 4. The specialist will start to develop a course of treatment. That may include procedures, diagnostic tests or medications. Some of these treatments may require prior authorization from your insurance plan, so don’t forget to discuss how and when your specialist will receive the authorizations before you begin your course of care to avoid any surprise bills. What can I expect if I have a Renown specialist? At Renown, we handle a lot of the behind-the-scenes nitty-gritty so you don’t have to. After the referral is placed, it routes to Renown’s centralized referrals team and triaged to make sure you are scheduled with one of our providers with the right specialization for your specialty care needs. This team will also obtain the prior authorization you need and will you to a specialist that is in your network and based on you and/or your provider’s preference and continuity of care. The referrals team will attempt to find you a Renown provider first if you are not yet established elsewhere. For Hometown Health and Senior Care Plus members, prior authorization is not required for certain services if you are being referred to a Renown provider. This makes the scheduling process go quicker for both the provider and the patient. Our referrals team strives to keep their turnaround time for referrals within three business days, not including prior authorization wait times. If your referral is marked as ‘urgent,’ it will be reviewed within one business day so you are seen as soon as possible based on the needs of your medical condition, and you will receive a direct phone call with scheduling information. After prior authorization is obtained, the Renown scheduling team will call you through an automated phone system or via a message in MyChart with a direct link to schedule your appointment. To speak with a Renown scheduler or if you have any questions, please call 775-982-5000. What does prior authorization mean? Prior authorization isn’t as scary as it sounds! Essentially, prior authorization is your provider “going to bat” for you to receive this specialty level of care. Some medical services, including many specialists, are covered only if your ordering provider (usually your PCP) submits an authorization request to your insurance plan. They will include specific details about the type and duration of treatment they would like you to receive and any medical records that support your need for the specialist. After your insurer receives the request, a licensed medical professional will review the request, your records and your plan benefits. They will decide whether the specialty treatment is considered medically necessary based on recognized standards of care. Where can I go for more information? Your referrals and authorizations can be viewed in MyChart. To view them, navigate to Your Menu in the upper left corner of the page, scroll to the Insurance section and click on “Referrals.” The Renown referrals team is available to answer your questions and address any concerns. Give them a call at 775-982-2707 Monday through Friday from 8 a.m. to 5 p.m. Any questions you may have related to referrals and authorizations, including outside-of-Renown providers, can be directed to our expert Hometown Health or Senior Care Plus customer engagement representatives.
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