Does Anybody Have Any Experience Selling Medicare Snp's

[FinalExpenseRookie]

I am interested in learning more in regards to sell medicare advantage snp's. Does anybody here have any experience selling them? I am going to target folks that are 66-79 that have chronic problems. What advantage is to the client, for them to switch from their regular med advantage plan to a snp plan? How does a snp plan differ from a reg med supp plan?

 

[VaDwayne]

I am interested in learning more in regards to sell medicare advantage snp's. Does anybody here have any experience selling them? I am going to target folks that are 66-79 that have chronic problems. What advantage is to the client, for them to switch from their regular med advantage plan to a snp plan? How does a snp plan differ from a reg med supp plan?

I wouldn't say that I know very much about them but (SNP's) Special Needs Plans ARE Medicare Advantage plans but they are more specific on the ilnesses that are covered, and the benefits are geared toward that specific issue.

I think to qualify the beneficiary has to have a covered chronic illness, or be on Medicare and Medicaid, or live in a nursing home/have home nursing.

I would assume that the premium would depend on the illness that is covered, and like most MA's would be paid if the beneficiary is a dual eligible.

 

[Longtimeagent]

If you are going to sell SNP's then you should focus on Care Improvement Plus or UHC's Evercare. They are the two best ones that I come across and have sold in the past. I don't sell a lot of the Evercare anymore because now they have to be on Medicaid and there isn't a huge value. The SNP for UHC (Evercare MP) is now a premium plan of $25 unless they get LIS. They need to have a couple chronic conditions like diabetes, heart failure, COPD or something else. There are SNP's that target residents or nursing homes or Alzheimer's. The only problem with SNP's is that they can switch usually (dual eligible) at any time of the year - so chargebacks can occur.

 

[jdeasy]

And, all SNP's are HMO plans. You must make sure their primary care doctor, their specialists and their hospital are in the network.

Since they all include their PDP, you have to make sure their drugs are in the formulary.

If there is a premum for the SNP, don't waste your time pushing it.

 

[Josh]

And, all SNP's are HMO plans. You must make sure their primary care doctor, their specialists and their hospital are in the network.

Since they all include their PDP, you have to make sure their drugs are in the formulary.

If there is a premum for the SNP, don't waste your time pushing it.

No, they're not all HMO plans. UHC offers one that's a PPO and many others do the same. SNP plans are extremely complicated and it would take more than even a few pages of forum posts to over all the ins and outs of it, especially since it varies state to state. In NY for example, it doesn't matter if the drug is on the formulary or not, because the stay will pay for anything that the formulary doesn't cover, so to the member it's a no-issue. They treat the doctors the same way, if it's in network they pay the balance of what's left, if it's out of the network with a PPO they pay whatever the plan doesn't. If it's an HMO and it's an out of network claim and the MA plan denies the claim, Medicaid will still pay it. Other states won't pay anything if they aren't in original Medicare. That's just to give you an idea of how tricky it can be, but don't mistake that as me telling you it's a bad idea to market them, just be careful with the training you get. Most carriers don't even know how the plans work, let alone agents.

If UHC has a SNP in your area that's a PPO and they have a good network I would DEFINITELY go that route. Generally I think UHC's products will hurt a beneficiary more than help them, but I'm a huge fan of their SNP products. PM me if you want more info about this and I'll answer in greater detail, but it's certainly a niche market and a product you should at least have in your bag.

 

[jdeasy]

No, they're not all HMO plans. UHC offers one that's a PPO and many others do the same. SNP plans are extremely complicated and it would take more than even a few pages of forum posts to over all the ins and outs of it, especially since it varies state to state. In NY for example, it doesn't matter if the drug is on the formulary or not, because the stay will pay for anything that the formulary doesn't cover, so to the member it's a no-issue. They treat the doctors the same way, if it's in network they pay the balance of what's left, if it's out of the network with a PPO they pay whatever the plan doesn't. If it's an HMO and it's an out of network claim and the MA plan denies the claim, Medicaid will still pay it. Other states won't pay anything if they aren't in original Medicare. That's just to give you an idea of how tricky it can be, but don't mistake that as me telling you it's a bad idea to market them, just be careful with the training you get. Most carriers don't even know how the plans work, let alone agents.

If UHC has a SNP in your area that's a PPO and they have a good network I would DEFINITELY go that route. Generally I think UHC's products will hurt a beneficiary more than help them, but I'm a huge fan of their SNP products. PM me if you want more info about this and I'll answer in greater detail, but it's certainly a niche market and a product you should at least have in your bag.

It's not a true SNP is if it's not an HMO. Wellcare tried the same bullshit with their DUET/Melody plan which was PFFS. They attempted to market it as an SNP.

Where are they today?

There is no such thing as an SNP that is a PPO. There may be in name only and it may be marketed as such by recruiters, but, that doesn't make it so.

 

[LadyYaYa]

I sold a TON of Coventry SNP's...until they got dropped this year.

 

[Josh]

It's not a true SNP is if it's not an HMO. Wellcare tried the same bullshit with their DUET/Melody plan which was PFFS. They attempted to market it as an SNP.

Where are they today?

There is no such thing as an SNP that is a PPO. There may be in name only and it may be marketed as such by recruiters, but, that doesn't make it so.

I hate to be like this but once again you have absolutely no idea what you are talking about. Go to medicare.gov and look at the available plans in area code 13104. I've attached an image to make things simple, but it's a SNP that is a PPO. You are absolutely, completely, and undeniably wrong.

 

[Josh]

It's not a true SNP is if it's not an HMO. Wellcare tried the same bullshit with their DUET/Melody plan which was PFFS. They attempted to market it as an SNP.

While I'm on the subject of correcting you, the problem with the WellCare product is they called it a SNP when it wasn't filed as one. There are also of SNPs that are PFFS plans, but unless it's filed as a SNP you can't sell it as one, that was their problem, not that it was a PFFS.

 

[policy doctor]

Care Improvement is actually a regional PPO so here in Atlanta they could use providers in both SC and Georgia. No limit to county or zip code....therefore, wider choices.

But they are more restrictive....must be diabetic or Heart Failure patient.