Dual Eligible & SNP Plans; Where Are They Listed Separate by Area ?

[CALTCAgent]

On medicare.gov, I don't see where they list out which plans are Dual Eligible and/or SNP chronic illness plans.

I only see them all listed together.

Or is there a better way or site, like CMS, for specifically finding the Dual Eligible & SNP plans in an area

Thanks!

 

[yogooglethis]

On medicare.gov, I don't see where they list out which plans are Dual Eligible and/or SNP chronic illness plans.

I only see them all listed together.

Or is there a better way or site, like CMS, for specifically finding the Dual Eligible & SNP plans in an area

Thanks!

Not sure if you can have med.gov display ONLY SNP plans but to display SNP plans in your area use the " select special needs plans " filter on step 4 of 4 in the plan finder process. http://www.medicare.gov/find-a-plan/results/planresults/summary-of-results.aspx


If you are in the least bit familiar with the landscape of MA plans in your area and are competent enough in the in the SNP market and product knowledge of plans you are appointed with to sell them I think it is pretty obvious which of the plans listed are the DE SNP's when using the filter.

 

[CALTCAgent]

Not sure if you can have med.gov display ONLY SNP plans but to display SNP plans in your area use the " select special needs plans " filter on step 4 of 4 in the plan finder process. http://www.medicare.gov/find-a-plan/results/planresults/summary-of-results.aspx

Thanks!

That is what I was not doing. Many more plans show up.

If you are in the least bit familiar with the landscape of MA plans in your area and are competent enough in the in the SNP market and product knowledge of plans you are appointed with to sell them I think it is pretty obvious which of the plans listed are the DE SNP's when using the filter.

I am seeing one plan that I thought I was told was a DE SNP plan, but it does not show as that. Nothing says SNP. Just regular HMO.

I believe the carrier was telling me somethiong about it working like a dual or something like that. When I looked at the co-pays and premium, it didn't look like a dual plan on the medicare site and the summary of benefits.

I guess I need to call them to clarify.

 

[GreenSky]

I am seeing one plan that I thought I was told was a DE SNP plan, but it does not show as that. Nothing says SNP. Just regular HMO.

I believe the carrier was telling me somethiong about it working like a dual or something like that. When I looked at the co-pays and premium, it didn't look like a dual plan on the medicare site and the summary of benefits.

I guess I need to call them to clarify.

You'll see that carriers promote plans as if they are designed for duals when they really are not. The member is still required to see a Medi-Cal doctor to get copays waived.

You can use any MA plan and say the same BS if you want.

WellCare did that years ago with a plan called Duet. They marketed it as a SNP until CMS did more than give them a slap on the hands. It's because of this kind of crap that has caused me to not work with them.

Rick

 

[WCMason]

You'll see that carriers promote plans as if they are designed for duals when they really are not. The member is still required to see a Medi-Cal doctor to get copays waived. You can use any MA plan and say the same BS if you want. WellCare did that years ago with a plan called Duet. They marketed it as a SNP until CMS did more than give them a slap on the hands. It's because of this kind of crap that has caused me to not work with them. Rick

I get more calls from unhappy WC clients than all other carriers combined.

 

[CALTCAgent]

You'll see that carriers promote plans as if they are designed for duals when they really are not. The member is still required to see a Medi-Cal doctor to get copays waived.

If I understand this, they would not have co-pays anyway with the Medi-Cal Dr., with a full dual, so the plan didn't do much as far as improving the network ?

The main benefit would be the extra benefits the plan may provide? ( Gym, dental, transportation, etc.)

You can use any MA plan and say the same BS if you want.

Will the carrier allow you to write a Dual person a regular MA plan ?

WellCare did that years ago with a plan called Duet. They marketed it as a SNP until CMS did more than give them a slap on the hands. It's because of this kind of crap that has caused me to not work with them.

That was the company I was thinking of.

They told me it was a "lookalike" SNP plan. I guess that means not officially a SNP plan, but works like one. Not sure the implications of using a "lookalike" plan ?

They said you have to go to their network doctors, nothing about med-cal doctors.

 

[wln417]

You should check out this website:

CalDuals.org |

 

[GreenSky]

.

They told me it was a "lookalike" SNP plan. I guess that means not officially a SNP plan, but works like one. Not sure the implications of using a "lookalike" plan ?

They said you have to go to their network doctors, nothing about med-cal doctors.

Give me a call and we can discuss this. If the dual goes to a network doc who is not in the medi-cal system, they then have to pay the copays on the plan. If the doc does accept medi-cal then they may not charge a higher share of cost than fee for service medi-cal.

Anyone can call their plan a "lookalike." It's complete bullsheit and a marketing gimmick. Typical of Wellcare.

Rick

 

[CALTCAgent]

Give me a call and we can discuss this. If the dual goes to a network doc who is not in the medi-cal system, they then have to pay the copays on the plan.

Dang these people, I asked them this and they said no co-pay.

If the doc does accept medi-cal then they may not charge a higher share of cost than fee for service medi-cal.

Is there an example of an actual cost?

I am trying to wrap my brain around this concept.

Anyone can call their plan a "lookalike." It's complete bullsheit and a marketing gimmick. Typical of Wellcare.

I wonder why they would just get the plan approved for dual as a SNP ?

There must be a pro and con here ?

 

[GreenSky]

Dang these people, I asked them this and they said no co-pay.



Is there an example of an actual cost?

I am trying to wrap my brain around this concept.



I wonder why they would just get the plan approved for dual as a SNP ?

There must be a pro and con here ?

If a plan has no copays, there are no copays. But not every benefit is zero copay.

Seriously, this would be much easier if we talk.

Rick