LA HAP Bulletin for 1/15/19
Pifeltro and Delstrigo added to formulary for uninsured clients
LA HAP has requested the addition of Pifeltro (doravirine) and Delstrigo (doravirine/lamivudine/tenofovir disoproxil fumarate) to the formulary effective 1/15/19 for uninsured clients. Insured clients can access these medications provided they are covered by their primary insurer.
Ongoing dental enrollment and resources available
We have over 900 clients enrolled in the LA HAP/Guardian Dental Plan and counting! We are phasing out the original enrollment forms used during the transition and are now using a pre-filled Insurance Add/Change Form for new enrollments. See www.lahap.org/dental for this form and for other information related to the dental benefit.
This form can be submitted on its own for currently eligible clients, or along with the LA HAP application for recertifying clients. Recertifying clients who are already enrolled in this plan can simply write “LA HAP Guardian Dental Plan” in the dental insurance section of the LA HAP application. LA HAP staff are working on changes to the application design that will make this option more clear.
Open Enrollment Period ONLY for Medicare Advantage members runs January 1st-March 31st
Beginning in 2019, Medicare has made changes to Medicare Advantage [Part C] enrollment. From January 1st-March 31st, Medicare Advantage enrollees are able to :
- Switch to a different Medicare Advantage plan
- Drop their Medicare Advantage plan and return to Original Medicare [Parts A and B]
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if they return to Original Medicare)
Note that this Open Enrollment only affects members who currently have an Advantage plan; Original Medicare members may not use this time to enroll in a Part C plan for the first time.
For our clients who are enrolled in an Advantage plan, this is an excellent time for them to review the relatively limited provider networks provided by their plans to gauge whether Original Medicare is more appropriate to their needs. Please note that any LA HAP clients dropping an Advantage plan would be required to enroll in a Part D plan during this time.
Ramsell User Request Forms
A reminder that the Ramsell User Request Form can be found on our website under “Provider Resources,” allowing access to clients’ eligibility profiles. When filling out this form:
- Fill in the information as completely as possible, including correct email addresses and legible names;
- Select your “primary role” based on which description on the form most accurately reflects your role at your agency, rather than which job title is most similar to your own.
This will help us speed our processing time considerably and avoid assigning inappropriate user access levels. Thanks!