Insurance Talk — Learn About PacificSource Medicare Benefits for 2021

Insurance Talk — Learn About PacificSource Medicare Benefits for 2021

Rex and Cheri have the answers. Listen here.


Insurance Talk — Learn About PacificSource Medicare Benefits for 2021

Cheri Martinen – Thank you for joining Insurance Talk with Cheri Martinen. Today I have a very special guest coming to us all the way from Bend, Oregon. Emily Carrick from PacificSource Medicare is in our studio today. I’m super excited to have her here because Open Enrollment, or Annual Election Period, is right around the corner. And I want to make sure everyone in Central Oregon, Northern Klamath County, and Northern Lake County knows everything about all the plans that are available. One of our favorite partners, because Emily is just wonderful and that’s why she’s one of our favorites, is PacificSource. Emily, welcome to the show and I’m so happy to have you here again. Thank you for joining us.

Emily Carrick – Thanks for having me. It’s fun to be here again.

CM – Last year we did this for the first time, Emily did a radio podcast with us, and so this will be our second year. Emily, you have some exciting changes to tell us about for this new Annual Election Period, which again starts October 15th and runs through December 7th of this year. So like I said, we’re recording this in early October and we hope to have this out in early October, but if you’re interested in looking at a new Medicare advantage plan, this would be the time to do it: October 15th through December 7th.

PacificSource Medicare Benefits

EC – Yes, exactly. Well, thanks for having me again. I am really excited to share some information about some new benefits that are coming to all of our plans in 2021. So for those of you that are already members with PacificSource, thank you so much. You will be getting some new benefits next year. And for those that are maybe with a different plan and want to take a look, please check in with Bancorp Insurance and they can show you everything we have to offer.

The two new benefits are really around taking care of our members, which is so important to us. If you’re not familiar with PacificSource, we are a not-for-profit organization, which means that we pay taxes, but we cannot make a margin of over 2%. So we do a lot to give back to the community through our foundation.

Some of the ways we want to take care of our members next year is through a program that we’re calling Rewards for Healthy Actions, where members can earn a gift card for things they’re probably already doing now. For example, if a member goes in for an annual routine physical, which we do cover for our members, it costs them nothing, and they will be eligible for a $50 gift card. And there are over a hundred different retailers to choose from for your gift card. And it’ll be your choice. It includes places online like Amazon, Target, Starbucks, Walmart, Macy’s, there are just too many to even name, but it’ll be your choice.

One of the others that you can do to earn a gift card is to get an annual mammogram, which is no cost to you. And you can earn a $25 gift card. Also, if you get an A1C blood glucose test, you will earn $15 for your first test and $25 for your second test. And if you are a diabetic, you may not be aware that you can get a no-cost eye exam once a year. And under this new program, starting in January, you will also earn a $25 reward for doing that.

CM – That’s pretty cool. So all they have to do is get these annual checkups and exams. How do they know that they get to choose a gift card?

EC – Great question. So here’s how it’s going to work. We, of course, process the claims. So we will get the information once you’ve had that test done, and we’re going to send a monthly report to the vendor that manages the program. They’re going to send you a letter letting you know what you qualified for, and there’ll be a variety of ways you can order your gift card. I’m sure you can go online or call or there’ll be instructions there on how to do that.

CM – Got it. That’s not hard at all. It’s something easy that you probably do anyway, and then you get rewarded for it.

EC – Exactly, that’s what we’re hoping. And the reason we did call out these specific measures is Medicare really wants Medicare beneficiaries to be getting these done. And they score the health plans on how many members are doing these things. And we know our members are great. They’re already doing this, but we’re just hoping to increase participation because we do get scored by Medicare and part of our score, which they call a ‘star rating,’ does affect our funding and the funding we get from Medicare has an impact on the monthly premiums. So if we can get additional funding in the future, we can give that back to our members and either keep premiums the same, or maybe even lower them at some point.

PacificSource Medicare Premiums in 2021

CM – And that was exciting news as well for PacificSource, right? With the premiums coming into 2021?

EC – Yes. Three of our most popular plans are having no change to the monthly premium, so this is definitely not a fall where we want any more change in our life. And one plan is changing by a dollar. So it’s pretty much a rate hold.

CM – Which is awesome. I’m clapping in the background. It’s really nice to see that when you can tell a member that your plan isn’t going up. You’re looking good for next year.

EC – And just a reminder, you don’t need to re-enroll every year. If you’re already with PacificSource, you don’t need to do anything, you can just relax. And the other new benefit I wanted to mention is one that’s called Meals as Medicine. This is a program where if you’ve recently been in the hospital or in a rehabilitation facility like a skilled nursing facility, once you’re discharged, you’ll be contacted and offered up to a week’s worth of healthy meals that will be delivered to you free of charge. And there’s a variety of meal options to suit your needs. For example, heart-healthy or low sodium or vegetarian or kosher. There’s pretty much something for everyone. And the reason for this is it really is critical to get healthy nutrition following something serious such as a hospital stay or a stay in a rehab facility.

CM – This one’s really good. I like that this is an option for members now. Nobody wants to cook when you’re sick or when you’re healing.

EC – It’s so true. And one thing that I also like is you don’t have to ask for it. You will be contacted and reminded that you have this benefit and you have up to 30 days to start the delivery. If you have someone staying with you and helping you with meal preparation, maybe for the first two or three weeks, you can set it to start 30 days out. You don’t have to start it immediately and it won’t go away. And the benefit renews every time you’re discharged. So if you had to go back into the hospital again, once you get home, you’re eligible again to start that program any time during the next 30 days.

CM – Wow. I didn’t know that, that’s awesome.

EC – It really is. And I’m just excited that especially members don’t have to ask for it, they’ll be contacted because when you’re discharged from the hospital, you are probably not feeling very well. And you’re not going to be thinking about that.

CM – No, not at all. You’re thinking, gosh, just give me something comforting and warm. And you’re just glad to be back in your own bed.

EC – I know I’ve very rarely been in the hospital, but they wake you up every three hours. That’s the worst part. You’re not getting a full night’s sleep.

Additional Benefits

CM – Other benefits that we just love that PacificSource offers and you guys might’ve already known this if you’re a current member or if you’ve looked at their plans in the past, things like eyeglasses and vision benefits, hearing aid benefits, alternative care benefits. They’ve got benefits for fitness programs. A lot of us aren’t going to the gym anymore, but one of the nice things about PacificSource’s fitness program is that they also have workout videos for home or online classes. So if you’re not going to the gym and you’re missing that community or just getting your body moving, there are still options for working out at home.

EC – And they’re adding a new benefit through Silver&Fit where you can order a fitness tracker, something similar to a Fitbit, and there’s no cost to you for that. So I think that’s amazing if you want to start a walking program or something like that.

CM – That’s neat, I didn’t know they were doing that too, all these new things this year.

Medicare and Prescription Drug Costs

EC – There’s one other thing I want to call out. This is not anything new, but if you’re not a member of ours, you may not know that we have a whole bunch of medications that we cover that are no cost to our members. And it’s a long list of medications for blood pressure, high cholesterol, type 2 diabetes, and osteoporosis. So keep that in mind if you take any of those medications, you can likely join our plan and maybe not have to pay anything at all for those medications.

CM – And they can do that up to 90 day supply. You don’t have to go to the pharmacy over and over again, and they can help with mail order as well if you never want to go to the pharmacy again.

EC – Correct. We have a fabulous mail order system through CVS Caremark. I actually use it myself and it’s been fantastic. There’s also savings on other medications if you get them through mail order, so there’s some real financial reasons you might also want to do that. And just to let you know, our lowest premium plan with prescription coverage is $55 a month. You would get access to those zero copay medications through that program and all of our plans with prescription coverage.

CM – You might be saving money just by not paying full price for the prescriptions.

EC – Don’t forget to look at that side of the equation when you’re figuring out the cost of a health plan. It’s not just the monthly premium, but what are your prescription drug costs?

CM – And one of the things I always like to bring up is PacificSource is local to Central Oregon, which is wonderful. They have a beautiful office in Bend, and I think they’ve got updates for us on that.

EC – We have a lot of members who love to come and see us in our office. Unfortunately it is going to remain closed to visitors this fall. We’re just trying to be very safe, keep our employees safe, keep the public safe. Most employees have been working from home for the last six months, including myself, but we do keep a very skinny staff inside the building to handle things like the mail and certain tasks that really need to be done in the office. We can do everything over the phone with you and you have Bancorp Insurance here to help you as well. If you do really need to meet face-to-face with someone, just give them a call and I’m sure they can help you with any questions you might have.

CM – That’s true. 541-536-1726. You can call to make an appointment today. We’re already making appointments for October 15th and onward to start looking at different plans for individuals in our area. We work very closely with all of our partners, but we’re very excited to have PacificSource with us again this year. I think there were a few more announcements on your end though. You’re not having the big event this year.

Virtual Medicare Expo

EC – Right, last year we were so excited about our new Medicare Expo. We had a great turnout at that event where we had both members and prospective members come to check out what we had to offer and give plan updates. This year we are taking a leap of faith and we’re making it a virtual expo. We’re hoping people will log on and check it out. The nice thing is it’s on our website. You can view it anytime you like. If you’re a night owl and you want to watch it at midnight, you can do that. And the link is a little bit long for me to give over the radio, so just call our office and ask them for the Medicare Expo link or also our members who we have an email for will get an email with the link embedded. And we’re also going to do a mailing to our members with that link.

I do encourage you to watch it because there are some good updates on the plans that go into more depth than I’m able to give today. And then you can sign up for a live session with some of our vendors, like from TruHearing to learn more about our hearing aid benefits, Silver&Fit, more about our vision benefits, so you can take a deeper dive and sign up for a live session if you’re interested.

CM – I know that was going to be different. No in-person, but it’s virtual. Everything’s going virtual. We’re all going online.

EC – We’re making the best of a sad situation, and we’re just trying to keep everyone safe.

CM – I want to make sure that we got everything covered. I don’t know if everyone knows about your veteran plan.

Veteran Medicare Plan from PacificSource

EC – We have a plan that actually is available to everyone, but we have found it’s a great fit for people who have the VA health plan for veterans. It is a zero monthly premium plan. And it basically gives you access to choose to get your care outside of the VA health system and pay less for those services than you would if you just had them billing your Medicare benefits. There’s no part D prescription coverage included, and most veterans don’t need that because they’re getting that through the VA.

You can add this to your Medicare and it just gives you more options than you had before, and you’ll have access to all those extra benefits I just described like the meal delivery following a hospital stay, the rewards program for getting a physical or other services like that. And the eyeglasses benefits, the hearing aid discounts, there’s a whole lot of nice extras that you’ll get just by signing up for our plan. And it doesn’t cost you anything. Again, that price is $0. In case you’re wondering, how can they do that? Keep in mind, we do get funding from Medicare that subsidizes our plan premiums. It’s not that it’s just a free plan and nobody’s paying for it. But the money we’re getting from Medicare is sufficient to subsidize the cost for our members on that plan.

CM – If you do need prescription drugs, that $55 plan is a great fit. If you’re with the VA and have your prescription drugs covered by the VA, check out the $0 plan, it might be a really good fit just to get a few extra benefits that you don’t get otherwise.

EC – It’s been a really popular plan with veterans so I encourage you to check it out, and remember you do need to sign up for it during an Open Enrollment season like the one that’s starting October 15th.

CM – Just another reminder, there are other options available for PacificSource. We’re just talking about these two because they’re some of the most popular. I know one of the questions I get a lot when I have individuals look at your plan is they say, oh, it says HMO. What’s going to happen?

Pacific Source HMO Plans

EC – Don’t be scared of our HMO plans. Back in the day with an HMO-style plan, which just stands for Health Maintenance Organization, you always had the gatekeeper and you had to get a referral before seeing a specialist. We have a no-referral requirement on all of our plans and within an HMO plan, you’re expected to see doctors in the network for any appointments that you schedule that’s not an immediate need.

We have such a broad network of providers, almost all the providers throughout Central Oregon and La Pine are in our network. We also have OHSU in Portland and the Legacy system in our network. It goes far beyond just this region. And if you’re traveling, I know we’re not taking a lot of vacations, but maybe you need to go stay with a family member to help them. You are covered anywhere you go for something immediate. If you get a deep cut in your finger and you need stitches, you just go to the nearest urgent care clinic, or if it’s more serious and life-threatening, you just go to the nearest hospital.

I also want to mention our COVID-19 coverage. I want to reassure all of our PacificSource members that if you need to be tested for COVID, whether it’s because of a symptom or you’ve been exposed or even to travel some places, we are going to cover that 100% for you. If you have to be hospitalized due to COVID, we cover that 100%. If you have to be in the ICU due to COVID, we covered that 100% anywhere in the United States. So please don’t hesitate if you need to go stay with family somewhere to help them out. Your coverage for COVID is going to be covered 100% anywhere in the US.

CM – That is amazing.

EC – Yes. I just want to reassure people because it’s scary especially with the news we got about the White House and the President having COVID. It can happen and we just want to put people’s mind at ease that at least they won’t have to worry about finances.

CM – Take care of yourself first. And that’s why we buy insurance in the first place is to help with that cost. Well, is there anything else we’re missing?

PacificSource Pandemic Response

EC – One thing I did want to mention is our company really stepped up when the pandemic first started early in the spring to ask our provider partners like St. Charles, Mosaic, Summit, what do you need and how can we support you? What we heard is we need to strengthen or put in place a telehealth system. Maybe they didn’t really have that and maybe they needed help paying just overhead costs because they didn’t have as many customers or clients coming in for care.

We gave several million dollars to providers throughout our four-state service areas of Oregon, Washington, Montana, and Idaho, to help them basically keep the lights on during this really tough financial time. That’s part of our foundation that we have. And as a not-for-profit, that’s really how we use that money to benefit our entire community. We’ve also done a lot for the recent wildfires. We’ve given a lot of money, many thousands of dollars to the United Ways in all the areas affected. It’s pretty important to us. And I like that we’re nimble, we’re able to react quickly to a need that we see in our community.

CM – And we love that you do it too.

EC – Thank you. I’ve been with the company for 15 years now and that’s one of the reasons I stay. I love that we give back to the community. That’s just very important to me personally. It feels good, frankly, to support a company that does that. And we are an Oregon-based company so if you’re someone who really likes to shop local, you’re shopping pretty local if you buy from PacificSource because we are an Oregon-based company.

Make an Appointment with Bancorp Insurance

CM – So again, if you’re interested in learning more about PacificSource and maybe purchasing one of their Medicare Advantage plans, you can visit Bancorp Insurance. We are located right off Highway 97 in beautiful downtown La Pine. You can also call us at 541-536-1726 or visit us online at www.bancorpinsurance.com. If you’re listening to this podcast and have heard it in the past, then you know that we love to put different topics on here. This is our second year with Emily. Thank you so much for coming and updating us on all of the happenings at PacificSource. We look forward to offering your plans for this 2021 season. And I think all the individuals that are members will be excited to hear all the updates.

EC – Great. Well, thank you for having me. I really appreciate the opportunity.

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