Dual eligibility question and LIS question

[jack3454]

Two questions for those who know about this stuff please:

1. If someone is turning 65 and they’re on medical assistance right now and will be for the foreseeable future, and knowing that you wont know what medicare saving program they’ll qualify for until they hit 65, what do you do? Pick the best MAPD plan for right now, then switch them to a DSNP after 65 if they’re eligible an on a medicare savings program?

Im asking because I was told by the welfare office they must wait until they hit 65 until they're eligible for a Medicare savings program.

2. If someone is on Medicaid, dont they automatically qualify for Extra Help? Is it standard for these people to automatically receive an Extra Help Application? If so, is it necessary to fill it out, or is it redundant since they are on Medicaid already?

Thank you.

 

[DonP]

1. I think you’re getting confused . What’s the difference between medical assistance and Medicare savings program ? What medical assistance were they on before age 65 that wasn’t Medicaid ?People on Medicaid before they get there Medicare automatically are put in the Medicare savings program not having to pay there B .But yes you can write them a mapd till 65 then after they get Medicaid switch to a dual . But I know uhc will chargeback the full amount if mapd and give you the remaining true up on new plan .

2. If your on Medicaid your automatically on lis . 90% of people who lose there Medicaid keep there lis . Remember Medicaid is state and Lis is federal . In many states the agent can apply online for lis for the client and leave the box unchecked and it’s automatically sent to the state to apply for Medicaid . In some states you’ll get a Medicaid answer having to fill nothing else out . They make decision based on lis app info that’s sent to state .

 

[hockeyday]

1. I think you’re getting confused . What’s the difference between medical assistance and Medicare savings program ? What medical assistance were they on before age 65 that wasn’t Medicaid ?People on Medicaid before they get there Medicare automatically are put in the Medicare savings program not having to pay there B .But yes you can write them a mapd till 65 then after they get Medicaid switch to a dual . But I know uhc will chargeback the full amount if mapd and give you the remaining true up on new plan .

2. If your on Medicaid your automatically on lis . 90% of people who lose there Medicaid keep there lis . Remember Medicaid is state and Lis is federal . In many states the agent can apply online for lis for the client and leave the box unchecked and it’s automatically sent to the state to apply for Medicaid . In some states you’ll get a Medicaid answer having to fill nothing else out . They make decision based on lis app info that’s sent to state .

Where you checking Medicaid status now days

 

[DonP]

Where you checking Medicaid status now days

Anthem is awesome . Just like vantage of old and better . Shows Medicaid level and even shows Medicaid #. Also Cigna shows if they got Medicaid . Cigna also shows the last 2 plans they had . Someone told me vantage lookup on anything not coming back . I find that hard to believe . I’m amazed United or Aetna have never got it back up. Anthem shows it’s being done . Humana’s fixing to lay off home office staff big I bet . Wonder if they let regionals go . Agents are not understanding the profitability and value of a mapd is much less than before . Some CO’s appear not to care if they lose 5-10% of there members .

 

[jack3454]

1. I think you’re getting confused . What’s the difference between medical assistance and Medicare savings program ? What medical assistance were they on before age 65 that wasn’t Medicaid ?People on Medicaid before they get there Medicare automatically are put in the Medicare savings program not having to pay there B .But yes you can write them a mapd till 65 then after they get Medicaid switch to a dual . But I know uhc will chargeback the full amount if mapd and give you the remaining true up on new plan .

2. If your on Medicaid your automatically on lis . 90% of people who lose there Medicaid keep there lis . Remember Medicaid is state and Lis is federal . In many states the agent can apply online for lis for the client and leave the box unchecked and it’s automatically sent to the state to apply for Medicaid . In some states you’ll get a Medicaid answer having to fill nothing else out . They make decision based on lis app info that’s sent to state .

I should have just said Medicaid, but a lot of people around here use “medical assistance” instead.

So they were on Medicare prior to 65, then still on Medicaid after 65. So you dont know what medicare savings program someone will be on (what level) until they’re 65.

I dont want a chargeback, so im wondering if it would be a good idea to wait until they’re 65, find out what level they’re gonna be on, then write the application for the following month? They still have Medicaid and medicare their birth month, and then the next month they’ll have a DSNP (or regular MAPD depending on level)?

 

[straightnochaser]

I should have just said Medicaid, but a lot of people around here use “medical assistance” instead.

So they were on Medicare prior to 65, then still on Medicaid after 65. So you dont know what medicare savings program someone will be on (what level) until they’re 65.

I dont want a chargeback, so im wondering if it would be a good idea to wait until they’re 65, find out what level they’re gonna be on, then write the application for the following month? They still have Medicaid and medicare their birth month, and then the next month they’ll have a DSNP (or regular MAPD depending on level)?

I have never had to wait to enroll someone t-65 because of Medicaid. They typically already have an MSP determination, the one thing I do see is no active LIS but it's a simple app to do online and if they have MSP they will be approved for LIS.

 

[hockeyday]

I have never had to wait to enroll someone t-65 because of Medicaid. They typically already have an MSP determination, the one thing I do see is no active LIS but it's a simple app to do online and if they have MSP they will be approved for LIS.

What state are you in ? Michigan makes people wait till 30 days before your part b effective date before applying for the MSP, even if they have current medicaid

 

[DonP]

I should have just said Medicaid, but a lot of people around here use “medical assistance” instead.

So they were on Medicare prior to 65, then still on Medicaid after 65. So you dont know what medicare savings program someone will be on (what level) until they’re 65.

I dont want a chargeback, so im wondering if it would be a good idea to wait until they’re 65, find out what level they’re gonna be on, then write the application for the following month? They still have Medicaid and medicare their birth month, and then the next month they’ll have a DSNP (or regular MAPD depending on level)?

Depends on state . 90% of people who have full Medicaid get there Medicaid card before age 65 if there illegal . Most disabled before 65 . Many people under 65 won’t qualify for Medicare who are on Medicaid ( depending on state ) as there on SSI and don’t have the work credit . The problem of you wait till age 65 somebody will have wrote the iep app already