Medicare Assistance Bureau Innovates to Serve Residents During COVID-19

More ways to receive Medicare counseling and information as Open Enrollment approaches, Bureau earns federal grants to support efforts

When COVID-19 required cancellation of the Department of Insurance Delaware Medicare Assistance Bureau series of statewide Welcome to Medicare in-person events, the team responded rapidly, engaging with residents in new ways and offering their free, one-on-one Medicare counseling remotely. The Delaware Medicare Assistance Bureau (DMAB) has provided more than 2,930 counseling sessions so far this year, saving beneficiaries more than $192,000 in premiums through application assistance.

“We are all facing new challenges due to COVID-19, and I’m proud that our DMAB team has found ways to communicate with Medicare beneficiaries and made Medicare education and empowerment more accessible despite the inability to offer in-person events,” said Insurance Commissioner Trinidad Navarro.

DMAB will engage in thousands of counseling sessions in the coming months, as Medicare Open Enrollment takes place October 15 through December 7. During this time, beneficiaries can make changes to their health insurance coverage and review existing coverage against other options. DMAB will offer virtual Open Enrollment appointments throughout this period, available via Webex, Duo, and Skype, as well as by phone. Residents are encouraged to register for a MyMedicare.gov account prior to their counseling session so that DMAB can generate personalized plan comparisons.

“Many people have questions about Medicare and don’t know where to start, and COVID-19 has only increased the stress of choosing the right healthcare plans. We are here to help people in Delaware deal with the complex and often confusing health insurance system,” said DMAB Director Lakia Turner, “and, we’re more accessible than ever through our new virtual programs.”

DMAB began to offer virtual Welcome to Medicare seminars in May, engaging 150 residents. The Virtual Medicare Seminar, which is now available on-demand online, educates participants on topics including Medicare benefits, supplemental insurance policies, Medicare Advantage plans, prescription drug coverage and details on signing up.

As Medicare Open Enrollment approaches, the department reminds residents to assess any contact during the open enrollment period to ensure it is from a known, credible source. The most frequent fraudulent contact occurs by phone, but residents should review communications carefully.

“If you are receiving contact regarding Medicare that you did not initiate, or contact not from one of your healthcare providers, it could be fraudulent,” said Commissioner Navarro. “Protect your Medicare Number like you do your Social Security number or bank account information, and never give it out to unknown or unexpected callers.”

DMAB has been awarded two significant grants during 2020. The 2020 State Health Insurance Assistance Program Base Grant provides $234,293 in federal funds to DMAB. This is a five-year grant, with annually awards in April. It is a primary source of funding for marketing and outreach, counseling, developing and training the volunteer network, and other strategic efforts. The MIPPA 2020 Grant awarded the bureau $43,270, which has and will assist the bureau’s outreach, education, and one-on-one beneficiary assistance programs over the next year for those beneficiaries who are likely to be eligible for the Low-Income Subsidy program (also called “Extra Help”) or Medicare Savings Programs.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1-(800) 336-9500 or (302) 674-7364 to set up a free confidential session. Counselors can assist with Medicare, Medicaid, Medigap (Medicare supplement insurance), long term care insurance, billing issues, prescription savings, and much more.


Regulations That Can Increase Affordability Of Medications Announced

New regulations increase oversight of Pharmacy Benefit Managers

Excessive pharmaceutical costs are a concerning trend occurring across the nation, and today the Delaware Department of Insurance has finalized new regulations for Pharmacy Benefit Managers (PBMs) to proactively combat the issue. The regulations go into effect on August 11 as part of implementing HB 194, and come after extensive stakeholder discussions.

PBMs administer prescription drug plans for health insurers, large employers, Medicare Part D plans, and other groups, determining the list of medications that a plan will cover and the consumer costs of those drugs. These companies hold massive negotiating power and receive billions of dollars in rebates from manufacturers, but to date have widely not used their power to reduce the costs of medications and insurance. The new regulations from the Department of Insurance will begin an increasing level of oversight and transparency, allowing the department to investigate companies, require corrective actions, and to suspend, deny, or revoke a PBM’s registration if they are acting in violation of the Code.

“Increasing the affordability of prescriptions and healthcare increases their accessibility, creating a healthier Delaware. These steps towards regulating this multi-billion-dollar industry will save residents money, and could save residents lives,” said Insurance Commissioner Trinidad Navarro. “I want to commend Pharmacy Reimbursement Task Force co-chairs Sen. Sokola and Rep. Bennett, as well as Chair of the former Interagency Pharmaceuticals Purchasing Study Group Rep. Seigfried, for their passion and hard work towards these regulations and their inclusion of a diverse array of stakeholders throughout the process. Our work on this issue is just beginning, and we are grateful for your partnership.”

The Pharmacy Reimbursement Task Force and the former Interagency Pharmaceuticals Purchasing Study Group each demonstrated the General Assembly’s focus on lowering the cost of care, working on a range of issues surrounding protecting Delawareans from excessive medication costs, negotiating and lowering drug prices, and creating price transparency and corporate accountability.

“One of the most important things we can do as elected officials is work to keep prescription drugs affordable and accessible, particularly for our most vulnerable residents,” said Sen. David Sokola, D-Newark. “I’m proud of our work on the Pharmacy Reimbursement Task Force and proud to have helped develop regulations that will increase transparency around a little-known sector of our health care industry. These regulations from Commissioner Navarro and his team at the Department of Insurance represent a solid beginning to the work I look forward to continuing in 2021.”

The department and the General Assembly plan to work together to advance legislation regarding PBMs in the future. A related bill was proposed during this year’s session, but it did not advance due to the compressed legislative timeline during COVID-19.

“High prescription drug costs can debilitate a person’s finances, hindering how they save and plan for daily and long-term expenses. We owe it to consumers to fight for their best interests, increasing access and affordability to needed medications,” said Rep. Andria Bennett, who sponsored HB 194 to regulate PBMs. “Pharmacy benefit managers should put the consumer first, not profit. That’s why we fought to increase transparency and oversight: so Delawareans are not taken advantage of in such a vulnerable way. Commissioner Navarro’s regulation will provide even more transparency and comfort to our residents, and I thank him for his commitment to them.”

“Pharmacy Benefit Managers are companies that have, through the years, gained significant control over the supply, demand, and cost of pharmaceuticals – around 80% of the market – with little to no regulation at all. They are, in essence, governing both the cost and flow of medicines between people in need of medication and the manufacturer, health insurance company, community pharmacies, and the company providing medication benefits. This has led to higher costs for residents who don’t really have a choice in whether to pay for lifesaving medication,” said Rep. Ray Seigfried, a former Christiana Care senior vice president.

“My colleagues and I pushed HB 194 to require registration of all PBMs doing business in Delaware as a first step to reining in these managers. Commissioner Navarro’s regulations create standards such as having access to books and records of their operation, contract templates, and staffing. It provides the right to denial, suspension, or revocation. This order will provide the first step to begin opening the door to greater transparency. I thank Commissioner Navarro and his team for taking these important steps forward.”

Registration of Pharmacy Benefits Managers Regulation


Important Insurance Reminders After Tropical Storm Isaias

Commissioner Navarro encourages caution in repairs, meets with community

Tropical Storm Isaias produced tornado activity, heavy rain and flooding, hail, and strong winds throughout the state, causing significant destruction in several Delaware communities. Insurance Commissioner Trinidad Navarro visited residents and assessed damage on Wednesday.

“While measuring the full extent of this storm will take time, we know one thing – we must come together as a community and support those that need to rebuild,” said Commissioner Navarro after touring Amberwood community in Bear, which saw extensive storm impacts, and speaking with those beginning the insurance claims process. “I understand the eagerness of every resident to clean up and make repairs, but I can’t emphasize enough the importance of contacting your insurance company first. Take photos of everything and do not make permanent repairs before working with your insurance adjuster. Make only necessary, temporary repairs to prevent additional damage. Save all documentation, pictures, and receipts.”

Insurance Commissioner Trinidad Navarro talks with a resident next to a down tree.

The Delaware Department of Insurance Consumer Services Division is working with residents who have questions or concerns about their insurance company’s actions, and can be reached at (800) 282-8611 or (302) 674-6227, or by email at consumer@delaware.gov.

Underscoring the importance of proceeding through the insurance claim and property repair process with caution, Commissioner Navarro highlighted the frequency of fraudulent activity after a storm: “Anytime we experience a big storm like Isaias, we see storm-chasing scammers pop up in neighborhoods, falsely stating they are with an insurance company, or encouraging homeowners to sign on to repair contracts without going through the proper channels – often price gouging residents, or completing shoddy repairs if they make any at all, leaving the consumer on the hook for costs that could have been covered by an insurer.”

Residents who encounter a storm-related insurance scam can contact the Fraud Prevention Bureau at (800) 632-5154 or (302) 674-7350, or email fraud@delaware.gov. Consumers are urged to carefully review contracts for home repairs, ask for references and research companies through the Better Business Bureau.

Consumers may contact the Delaware Emergency Management Agency, DEMA, to see what assistance may be available as a result of the Governor’s State of Emergency. Property insurance policyholders should be aware of the dwelling deductible stated on their insurance declaration page, and take note that there may be a deductible for named storms, wind, hail, or tornadoes that may apply to the claim, most often stated as a percentage of dwelling coverage.

Due to COVID-19 precautions, Department of Insurance offices are not currently open to the public, but residents are encouraged to contact the department at one of the emails or phone numbers above, or call (302) 674-7300 for assistance.

Insurance Commissioner Trinidad Navarro speaking to a resident whose deck was damaged by the storm.Insurance Commissioner Trinidad Navarro speaking to residents.


Commissioner Navarro Partners with Aquila to Distribute Overdose Medication

Will provide Naloxone kits and training at Seaford event

Insurance Commissioner Trinidad Navarro, the Town of Seaford, and Aquila Behavioral Health of Delaware have joined forces to deliver life-saving overdose reversal medication to residents on July 27 from 4:00 to 6:00PM at Williams Pond Park. Free opioid rescue kits provided by the Division of Public Health, will be distributed car-side to attendees along with trainings of how the product should be used. Each kit has two doses of Naloxone.

“I am proud to join Aquila in offering life-saving overdose reversal kits to residents. For individuals who are facing the struggle of addiction, or those who have family members or friends in this fight, a naloxone kit is a must-have. For those in this situation, having naloxone on hand is like having an airbag in your vehicle – we hope that you won’t need to use it, but it is important to have one because it could save a life” said Commissioner Navarro.

Coverage for mental health has been a priority of the Commissioner. Efforts include working with the General Assembly and insurers to require coverage for serious mental illnesses including addiction, creating Mental Health Parity and Addiction Equity Act reporting requirements, and ensuring that medication-assisted treatment for those with drug and alcohol dependencies can be accessible.

The event comes as the Delaware is seeing increased overdose rates during the coronavirus pandemic, with 39 suspected overdose deaths in May, tying the highest monthly total. As of the end of May, 160 suspected overdose deaths have occurred in Delaware, a 60% increase over a similar period of 2019.

“Aquila is pleased to partner with the Insurance Commissioner and the Town of Seaford to ensure Naloxone gets into the hands and homes of all individuals who may need it to keep their loved ones safe – we know that nobody chooses addiction, and by making this opioid reversal drug available, we can give individuals another chance to get treatment. Thank you to Public Health for continuing to provide these kits to the community,” said Amy Kevis, Director of Development for Aquila Behavioral Health of Delaware. Aquila provides comprehensive psychiatric and substance abuse treatment statewide. Learn more by calling (302) 999-1106.

The Division of Substance Abuse and Mental Health launched the 24/7 Hope line to serve as a single point of contact for resources, info, clinical and peer support, and crisis assistance. If you or a loved one are struggling with substance abuse, do not wait, find help today. Call 1-833-9-HOPEDE or visit HelpisHereDE.com.

Any residents having problems obtaining insurance approval for treatment or prescriptions related to substance abuse or mental health needs, contact the Delaware Department of Insurance’s Consumer Services Division by emailing consumer@delaware.gov or calling (302) 674-7300.

Event attendees and media representatives must observe social distancing and wear a face covering.


Life Insurance Policy Locator finds over $3.5 Million for Users

Over $1 million claimed by Delaware residents in 2019, More than $400,000 in early 2020

The Delaware Department of Insurance has released new data about local use of the Life Insurance Policy Locator, a free tool offered in conjunction with the National Association of Insurance Commissioners (NAIC). In total, 1,116 requests have been submitted, and 387 matches have been reported since the tool’s implementation – a match rate of nearly 35%. Throughout Delaware’s use of the tool, a total of $3,504,850 has been claimed by beneficiaries through located policies, and $1,071,516 during 2019 alone. In the first five months of 2020, residents were able to access $402,574 as a result of successful searches.

“The Life Insurance Policy Locator is a great tool for Delawareans to be aware of. When a loved one passes, there isn’t always a will or a detailed plan for the family’s future financially. Using the Policy Locator, it is easy to find out if a life insurance policy or annuity contract existed, and simple to claim the policy if there was one in place,” said Insurance Commissioner Trinidad Navarro. “This is just one of the many ways our department is offering a consumer-friendly insurance experience.”

Simplifying what can often be a long and frustrating process, only a nominal amount of information is needed to begin a search in the Life Insurance Policy Locator. After a request is submitted by a beneficiary, executor, or legal representative, dedicated NAIC liaisons take on the task of asking participating companies to search their records to identify any policies or annuity contracts in the name of the deceased. Then, if a participating company does have policy information on file, they will respond to the requester if they are authorized to receive information or are the designated beneficiary. Data is typically made available within 90 business days.

Delaware implemented the Life Insurance Policy Locator in November of 2016. Requestor preference and beneficiary specification may result in more matches than claimed policies.

Visit insurance.delaware.gov/services/missingpolicy to access the tool.