SHINE

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SHINE
Serving Health Insurance Needs of Elders
Alexandra Kruse Statewide Program Director
E. Douglas Beach, Ph.D Secretary, Department of
Elder Affairs
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Department of Elder Affairs

• Mission
• To foster optimal quality of life for
• elder Floridians
• Vision
• To foster a social, economic and intellectual
  environment for all ages, and especially for
  those age 60 and older, where all can enjoy
  Floridas unparalleled amenities in order to
• thrive and prosper

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SHINE Mission

• SHINE provides free and unbiased health insurance
  counseling through a dedicated network of
  volunteers, empowering Florida seniors to make
  informed healthcare choices.

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What is SHINE?

• Department of Elder Affairs volunteer program
• Funded by Centers for Medicare Medicaid
  Services
• State Health Insurance Assistance Program (SHIP)
• 11 Aging Resource Centers (ARCs)

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SHINE Program Structure
Federal
State
Local
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Who are SHINE clients?

• Medicare beneficiaries and caregivers
• Diverse individuals
• Underserved populations
• i.e. minorities, rural residents and disabled
  beneficiaries

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SHINE Services

• Individual counseling and assistance
• Outreach at community events
• Educational presentations to community groups and
  agencies

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Counseling and Assistance

• Explain options
• Assist with access benefits
• Assist with explaining paperwork
• Provide enrollment and prescription assistance
• Assist with appeals and grievance resolution
  process

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Outreach

• Distribute educational materials
• Perform special outreach projects
• Assist in recruiting new volunteers
• Foster partnerships

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Education

• Make presentations at public forums and local,
  regional and statewide events
• Make presentations to civic and community groups
  and associations

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SHINE Topics Covered

• Medicare and its many programs
• Medicare Supplements (Medigap)
• Prescription Drug Plans
• HMOs and PPOs
• Medicaid

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SHINE Topics Covered (cont.)

• Long-term Care Options
• Medicare claims, appeals, fraud and abuse
• Pharmaceutical assistance

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What We Will NOT Do

• We will not charge for any service.
• We will not share your information.
• We do not sell, promote or recommend any brands,
  providers or insurance plans.

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What We Will NOT Do

• We do not give legal advice or legal options.
• We do not give medical advice or diagnoses.
• We will not make decisions for you.

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Who are SHINE Volunteers?

• Diverse people who want to help
• Many are retired
• People who desire to learn
• Problem solvers

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Make a Difference

• Contact us today to learn about volunteer
  opportunities with SHINE!

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How to Contact SHINE
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Florida Discount Drug Card
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Topics to Discuss

• Purpose of Florida Discount Drug Card
• Who can enroll?
• How to enroll
• Florida Discount Drug Card Savings
• Florida Discount Drug Card Basics
• How can FLAIRS help?

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Florida Discount Drug Card

• Introduced by Governor Crist
• December 20, 2007
• Lower costs of prescription drugs
• Help those with no drug insurance coverage
• Jointly administered by AHCA, DOEA, and DCF

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Who can enroll?

• Those without prescription drug coverage
• May fall within the Medicare prescription drug
  plan coverage gap
• Age 60 and older
• No income limit

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Who can enroll? (cont.)

• Age 59 and younger
• 300 poverty level
• 30,636 (for an individual)
• 41,076 (for a family of two)
• 61,956 (for a family of four)

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How to enroll

• www.FloridaDiscountDrugCard.com
• 1-866-341-8894
• 1-866-763-9630 (TTY)

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How to enroll (cont.)

• Its easy!
• Takes only a few minutes
• Simple information needed
• Name
• Address
• Phone number
• Income (for those under 60)
• No Social Security or Medicare numbers!

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Florida Discount Drug Card Savings

• Savings vary
• Depends on quantity, type and brand of drug
• On 10 commonly used prescriptions, savings ranged
  from 5 42
• Savings on virtually every brand and generic
  prescription drug

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Florida Discount Drug Card Basics

• No enrollment fee
• One-time activation fee, 1.50/card
• Pharmacies
• More than 4,000 statewide
• Diabetic Supplies
• Discounts available with a prescription
• Mail Order
• 90-day option available

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Florida Discount Drug Card Basics

• May be used with other discount programs
• Only one program may be used per single
  prescription
• Member will be charged the lowest cost
• Ask pharmacist for cheapest option

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Florida Discount Drug Card Basics

• www.FloridaDiscountDrugCard.com or
• 1-866-341-8894, 1-866-763-9630 (TTY)
• Enrollment Option
• Option to print temporary card
• Pharmacy Locator
• Drug Pricing
• Mail Order
• Reprint Card

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How Can FLAIRS Help?

• Florida Discount Drug Card fliers can be provided
• Inform clients
• Add to mailings
• Spread the word!

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Questions

• www.FloridaDiscountDrugCard.com
• 1-866-341-8894
• 1-866-763-9630 (TTY)
• www.FloridaSHINE.org

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Cover Florida Health Care Access Program
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Topics to Discuss

• Purpose of Cover Florida
• Who is Eligible?
• Cover Florida Plans
• How to Enroll
• Cover Florida Benefits
• Cover Florida Rates
• Cover Florida Basics

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Purpose of Cover Florida

• Access to more affordable health insurance
  options.
• Voluntary program for individuals and employers.
• Opportunity for uninsured to take charge of their
  own preventive health care.

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Who is Eligible?

• All Florida applicants ages 19 64
• Without health insurance for at least 6 months.
• May also be eligible if
• Loss of job with employer-sponsored health
  benefits.
• Loss of benefits under COBRA.
• Death of, divorce from, spouse who provided
  employer-sponsored health benefits.

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Cover Florida Plans

• 6 private insurance companies with 25 health
  insurance products.
• Blue Cross Blue Shield of Florida and United
  Health Care available in all counties.
• The following counties will have additional
  options
• Broward, Miami-Dade, Flagler and Volusia

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Cover Florida Plans

• Plans are portable from one employer to another.
• Employers may voluntarily share in the cost of
  the plan with their employees or may assist
  employees with a payroll deduction.

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How to Enroll

• Applicants can purchase plans directly through
  one of the 6 authorized providers.
• Visit the Available Plans section at
  www.CoverFloridaHealthCare.com
• Each insurance company will have a toll-free
  number and website where you can learn more about
  the plan benefits.

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Cover Florida Benefits

• 6 carriers, 25 health insurance products
• At least two benefit options
• With or without catastrophic and hospital
  coverage
• Opportunity to choose primary and preventive care
  instead of ER.

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Cover Florida Benefits (cont.)

• Plan benefits include
• Preventive services
• Screenings
• Office visits and surgery
• Urgent care
• Hospital coverage
• Emergency care
• Prescription drugs
• Durable medical equipment
• Diabetic supplies

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Cover Florida Rates

• As low as 23.70/month
• Vary depending on age, gender and chosen benefit
  options
• Preventive plans
• Typically dont cover hospitalization
• Have lower premiums
• See details in Available Plans on
  www.CoverFloridaHealthCare.com

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Cover Florida Basics

• Pre-existing conditions
• Cannot be denied enrollment in a plan.
• Plans can exclude payment for treatment of a
  specific pre-existing condition for one year,
  then it must cover treatment.

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Cover Florida Basics (cont.)

• Can I see my own doctor?
• You will need to contact the plan to see.
• Is there coverage for children under 19?
• Yes.
• Policyholders may purchase plans for spouses and
  children.
• Families may pay full premiums and buy in to
  Florida Kid Care.
• Children can stay on policy until age 30.

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Cover Florida Basics (cont.)

• What type of prescription coverage is there?
• Every plan offers at least one of the following
• Prescription drug benefit coverage
• Prescription drug manager
• Discount drug card

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More Information

• www.CoverFloridaHealthCare.com
• Plan contact information available
• PDF comparing plans

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Contact Information

• Kira Houge
• Outreach and Publicity Assistant, SHINE
• Hougek_at_elderaffairs.org
• 850-414-2000
• Alexandra Kruse
• Statewide Director, SHINE
• Krusea_at_elderaffairs.org
• 850-414-2000