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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.

Your Information. Your Rights. Our Responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you.

Get a copy of your health and claims records

Ask us to correct health and claims records

Request confidential communications

Ask us to limit what we use or share

Get a list of those with whom we’ve shared information

Get a copy of this privacy notice

Choose someone to act for you

File a complaint if you feel your rights are violated

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Help manage the health care treatment you receive

Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

Run our organization

Example: We use health information about you to develop better services for you.

Pay for your health services

Example: We share information about you with your dental plan to coordinate payment for your dental work.

Administer your plan

Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

Do research

Comply with the law

Respond to organ and tissue donation requests and work with a medical examiner or funeral director

Address workers compensation, law enforcement, and other government requests

Respond to lawsuits and legal actions

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you.

Eon Health Plan
Attention: Privacy Officer
PO Box 3745
Scranton, PA 18505
E-Mail: compliance@eonhp.com
Phone: 1-866-467-6958. TTY users should call 711.
Website: www.eonhealthplan.com

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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.