Vision, Hearing and Fitness Calls Refresher

Member has additional eyewear coverage that resets every 2 years. 
Member called into Customer Service in March 2021 wanting to know if she was covered for another routine eye exam and additional eyewear coverage again. 
Member did their routine eye exam and purchased glasses using their routine eye exam and additional eyewear coverage in October 2019.

• Advised the member that they have to wait 24 months before they can get routine eye exam.

• In this scenario, the member could complete another routine eye exam and use their additional eyewear coverage at any point in 2021. The member does not need to wait 24 months to the date to qualify for using their vision benefits.

When a member pays out of pocket for any service covered under their benefit, where do they submit their claim for reimbursement?

• Part C Claims address

• To the medical claims address that can be seen at the back of their id card.

• Members send the standard Medical DMR form along with proof of payment to their Regional Mail Office.

• Part D Claims address

I have changed plans during the plan year. Do my routine vision accumulators carry over to the new plan?

• Yes. It will carry over to the new plan.

• No. Routine vision accumulators do not carry over to the new plan if routine vision is covered on the new plan.

Member is calling regarding benefit details, including specific hearing aid member copays and benefit allowances based on plan eligibility. Remember that copays are the member's out-of-pocket cost per hearing aid, whereas benefit allowances are applied against the cost of a hearing aid(s) purchase.
Advocate should?

• Advocate should handle the call.

• Trasfer the call.

• Disconnect the call.

Member is calling regarding information about needing a routine hearing test because member is experiencing hearing loss and may need a hearing aid.
Advocate should?

• Advocate should warm transfer the call to UHC Hearing

• Do cold transfer.

• Disconnect the call.

Member is calling regarding routine hearing test technical problems, submitting audiogram results, and hearing test interpretation.
Advocate should?

• Cold Transfer.

• Advocate should warm transfer the call to UHC Hearing

• Warm transfer to telesales dept.

Renew Active has its own ID card.

• True

• False

Confirmation codes for Renew Active/Fitness benefits expires every plan year.

• True

• False

Where can the member search for Fitness location?

• Myuhc.com

• Members should search for fitness locations via the member portal.

• Aarpmedicareplans.com

When generating a code for the member for Fitness program we need to access partneroptumfitness.com. Are we allowed to provide this website to our members if they wish to view the confirmation code online?

• Yes. We can actually provide the website for hassle free experience.

• Do NOT provide this website to members. It is for advocate use only. Direct members to the member portal if they wish to view their confirmation code Online