-
The Part D late enrollment penalty is a an amount added to your Part D monthly premium because you didn't sign up for drug coverage when it was available to you. If you go without a Part D plan or a Medicare Advantage plan with drug coverage for 6...
-
An exciting change has been made to your coverage – here’s what you need to know. Starting January 1, 2025, there is no longer a “Coverage Gap,” also called the “Donut Hole” Phase, in your prescription drug plan. This means that once you reach t...
-
Created On: 06/11/2020
in Medicare
When the Centers for Medicare & Medicaid Services (CMS) makes changes to the services that are covered, they update them through National Coverage Determinations. Learn more about National Coverage Determinations on their website . ...
-
Created On: 06/11/2020
in Medicare You, your authorized representative, or your prescribing doctor can ask for a coverage determination. Your provider can submit prior authorization requests through the GuidingCare Provider Portal. Mail or fax us a Coverage Determination Request...
-
Created On: 06/11/2020
in Medicare Your Hally Account
How do I order a new ID card? How can I check my claims? - Not available on our SmartHMO plan. How can I request or see my prior authorizations? What is my spending on services? ...
-
Created On: 06/11/2020
in Medicare Your Pharmacy Info Certain covered drugs have special rules or limits, like step therapy, prior authorization, and quantity limits, to keep you safe. Learn more about these and which drugs have them. How do I request a coverage determination or medical exception for...
-
Created On: 06/11/2020
in Medicare Your Plan Coverage To determine if a doctor or specialist is in-network, click here and select your plan type (POS or PPO). Then enter the name of the physician or specialist to see if the doctor is covered in one of our networks. ...
-
Fill out the Pharmacy Prior Authorization Request Form .
-
If you're having trouble affording your medicine, contact your doctor, your case manager, or our pharmacy department at (800) 481-1092, option 4 to discuss your options and support. For Group Medicare members: If you experience hardship from h...
-
Created On: 06/11/2020
in Medicare Your Plan Coverage