This notification is to make contracted providers aware of a Mercy Care Advantage (MCA) mailing that patients may questions because it affects their current Mercy Care Advantage Plan coverage. The information below explains the reason for this mailing and includes important facts to help assist with questions your office may receive from patients about the mailing.
Background:
Because the AHCCCS Complete Care (ACC) contract service area awarded to Mercy Care no longer includes Pima County, Mercy Care Advantage (MCA) is unable to continue to provide Medicare Dual Eligible Special Needs Plan coverage to our existing Acute members located in Pima County after December 31, 2018. As of October 1, 2018, these individuals will have AHCCCS Complete Care (ACC) coverage.
Due to the ACC contract award, the Centers for Medicare and Medicaid Services (CMS) are requiring Mercy Care Advantage to provide affected members in Pima County with an advance “Non-Renewal Notice”. This notice explains why they are losing their Mercy Care Advantage plan coverage and the need to select a new Medicare health plan for a January 1, 2019 effective date.
Important Information about the MCA Non-Renewal Mailing
- There are 1,685 MCA members that will receive the Non-Renewal Notice by October 2, 2018. Their MCA plan coverage will remain effective until December 31, 2018.
- Mercy Care Advantage is still available as a Medicare health plan option for individuals who are eligible for ALTCS and DDD Medicaid coverage and live in Pima County.
- The change communicated in the Non-Renewal Notice will only affect existing MCA members who will have AHCCCS Complete Care (ACC) coverage effective October 1, 2018 and live in Pima County.
- This change only affects an individual’s Mercy Care Advantage plan coverage. It does not affect their AHCCCS Complete Care coverage that becomes effective October 1, 2018.
- Affected members must select new Medicare Health Plan for a January 1, 2019 effective date. The Non-Renewal Notice explains the types of Medicare health plan options available for selection, which in include the following:
- Selecting another Medicare Dual Eligible Specials Needs Plan (serving ACC individuals in Pima County);
- Selecting another Medicare health plan; or
- Changing to Original Medicare. If this option is selected, Medicare will automatically enroll the member in a Medicare prescription drug plan and will send a letter telling them the name of their new drug plan. If a member does not make a Medicare health plan selection by December 31, 2018, they will be automatically enrolled in Original Medicare effective January 1, 2019 and enrolled in a Medicare prescription drug plan.
- CMS has provided a separate listing of organizations that are contracted to provide Medicare plan coverage in Pima County in 2019 and this listing will be included with the Non-Renewal Notice mailing.
Members can call Mercy Care Advantage at the number on their ID card with questions about the Non-Renewal Notice received.
As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our
Mercy Care website
.
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