https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9 How Does Someone Sign Up For a A Highmark Wholecare Medicare Assured Plan? en-us 2021-03-05 14:38:40 UTC 2025-10-05 00:02:36 UTC hello@padlet.com wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273831036 Members become eligible for Medicare when they:
1. Turn 65
2. Become disabled
3. Have End-Stage Renal Disease
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]]> 2021-03-05 14:41:30 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273831036 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273873563 Betty calls in to Customer Service and tells you that she is interested in Joining Highmark Wholecare for Medicare.  
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Is she eligible yet?]]> 2021-03-05 14:48:53 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273873563 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273943891 Now that Betty is actually eligible for one of the HMK Wholecare Medicare Assured Plans, she can apply.  There are a few ways to do this:
1. On HighmarkWholecare.com
2. By Calling our Sales Department
3. On the CMS.GOV website
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How can Betty reach our sales department?]]> 2021-03-05 15:02:21 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273943891 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273954112 Betty is 64 years old and currently a Medicaid recipient]]> 2021-03-05 15:04:25 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273954112 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273978229 The enrollment department at Highmark Wholecare reviews Betty's application and determines that because she is eligible for full Medicaid and is 65 and eligible for Medicare parts A & B, that she is a valid candidate for Highmark Wholecare Medicare Assured Diamond, and approves her as a member. ]]> 2021-03-05 15:09:08 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1273978229 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274160423 If Betty decides that she doesn't want Highmark Wholecare Medicare Assured anymore, but Enrollment has NOT YET added a profile for her in our systems, Betty can CANCEL her plan by speaking to our Retention department.
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What is a Cancellation Request?]]> 2021-03-05 15:44:38 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274160423 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274179083 If she doesn't cancel, after Betty's application has been approved, Enrollment will allow an account to be made for Betty.  She should soon show up in the systems, have a member ID, and everyone at the company will be able to see her account.  ]]> 2021-03-05 15:48:17 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274179083 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274200681 If Betty loses her Medicaid eligibility, she's going to be notified by Highmark Wholecare because BOTH of our Medicare Assured plans are considered D-SNPs.  If she calls Customer Service about this, there will be a Power Queue note on her account called "Loss of Medicaid LTR".  If you see this, she needs to speak to the RETENTION department to discuss her options! 
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What is a Loss of Medicaid?

]]> 2021-03-05 15:52:25 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274200681 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274201206 This is called the Disenrollment Request.  She'll call Customer Service and we should try to figure out why she wants to disenroll and see if we can fix things first.  If she is adamant about disenrolling, we INITIATE the disenrollment REQUEST process for her. 
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What is a Disenrollment?]]> 2021-03-05 15:52:31 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274201206 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274206610 Since enrollment has already created Betty's  account, Customer Service Representatives should now be able to locate her account in our systems.  Note:  She's a new member, so she may not have an ID card yet!  To verify, you might ask for her social security number.  ]]> 2021-03-05 15:53:36 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274206610 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274210493 As she uses her insurance, she may call Customer Service every now and then to ask questions about her benefits, bills she gets, and supplemental benefits! ]]> 2021-03-05 15:54:24 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274210493 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274211060 Betty will most likely call customer service and expect CSRs to update that for her.  We cannot verify that information ourselves so we will need to transfer that call to Retention.
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What does the Retention department do?]]> 2021-03-05 15:54:32 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274211060 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274213202 Anytime a Medicare Assured member has any kind of demographic update (including name, DOB, etc.), we need to route that info to the Enrollment department using the Power Queue system.  
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What is a demographic update?

]]> 2021-03-05 15:54:56 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/1274213202 wholecaretrainers https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/2117149779 2022-03-28 13:26:30 UTC https://padlet.com/wholecaretrainers/n5tn8l61d3w4p0h9/wish/2117149779