Extra Help Lis and also Medicaid SEPs

[rmhaire]

Not true. I've moved many csnps 2-3 times in a yr . I can't tell you how many times someone rolled my csnp and I rolled them right back using the csnp sep . Just like mov, loss of Medicaid , state pharmaceutical sep carriers never check. It might be stated in the rules but csnps can move monthly

Then you're doing it till you get caught.

Maybe you should start your own call center.

 

[EckoRomeo]

Everyone is right. The CSNP SEP is supposed to be only used once but most carriers don't verify. Call centers will also use the SEP even when the member doesn't actually qualify because when the members chronic condition can't be verified by the carrier, it opens another SEP.

 

[DonP]

Everyone is right. The CSNP SEP is supposed to be only used once but most carriers don't verify. Call centers will also use the SEP even when the member doesn't actually qualify because when the members chronic condition can't be verified by the carrier, it opens another SEP.

Few agents know this . When you can't in touch with your csnp in 60 days and they're put back on orginal Medicare because of non verification. It's a new true commission no matter what time of yr when you re enroll them . They have neither Medicare nor a pdp card .

 

[costrand]

There is no CMS reg that says you can only use the CSNP once per lifetime. I have went down this rabbit hole. Read the CMS Managed Care Manual. It only says once you exercise the SEP, that SEP is over. It doesn't say anything about once per lifetime, even though you could assume that is the interpretation.

"Also, they are assigned a PCP and a specific care plan than is strictly monitored. Abuse it and you lose it."

The statement above is inaccurate. You could be on a CSNP and never see a doctor. With the 3 carriers I worked for, there was no specific care plan, and it was not strictly monitored. Really a CSNP needs to offer extra resources in relation to your condition.

 

[straightnochaser]

There is no CMS reg that says you can only use the CSNP once per lifetime. I have went down this rabbit hole. Read the CMS Managed Care Manual. It only says once you exercise the SEP, that SEP is over. It doesn't say anything about once per lifetime, even though you could assume that is the interpretation.

"Also, they are assigned a PCP and a specific care plan than is strictly monitored. Abuse it and you lose it."

The statement above is inaccurate. You could be on a CSNP and never see a doctor. With the 3 carriers I worked for, there was no specific care plan, and it was not strictly monitored. Really a CSNP needs to offer extra resources in relation to your condition.

Where do they come up with this stuff?

 

[Fisher]

If they cannot or do not confirm they have the diagnosis within the first 60 days, it opens up another SEP to enroll in any MA plan.

That part I did not know.