March 2023 Stakeholder UpdatE
In this edition, Healthy Connections Prime focuses on the following:
- Annual Reviews and Re-determinations
- Eligibility Review Process
- Change of Address and Contact Information
- Palliative Care Member FAQs
January 2022 Stakeholder UpdatE
In this edition, Healthy Connections Prime focuses on the following:
- New county coverage
- Educational opportunities through partnership with SC Thrive
- Absolute Total Care's new name - Wellcare Prime by Absolute Total Care
Health Plan Name Change – Absolute Total Care (Medicare-Medicaid Plan) is Now Wellcare Prime
One of our Healthy Connections Prime health plans, Absolute Total Care has changed its name to Wellcare Prime by Absolute Total Care. This name change will not affect current medical benefits or services to members. Please note that as part of the rebranding, Wellcare Prime has an updated logo and color palette so their website and materials will be updated to reflect this change.
Healthy Connections Prime is Now Available Statewide (including York and Lancaster Counties)
As of January 1, 2022, at least one Healthy Connections Prime plan is present in all 46 counties in South Carolina (including York and Lancaster Counties)! Eligible individuals living anywhere in the state can choose to receive both Medicare and Medicaid benefits from a single participating Medicare-Medicaid health plan (MMP). To see which MMPs are operating in each county, view the Plan Coverage by County chart. View the updated county participation map.
October 2021 Stakeholder UpdatE
In this edition, Healthy Connections Prime focuses on the following:
- Healthy Connections Prime is now available statewide
- Rcent comments gathered from our Member Experience Interviews
- Absolute Total Care's MMP name change
Member Experience InterviewS
In December 2020 and January 2021, South Carolina Healthy Connections Medicaid partnered with the Centers for Medicare & Medicaid Services (CMS) to engage an independent research firm for an interview exercise with members. The research firm conducted in-depth interviews with a sample of Healthy Connections Prime members in urban and rural areas of South Carolina. In these conversations, members consistently reported high satisfaction with the program, an overall sense of “being taken care of,” and especially appreciated the outreach from their care coordinator.
Some reasons for high satisfaction included peace of mind from full benefits coverage and the health plans’ attention to the member’s health care needs. Also cited were access to high-quality and compassionate care providers and helpful care coordinators and waiver case managers (some of whom work through the Community Long Term Care [CLTC] program.) Participants mostly found it difficult to identify any negatives about their experiences with the Healthy Connections Prime health plan.
April 2021 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- Non-Emergency Medical Transportation (NEMT) provider name change
- Reminders of key Healthy Connections Prime benefits and other supporting documentation
Note: If you have requested updates from Healthy Connections Prime, please add scdhhs@messages.scdhhs.gov to your Safe Sender email list.
Healthy Connections Prime is now available in Darlington County and Horry County
Effective January 1, 2021, Healthy Connections Prime is now available in Darlington County and Horry County. Beneficiaries in these counties are now included in the program's passive enrollment efforts. Click on the image below to view the updated county coverage map or click here to see the Coverage by County chart.
December 2020 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- Absolute Total Care's county expansion efforts
- SC Thrive community outreach efforts
- Updated member stories/testimonials
- Guidance regarding the 2021 Medicare-Medicaid Plan comparison chart
Plans' Expansions to New Counties
Over the last few months, our Medicare-Medicaid Plans (MMPs) have expanded to a few counties.
- Absolute Total Care has expanded into Cherokee and Dorchester counties.
- First Choice VIP Care Plus has expanded into Aiken and Dorchester counties.
- Molina Dual Options has expanded into Aiken, Berkeley and Cherokee counties.
The plans' expansions also mean Healthy Connections Prime is now available to eligible individuals in two new counties, Aiken and Dorchester counties. See the updated chart of plan coverage by county . See the county participation map .
June 2020 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- COVID-19 and Healthy Connections Prime interactions
- Elder Abuse Awareness Day
- Program growth and county expansion information
- Outreach and educational activities facilitated by SC Thrive
- Current enrollment dashboards
December 2019 Stakeholder update
In this edition, Healthy Connections Prime focuses on the following:
- Updates to Incontinence Supply Guidance
- Information for identifying claims contacts at the MMPs
- Updates to the Phoenix help section for users
September 2019 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- 2019 Program Update
- Flu season information
- Updates to the Healthy Connections Prime Nursing Facility Guidance
June 2019 Program Update: Person-Centered Program Design & Family CaregiverS
Healthy Connections Prime has issued a 2019 update. Person-Centered Program Design & Family Caregivers focuses on four program design domains: assessment and care planning, benefit design, training, and quality improvement.
June 2019 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- County Coverage Expansion
- coverage model comparisons for members
- Medicaid Advantage Marketing Do's and Dont's
- Updated process for Nursing Facilities, Hospice and Institutional Respite Providers
Your Rights Concerning Marketing from Medicare Advantage Plan Representatives
In conjunction with CMS, Healthy Connections Prime has compiled a list of acceptable activities regarding health plans and their marketing activities.
Healthy Connections Prime Program Update July 2018 - Healthy Connections Prime Extended
Healthy Connections Prime is authorized by the Centers for Medicare & Medicaid Services (CMS) and the South Carolina Department of Health and Human Services (SCDHHS) as a “demonstration” under the Medicare-Medicaid Financial Alignment Initiative to explore how coordination between Medicare and Healthy Connections Medicaid can improve health outcomes, create administrative efficiencies and make accessing care easier for members. With the support of CMS and all three Medicare-Medicaid plans (MMPs), Healthy Connections Prime has been granted an extension through Dec. 31, 2020. During this extension period, SCDHHS will actively work with the MMPs (Absolute Total Care, First Choice VIP Care Plus and Molina Dual Options), along with other stakeholders, to continue providing a coordinated care approach for the management of the state’s dual-eligible population. SCDHHS will provide additional information regarding this extension over the coming weeks.
April 2018 Stakeholder UpdatE
In this edition, Healthy Connections Prime focuses on the following:
- Healthy Connections Prime and Nursing Facilities Update
- Healthy Connections Prime Waiver Services Appeals Process
- Provider Training Module
- Older Americans Month
- How to join our distribution list
Healthy Connections Prime Appeals Process - Waiver Case Managers
SCDHHS would like to provide a reminder of the appeals process for waiver services to Healthy Connections Prime members. There have been some instances of confusion as to the party to which an appeal should be filed at each stage of the process.
Please visit the Provider Toolkit to review this memo and more.
Healthy Connections Prime and Nursing Facilities - Claims Processing Update
Claims processing for Medicaid LTC nursing facility stays by an MMP has been modified to align with the Healthy Connections Medicaid fee-for-service methodology. All Medicaid LTC claims for Healthy Connections Prime members must be submitted to the MMP in which the member is enrolled.
To learn more, please visit the Provider Toolkit. To read the full Nursing Facility FAQ or read the Nursing Facility Provider Memo.
A New Medicare Card Is Coming Soon But the MMP Member ID Card Remains the Same
The Centers for Medicare & Medicaid Services (CMS) will be mailing members a new Medicare card soon. However, for Healthy Connections Prime members, their Member ID Card remains the same. Learn more below by clicking the image below.
To learn more about how this may impact providers, visit the Provider Tool Kit.
February 2018 Stakeholder Update
In this edition, Healthy Connections Prime focuses on the following:
- Education for dual-eligible members on the new Medicare cards they will receive
- Introduction to Healthy Connections Prime webinar