Q: What makes this plan different from AHCCCS Complete Care?
A. AHCCCS Complete Care does not include members who qualify for the Arizona Long Term Care System (ALTCS). DDD Health Plans are like AHCCCS Complete Care in that the health plan will provide both physical and behavioral health care to DDD/ALTCS eligible members. This will allow greater coordination between member’s providers to ensure they receive the care they need. DDD Health Plans are different from AHCCCS Complete Care because they are managed by DDD. In addition, DDD Health Plans will also provide limited long term services and supports (LTSS). The limited LTSS that will be provided by the DDD Health Plans include: skilled nursing facilities, emergency alert services and physical therapy for members over the age of twenty-one (21). All other LTSS will continue to be provided by DDD.
Q:What does LTSS mean?
A. LTSS stands for Long Term Services and Supports. LTSS can improve a member's quality of life including things like attendant care, occupational therapy and day treatment programs. LTSS are provided when deemed to be medically necessary.
Q: What do these changes mean to me?
A1: Members that are currently enrolled in a health plan provided by Care1st, a WellCare company, will need to select a new health plan. WellCare will no longer be providing services to DDD members after October 1, 2019.
A2: All members, including those designated as SMI, that currently receive behavioral health services from a Regional Behavioral Health Authority (RBHA) will receive all their services including behavioral health services from the DDD Health Plan they select after October 1, 2019.
A3: Members that currently receive Children’s Rehabilitative Services (CRS) from UnitedHealthcare Community Plan will receive CRS as well as their physical and behavioral health services from the DDD Health Plan they select after October 1, 2019.
A4: Members currently enrolled in the American Indian Health Plan (AIHP) can choose to stay with the AIHP or select a DDD Health Plan. Members that select a DDD Health Plan can receive behavioral health services from either their DDD Health Plan provider or the AIHP behavioral health providers (Tribal Regional Behavioral Health Authority, IHS or 638 Tribal Facility.)
A5: Members eligible and approved for any of these limited long term services and supports (LTSS): emergency alert system services, skilled nursing facilities, or physical therapy for members 21 years of age and older, will receive these services from the DDD Health Plan starting October 1, 2019. All other LTSS will be provided by DDD.
Q: Can DDD provide details on transition requirements between a members old and new Health Plans related to continuity of care/coverage?
A. The members newly selected DDD Health Plan is required to allow members to maintain their current providers for a least 180-days, if the member’s provider is not contracted with the new DDD Health Plan and the provider is agreeable to continue to serve the member. This time will allow members and/or their responsible party and the members new DDD Health Plan, with the help of their Support Coordinator, enough time to identify a provider that is within the new DDD’s Health Plan network. The new DDD Health Plan is required to honor previously approved service authorizations for at least 180-days.
Q: How will members be notified of the upcoming changes and open-enrollment?
A. Eligible members will receive letters in the mail, emails and phone calls in April and May. This communication will include details about the new DDD Health Plans, what actions members will need to take and when open-enrollment will be held June 14 to July 15, 2019.
Q: What can a member do if they realize they picked the wrong plan after open-enrollment?
A. After October 1, 2019, members that believe they picked a plan that will not work for them, will have the opportunity to select another plan for a period of 90-days.
Q: How do I choose a plan?
A. DDD will mail letters to members with details regarding each DDD Health Plan; including their member handbook, a link to search for providers, and contact information for the health plan liaison. Members are encouraged to review this information and contact each DDD Health Plan directly to make an informed decision based on their needs. This information will also be available on the DDD website.
Members that are DDD eligible before April 5, 2019, will be able to choose a DDD Health Plan by contacting DDD Member Services or their Support Coordinator with their choice of DDD Health Plan during open-enrollment June 14 to July 15, 2019.
If a member becomes DDD eligible after April 5, 2019, they can choose a DDD Health Plan by contacting DDD Member Services or their Support Coordinator with their choice of DDD Health Plan during open-enrollment October 1-30, 2019.
Q: Is there a way to compare health plans?
A. DDD will provide details on the DDD website regarding each contractor; including their member handbook, a link to search for providers and contact information for the health plan liaison. Members are encouraged to review this information and contact each DDD Health Plan directly to make an informed decision based on their needs.
Q: Who do members and families go to when they have questions regarding the new health plans?
A. Members with questions regarding the DDD Health Plans can contact their Support Coordinator, DDD Member Services at 1-844-770-9500 ext. 2, or the Customer Service Center at 1-844-770-9500 ext. 1.