LA HAP Bulletin for 6/76/19

Dovato added to LA HAP formulary for uninsured members

Effective 6/1/19, Dovato (dolutegravir/lamivudine) has been added to the LA HAP formulary for uninsured members. Insured members may access these medications provided they are covered by their primary insurer’s formulary.

Guardian dental enrollment issues

We have recently heard from a growing number of our clients that they were unaware their case manager enrolled them into the LA HAP/Guardian Dental Plan. Some of these clients are still presenting inactive insurance cards at the dentist’s office, and some are still enrolled in employer-based plans while also enrolled in the LA HAP plan. Clients have gone on to accuse LA HAP and HIP staff of canceling insurance plans without their consent, leading to a loss of trust between us and our clients.

• Clients should complete all LA HAP paperwork themselves unless a physical, mental or linguistic impairment prevents them from doing so.  While we do not require a client signature on Insurance Add/Change Forms, this is something we may institute going forward.

• It is illegal for LA HAP to pay for a Guardian plan for any client who is already enrolled in another form of comprehensive dental coverage. Having a significant amount of dually-enrolled clients jeopardizes our ability to offer the Guardian plan.

• For application submissions:

· If a client is adding the LA HAP/Guardian plan for the first time or returning to LA HAP/Guardian after a lapse in coverage, please send an Insurance Add/Change Form.  This pertains to clients new to LA HAP, clients new to Guardian, & clients whose eligibility has lapsed and need to re-enroll into Guardian.

· If a client is recertifying and already enrolled in LA HAP/Guardian, please include this information on page 7. There is no need to also submit an Insurance Add/Change Form.

· If a client is recertifying and already enrolled in LA HAP/Guardian but has not listed this information on the application, LA HAP staff currently follows up. After July 1st, if this information is not listed on the application, LA HAP staff will assume the client no longer wants to be enrolled in LA HAP/Guardian and will disenroll them from the Guardian plan.