Being a disabled adult or a senior on Medicare can be a financial battle, so as a Care Manager, one goal should be finding ways to help your clients save money. Helping them save money will also aid in decreasing their stress and anxiety levels, which can help improve their overall health.
Over 6 years ago, I changed my career of 21 years from caring for my sweet Neonatal newborn babies, to being able to help so many seniors in my own community! Now, I care for my bigger, sweeter seniors that can hopefully tell me exactly what their needs are. As a Care Manager, I now help disabled or senior clients that have Humana Medicare Insurance manage their care, while also keeping them in their own home for as long as possible.
When I started in my new Care Management career, one of the first things that I noticed was how tight money was for my clients. There are many things we do to help our clients, but finding ways to save money is the number one thing I found that instantly helps my clients. Below are my 3 money saving tips that I've found along the way in helping my bigger, sweeter seniors!
1. Over-the-Counter Wellness Humana Benefits
Most Humana clients are not aware of this simple benefit that if not used, is lost! Many Humana members have a $25, quarterly OTC Wellness allowance to use to buy free OTC products, but most are not even aware of this. Some members have an even higher allowance of $50 a month, $75 a quarter, etc. A client that has a Dual Insurance plan could have a very high quarterly allowance of $250 to $300 of free money, and not even know about it!
As a Care Manager, this is a simple question to ask your clients. If their answer is no, call Humana OTC Wellness at 1-855-211-8370 to find out what their benefit amount is, and to order them an OTC Wellness Catalog. You can then educate your client on how to call-in their order every month, or quarter, once they get their catalog.
2. "Go 365" Humana Benefits
This is another simple Humana benefit that most clients have never heard of. "Go 365" is a way for Humana members to stay on top of their health and get rewarded by doing their preventative care and screenings when due. They earn monetary value rewards each time they participate, that can be used to purchase gift cards or other items in the "Go 365" Mall.
- Yearly annual wellness exam - $25
- Yearly mammogram - $30
- Yearly colorectal screening - $30
- Yearly cardio disease screening - $10,
- Bone density: once every 2 years - $20
- Yearly flu shot - $10
- Workouts: 8 in a month - $5 per each month completed
- Community or social program events: up to 4 times a year - $5 per Event
3. The Extra Help/Low-Income Subsidy (LIS) program
Extra Help is a federal program that can help pay for part of, or all of, the out-of-pocket costs of Medicare prescription drug coverage. "Part D Low-Income Subsidy (LIS)" is another name for Extra Help. Low Income Subsidy (LIS) is a huge savings to any client that is eligible. As a Care Manager, we ask every new client whether they have Extra Help/LIS, and if not, if they've ever applied. If the senior is not sure, but their medication co-pays are no more than $3.60 for generic medications, and no more than $8.95 for brand name medications, then it is probably safe to assume that they already have Part D Low-Income Subsidy (LIS).
If a new client is not able to communicate their medication co-pays back to you, you can call Extra Help at 1-800-633-4227 to find out whether your client has this or not. If a senior does not have Extra Help, they can go to the Social Security Administration (SSA) website to apply for the program using either the agency’s print, or online application. Make sure they complete the entire application!
During the application process, clients will also be screened to see if they are eligible for one of the additional Medicare savings programs, i.e. QMB, SLMB, or QI, which will help pay for Medicare costs such as lowering Medicare premiums, covering co-pays or deductibles, and co-insurance costs. Other potential benefits for clients that are eligible for the Extra Help program are help with medication premiums, having a medication max out-of-pocket each year, and never going into a coverage gap.
As Care Managers, there are so many ways that we are able to help our clients, finding ways to save them money is just one of them!
Written By: Care Manager - Nona McKinney, RN