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Interested in Eon Health
Call us at: 1-855-249-7811
Member Services:
1-855-249-7811 (TTY: 711)
Hours of Operation

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Effective January 31, 2020 at 11:59p.m. EST, the Centers for Medicare & Medicaid Services (CMS) imposed intermediate sanctions on Delaware Life Insurance Company. This means that Eon Health cannot accept new enrollments into our plan and/or market to enrollees at this time. Due to an increase in enrollment, we experienced significant enrollment issues.

While you may not have experienced this directly, the deficiencies cited by CMS include:

Failing to timely and accurately process enrollment requests
Failing to provide timely notices of acceptance or denials of enrollment requests
Failing to provide proof of coverage and other plan materials prior to member effective dates
Failing to correctly process requests for medical or drug coverage
Failing to provide information on a timely basis to current and prospective enrollees through the customer service call center.
Failure to provide proper oversight of the plan vendors

Eon Health is working diligently to resolve these issues as quickly as possible.

This does not impact your coverage with Eon Health. The benefits you have as a member of Eon Health continue while our plan is sanctioned. You still have access to our providers and pharmacy network and coverage for medical services and drugs on our formulary.

Can I make changes to my medical or prescription drug coverage?

If you believe you have been negatively impacted by the deficiencies stated above, you may qualify for a special election period that will allow you to enroll in a new plan now. To find out if you qualify for a special election period, please contact 1-800-MEDICARE (1-800-633-4227) 24 hours a day/7 days a week. TTY users should call 1-877-486-2048.

If you are eligible for a special election period, here are your options:

Option 1: Keep your current plan. If you are satisfied with your current coverage, you do not need to do anything to stay in our plan.

Option 2: You can switch to a different Medicare Prescription Drug Plan, Medicare Advantage Plan or other Medicare health plan, including a plan that offers prescription drug coverage. Your new coverage can start as early as the month after the new plan gets your application. Most Medicare health plans include prescription drug coverage, but not all. If you want Medicare prescription drug coverage, be sure to join a Medicare health plan that has this coverage or join a Medicare health plan that allows you to join a separate Medicare prescription drug plan.

What if I have more questions?

If you have any questions, please contact Eon Health at (855) 249-7811 Monday to Sunday 8am — 8pm from October 1 thru March 31 and Monday to Friday 8am — 8pm from April 1 thru September 30. TTY users should call 711.

Thank you for your continued membership with Eon Health.

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Prescription Drug Transition Policy

Prescription Drug Transition Policy

Transition process requirements will be applicable to non-formulary drugs:

Prescription drugs that are not on your formulary
Prescription drugs previously approved for coverage under an exception once the exception expires
Prescription drugs that are on your formulary but require a prior authorization or step therapy, or that have an approved quantity limit lower than your current dose

Eon Health’s transition process applies to:

New members and members who switch from one plan to another after the start of the contract year
Current members affected by negative formulary changes
Members residing in long-term care facilities
Current members affected by the expiration of an approved exception

During the first 90 days of enrollment, Eon Health covers a one-time, temporary supply of a non-formulary drug. Eon Health extends up to one month transition supply of medication (unless the prescription is written for fewer days) to members for drugs that are not on our formulary as well as drugs with restrictions or limits.

For members residing in a long-term care facility, Eon Health’s transition policy provides for at least a 91 to 98 day supply of medication (unless the prescription is written for fewer days). After the transition period has expired, Eon Health provides for at least a 31-day emergency supply (unless the prescription is for fewer days). Also, for members being admitted to or discharged from a long-term care facility, Eon Health provides a refill upon admission or discharge.

Call Eon Health’s Member Service department at 1-888-906-3889 (TTY: 711) for more information. From October 1 – March 31, seven days a week, from 8am – 8pm and April 1 – September 30, Monday through Friday, from 8am – 8pm (you may leave a voicemail Saturday, Sunday and Holidays)

Eon Health has a contract with Medicare to offer HMO and PPO plans. Eon Health also has a contract with the Georgia Medicaid Program and a contract with the South Carolina Medicaid program. Enrollment in Eon Health depends on contract renewal.

Eon Health has a contract with Medicare to offer HMO and PPO Plans. Eon Health also has a contract with the Georgia Medicaid program and a contract with the South Carolina Medicaid program. Enrollment in Eon Health depends on contract renewal. Eon Deluxe (HMO SNP): This plan is available to anyone who has both Medicare and received assistance from the State. Eon Silver (HMO SNP) and Eon Gold (PPO SNP): These plans are available to anyone with Medicare who has been diagnosed with Cardiovascular Disorder, Chronic Heart Failure or Diabetes. Eon Health has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2022 based on a review of Eon Health’s Model of Care. This information is not a complete description of benefits. Contact the plan for more information. Limitations, Copayments, and restrictions may apply. Benefits, formulary, pharmacy/provider network, premium and cost sharing may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Premiums, co-pays/co-insurance may vary based on the level of Extra Help you receive. Please contact the plan for further details. Medicare beneficiaries may also enroll in Eon Health through the CMS Medicare Online Enrollment Center located at www.medicare.gov. The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary Eon Gold (PPO SNP) and Eon Choice (PPO),: Out of network/non-contracted providers are under no obligation to treat Eon Health members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask for a pre-service organization determination before you receive the service. Please call our customer service or see your Evidence of Coverage for more information, including cost-sharing that applies to out-of-network services.