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Louisiana Highlights: Baton Rouge
• $0 Premium - Ochsner Only HMO/ $0 Premium - Traditional HMO/$0 Premium MA Only HMO • Plans includes Dental, Hearing, & Vision benefits • 3.5 star HMO plan • Over the Counter (OTC) Benefits on HMO • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• Ochsner Only HMO Limited to Ochsner Network - Must Use Separate Ochsner Network Directory • Traditional HMO Network includes all area hospitals with large provider participation • Baton Rouge Clinic participates in traditional HMO network • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA plan in the state • Ochsner Only HMO plan is the richest Humana plan in this area • $0 premium MA only HMO plan for Veterans using VA for Rx and people with other credible Rx coverage • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
1
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Baton Rouge
Plan Name
$0 Premium MOOP: $6,700 PCP $5 SPEC: $45 Inpatient: $145 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-048-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge: Ascension, East Baton Rouge, Livingston, West Baton Rouge
Plan Name
$0 Premium MOOP: $6,700 PCP $5 SPEC: $50 Inpatient: $110 Days 1-10 Rx Included or No Rx: No Rx Contract/PBP: H1951-030-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge: Ascension, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, St Helena, West Baton Rouge, West Feliciana
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $40 Inpatient: $130 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-039-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge: East Baton Rouge, East Feliciana, Iberville, Livingston, St Helena, West Baton Rouge
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-032-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge: Ascension, East Baton Rouge, Iberville, Livingston, Pointe Coupee, St Helena, West Baton Rouge, West Feliciana
HMO MA Only HMO Ochsner Only HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Dual Eligible SNP HMO
Medicare Supplement
2
Louisiana Highlights: Baton Rouge North
• $0 Premium Ochsner Only HMO / $0 Premium MA Only HMO / $26 Premium Traditional HMO • Plans includes Dental, Hearing, & Vision benefits • 3.5 star HMO plan • Over the Counter (OTC) Benefits on HMO • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• Ochsner Only HMO - Limited to Ochsner Network - Must Use Separate Ochsner Network Directory - no coverage outside of Ochsner network (Except bona-fide Emergency Room Encounters)
• Traditional HMO Network includes all area hospitals with large provider participation • Baton Rouge Clinic participates in traditional HMO network • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA plan in this market • Ochsner only plan is the richest Humana plan in this area • $0 premium MA only HMO plan for Veterans using VA for Rx and people with other credible Rx coverage • Humana is the largest MA company in the state • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
3
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Baton Rouge North
Plan Name
$26 Premium MOOP: $6,700 PCP $10 SPEC: $50 Inpatient: $150 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-048-002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge North: East Feliciana, Iberville, Pointe Coupee, St Helena, West Feliciana
Plan Name
$0 Premium MOOP: $6,700 PCP $5 SPEC: $50 Inpatient: $110 Days 1-10 Rx Included or No Rx: No Rx Contract/PBP: H1951-030-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge area: Ascension, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, St Helena, West Baton Rouge, West Feliciana
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $40 Inpatient: $130 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-039-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge North: East Baton Rouge, East Feliciana, Iberville, Livingston, St Helena, West Baton Rouge
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-032-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Baton Rouge North: Ascension, East Baton Rouge, Iberville, Livingston, Pointe Coupee, St Helena, West Baton Rouge, West Feliciana
HMO Ochsner Only HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Dual Eligible SNP HMO
Medicare Supplement
MA Only HMO
4
Louisiana Highlights: Bayou & River Parishes
• $25 Premium HMO • Plans includes Dental, Hearing, & Vision benefits • 3.5 star HMO plan • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• All Key hospital systems • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA company in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
5
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Bayou & River Parishes
Plan Name
$25 Premium MOOP: $6,700 PCP $5 SPEC: $50 Inpatient: $150 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-047-002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Bayou & River Parishes: Assumption, Lafourche, Plaquemines, St James, St John the Baptist, Terrebonne
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-033-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Bayou & River Parishes: Assumption, Jefferson, Lafourche, Orleans, Plaquemines, St Charles, St James, St John the Baptist, Terrebonne
HMO Dual Eligible SNP HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
6
Louisiana Highlights: Lafayette
• $0 Premium HMO/$49 Premium LPPO/ $0 Premium DE-SNP • Plans includes Dental, Hearing, & Vision benefits • 4 star LPPO plan/3.5 star HMO plan • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers – free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy Mail order for 90 day supply •
Benefit Highlights
• Both major hospital systems in Lafayette • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA plan in the state and in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Local Market office and Support Team • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
7
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Lafayette
Plan Name
$0 Premium MOOP: $6,700 PCP $5 SPEC $40 Inpatient: $215 Days 1-8 Rx Included or No Rx: Included Contract/PBP: H1951-049-002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Lafayette area Acadia, Iberia, Lafayette, St Landry, St Martin, Vermillion
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-041-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Multiple Areas and parishes: Acadia, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, East Carroll, Franklin, Grant, Iberia, Jackson, Lafayette, Lincoln, Madison, Morehouse, Ouachita, Rapides, Richland, St Landry, St Martin, Tangipahoa, Tensas, Union, Vermillion, Webster, West Carroll parishes
Plan Name $49 Premium MOOP: $6,700/$10,000 PCP $5 SPEC: $45 Inpatient: $225 Days 1-7 Rx Included or No Rx: Included Contract/PBP: H5216-064-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Lake Charles & Alexandria: Calcasieu, Caldwell, Cameron, LaSalle, Lafayette, Morehouse, Ouachita, St Bernard, St Landry, St Martin, St Mary, Washington
HMO Dual Eligible SNP HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
Local PPO
8
Louisiana Highlights: Monroe
• $0 Premium HMO/$49 Premium LPPO / $ 0 Premium DE-SNP • Plans includes Dental, Hearing, & Vision benefits • 4 star LPPO plan/3.5 star HMO plans • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• Key hospital systems in Monroe • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• Humana is the second largest MA company in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
9
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Monroe
Plan Name
$0 Premium MOOP: $6,700 PCP $15 SPEC: $45 Inpatient: $215 Days 1-8 Rx Included or No Rx: Included Contract/PBP: H1951-049-003 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Monroe area: Caldwell, Catahoula, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-041-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Multiple Areas and parishes: Acadia, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, East Carroll, Franklin, Grant, Iberia, Jackson, Lafayette, Lincoln, Madison, Morehouse, Ouachita, Rapides, Richland, St Landry, St Martin, Tangipahoa, Tensas, Union, Vermillion, Webster, West Carroll parishes
Plan Name
$49 Premium MOOP: $6,700 PCP $5 SPEC: $45 Inpatient: $225 Days 1-7 Rx Included or No Rx: Included Contract/PBP: H5216—064-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Multiple areas and parishes: Calcasieu, Caldwell, Cameron, LaSalle, Lafayette, Morehouse, Ouachita, St Bernard, St Landry, St Martin, St Mary, Washington
HMO Dual Eligible SNP HMO Local PPO: LPPO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
10
Louisiana Highlights: New Orleans
• Three $0 Premium HMO plans • Plans includes Dental, Hearing, & Vision benefits • 3.5 star HMO plans • Over the Counter (OTC) Benefits on our HMO products • Transportation benefits on Traditional HMO plan, Dual Eligible SNP plan and Diabetic & Heart SNP plan • SilverSneakers - free fitness and gym membership • $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Pharmacy Mail order for 90 day supply
• Very large network of providers, including all area hospitals except University Medical Center Hospital • Large portfolio of plans to choose from in New Orleans area • Strong Relationships with Providers • Must use separate directories for Diabetic & Heart SNP plan and Ochsner Only plan - no coverage outside of these
special networks/provider directories
Network Highlights
• Humana is the largest MA company in this market • Diabetic & Heart SNP HMO and Ochsner Only HMO plans are richest Humana plans in this area • Local Market office and Support Team • Year Round Selling opportunities with Dual Eligible Plan • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities
Competitive Advantages
Benefit Highlights
11
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: New Orleans
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $45 Inpatient: $105 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-047-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: New Orleans: Jefferson, Orleans, St Charles
Plan Name
$0 Premium MOOP: $3,400 PCP $0 SPEC: $25 Inpatient: $50 Days 1-5 Rx Included or No Rx: Included Contract/PBP: H1951-044-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: New Orleans: Jefferson & Orleans
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $40 Inpatient: $105 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-038-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: New Orleans: Jefferson, Orleans, St Charles
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-033-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: New Orleans: Assumption, Jefferson, Lafourche, Orleans, Plaquemines, St Charles, St James, St John the Baptist, Terrebonne
HMO Diabetic & Heart SNP HMO Ochsner Only HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Dual Eligible SNP HMO
Medicare Supplement
12
Louisiana Highlights: Northshore
• $28.90 Premium HMO/$49 Premium LPPO (Washington parish only) • Plans includes Dental, Hearing, & Vision benefits • 4 star LPPO plan/3.5 star HMO plan • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Copay Rx Benefit - Tier 1 & 2 Rx, if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• All Key hospital systems in both parishes • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA plan in the state and in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Humana has very strong market penetration in this area • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
13
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Northshore
Plan Name
$28.90 Premium MOOP: $6,700 PCP $10 SPEC: $45 Inpatient: $195 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-028-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Northshore: St Tammany & Washington parishes
Plan Name
$49 Premium MOOP: $6,700 PCP $5 SPEC: $45 Inpatient: $225 Days 1-7 Rx Included or No Rx: Included Contract/PBP: H5216-064-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Northshore: Washington parish only
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-034-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Northshore: St Tammany & Washington parishes
HMO Local PPO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Dual Eligible SNP HMO
Medicare Supplement
14
Louisiana Highlights: Shreveport
• $29 Premium HMO / $49 Premium LPPO / $0 Premium DE-SNP • Plans includes Dental, Hearing, & Vision benefits • 3 star LPPO plan ; 3.5 star HMO plans • Over the Counter (OTC) Benefits on our HMO products • Transportation benefits on Dual Eligible SNP plan • SilverSneakers - free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• Both major Shreveport hospitals systems (Willis Knighton & Christus Schumpert) participate in our HMO & PPO plans • Many other rural hospitals around the Shreveport area participate in our HMO & PPO Plans • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA company in the state and in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Local Market office and Support Team • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
15
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Shreveport
Humana Gold Plus
$29 Premium MOOP: $6,700 PCP $5 SPEC: $40 Inpatient: $175 Days 1-10 Rx Included or No Rx: Included Contract/PBP: H1951-013-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Shreveport: Bossier, Caddo, Webster parishes
Humana Gold Plus
$0 Premium MOOP: $6,700 PCP $0 SPEC $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-041-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Multiple Areas and parishes: Acadia, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, East Carroll, Franklin, Grant, Iberia, Jackson, Lafayette, Lincoln, Madison, Morehouse, Ouachita, Rapides, Richland, St Landry, St Martin, Tangipahoa, Tensas, Union, Vermillion, Webster, West Carroll parishes
Plan Name
$49 Premium MOOP: $6,700/$10,000 PCP $5 SPEC $45 Inpatient: $225 Days 1-7 Rx Included or No Rx: Included Contract/PBP: H5525-015-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Northwest Louisiana: Bienville, Claiborne, De Soto, Natchitoches, Red River, Sabine, Winn parishes
HMO HMO Dual Eligible SNP Local PPO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
16
Louisiana Highlights: Southwest/Central Lafayette, Lake Charles, Alexandria
• $0 Premium HMO/$49 Premium LPPO • Plans includes Dental, Hearing, & Vision benefits • 4 star LPPO plan/3.5 star HMO plan • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy Mail order for 90 day supply
Benefit Highlights
• Both major hospital systems in Lake Charles and Alexandria • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• Humana is the largest MA plan in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Local Market office and Support Team • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
17
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana: Southwest/Central Lafayette, Lake Charles, Alexandria
Plan Name
$0 Premium MOOP: $6,700 PCP $15 SPEC $45 Inpatient: $225 Days 1-8 Rx Included or No Rx: Included Contract/PBP: H1951-049-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Lake Charles & Alexandria: Calcasieu, Cameron, Grant, Rapides parishes
Plan Name
$0 Premium MOOP: $6,700 PCP $0 SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H1951-041-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Lake Charles & Alexandria: Acadia, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, East Carroll, Franklin, Grant, Iberia, Jackson, Lafayette, Lincoln, Madison, Morehouse, Ouachita, Rapides, Richland, St Landry, St Martin, Tangipahoa, Tensas, Union, Vermillion, Webster, West Carroll parishes
Plan Name
$49 Premium MOOP: $6,700/$10,000 PCP $5 SPEC:$45 Inpatient: $225 Days1-7 Rx Included or No Rx: Included Contract/PBP: H5216-064-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Lake Charles & Alexandria: Calcasieu, Caldwell, Cameron, LaSalle, Lafayette, Morehouse, Ouachita, St Bernard, St Landry, St Martin, St Mary, Washington
HMO Dual Eligible SNP HMO Local PPO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
Plan Name
$49 Premium MOOP: $6,700/$10,000 PCP $5 SPEC:$45 Inpatient: $225 Days1-7 Rx Included or No Rx: Included Contract/PBP: H5216-135-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Allen, Avoyelles, Beauregard, Evangeline, Jefferson Davis, Vernon
Local PPO
18
• $0/$55/$89 Premium - three RPPOs to choose from • R5826-011 and R5826-068 plans includes Dental, Hearing, & Vision benefits • R5826-068 MA Only • R5826-078 includes Vision & Hearing • 3.0 star RPPO plans • Over the Counter (OTC) Benefits on all three RPPOs products • SilverSneakers - free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply
Benefit Highlights
• All major hospital systems participate in our RPPO plans • Many other rural hospitals around the state participate in our RPPO Plans • Strong Relationships with Providers
Network Highlights
• Humana has over 18,000 RPPO members in the state • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Strong Brand Recognition In Market • Local Market office and Support Team in New Orleans, Baton Rouge, Lafayette, Lake Charles and Shreveport • RPPO gives agents more plans to offer your clients, but our LPPO plans have same network, lower premium and
richer benefits
Competitive Advantages
Louisiana Highlights: Statewide Regional PPOs
19
This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Statewide Regional PPOs
Plan Name
$89 Premium MOOP: $6,700/$10,000 PCP $15 SPEC $50 Inpatient: $275 Days 1-7 Rx Included or No Rx: Included Contract/PBP: RO110-003 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: All LA Parishes
Plan Name
$0 Premium MOOP: $6,700 PCP $10 SPEC $35 Inpatient: $195 Days 1-6 Rx Included or No Rx: No Rx Contract/PBP: RO110-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: All LA Parishes
Plan Name
$55 Premium MOOP: $6,700 PCP $15 SPEC $50 Inpatient: $275 Days 1-7 Rx Included or No Rx: Included Contract/PBP: RO110-002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: All LA Parishes
Regional PPO Regional PPO Regional PPO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
20
Louisiana Highlights: Tangipahoa Parish
• $61 Premium HMO • 4 star LPPO plan/3.5 star HMO plan • Over the Counter (OTC) Benefits on our HMO & LPPO products • Transportation benefits on Dual Eligible plan • SilverSneakers - free fitness and gym membership • $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy Mail order for 90 day supply)
Benefit Highlights
• All Key hospital systems • Many other rural Hospitals participate in our HMO and PPO plans • Strong Relationships with Providers
Network Highlights
• HMO is the largest MA plan in the state and in this market • Many additional Medicare Supplemental benefits such as meals delivered to home after facility stay, 24/7 Nurse
Hotline, Over the counter benefit, Rewards for preventive care and select physical activities • Multiple products in this area: HMO, Dual Eligible SNP, RPPO and LPPO (Washington parish only) • Strong Brand Recognition In Market • Year Round Selling opportunities with Dual Eligible Plan
Competitive Advantages
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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.
Louisiana Highlights: Tangipahoa Parish
Plan Name
$61 Premium MOOP: $6,700 PCP $5 SPEC $45 Inpatient: $217 Days 1-7 Rx Included or No Rx: Included Contract/PBP: H1951-024-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Tangipahoa: Tangipahoa parish
HMO Local PPO
PDP
HMO
SNP
Regional PPO
PFFS
Medicare Supplement
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Louisiana Market Managers
Bonnie Lee 337-540-0002
Steve Kent 318-773-8858
Dale LaBorde 504-214-9200
Elizabeth Gremillion
504-564-3158
Rebecca Rome 225-323-5020
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Click here to open the 2018 National Plan Grid
Click the link below for the 2018 National Plan Grid. Viewable on all devices but the filter function is only usable with Microsoft Excel compatible devices.
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