LIS?

[jdeasy]

Anyone know how much will be paid towards the part D premium for LIS eligibles for '09.

I've been told 2 or 3 different amounts, but, I've seen nothing official, or maybe I haven't looked in the right place?

Also the co-pays for those LIS meds?

They pay $2.25 for generics now and $5.60 for brands. I was told that the $5.60 is going to $6.00. The person that told me that didn't know about the generic co pay for '09.

I'm getting a lot of call from clients that are getting their ANNOC info and they can't make heads or tails of what they have been sent.

 

[theinuranceguy]

Anyone know how much will be paid towards the part D premium for LIS eligibles for '09.

I've been told 2 or 3 different amounts, but, I've seen nothing official, or maybe I haven't looked in the right place?

Also the co-pays for those LIS meds?

They pay $2.25 for generics now and $5.60 for brands. I was told that the $5.60 is going to $6.00. The person that told me that didn't know about the generic co pay for '09.

I'm getting a lot of call from clients that are getting their ANNOC info and they can't make heads or tails of what they have been sent.

There are different levels to the LIS. from 25% to 100%. I remember somewhere in Coventry's training them going over it, but I do not recall exact copays.

 

[jdeasy]

There are different levels to the LIS. from 25% to 100%. I remember somewhere in Coventry's training them going over it, but I do not recall exact copays.

Yes, I know. I'm just trying to get an answer for the 100% right now.

A lady called me last night that is a 100% LIS, she is on Wellcare's Signature. They way she reads the letter, she is going to have to pay $24/mo for her premium in '09. She doesn't pay anything now.

 

[theinuranceguy]

Yes, I know. I'm just trying to get an answer for the 100% right now.

A lady called me last night that is a 100% LIS, she is on Wellcare's Signature. They way she reads the letter, she is going to have to pay $24/mo for her premium in '09. She doesn't pay anything now.

Well most people on a 100% LIS are Dual Eligible. And I believe if the premium of thier part D is below the national average they pay $0 regardless of what the premium actually is. I dont know what the national average is but its more than $24.

The Evercare DH plan that we sell up here in OH to dual eligibles actually does have a premium to it, but he explain to our clients that this premium will be subsidized and they will pay no additional premium.

 

[jdeasy]

Well most people on a 100% LIS are Dual Eligible. And I believe if the premium of thier part D is below the national average they pay $0 regardless of what the premium actually is. I dont know what the national average is but its more than $24.

The Evercare DH plan that we sell up here in OH to dual eligibles actually does have a premium to it, but he explain to our clients that this premium will be subsidized and they will pay no additional premium.

Right, that's how it has been. Those rules have changed for '09. I know the rules have changed, I just don't know what they changed to. If you go to the medicare.gov site and enter your state for part D plans, it will tell you "yes" or "no" as to whether or not the full premium is paid for 100% LIS folks.

I looked at it for Ky and there is only a handful of "yes" plans for '09. This year, ost all of them were. Even Coventry's $24/mo plan for '09 is marked "no".

Our clients are getting their info now from the companies, but, the agents do not have the same info, or, at least, this one doesn't.

And, that's before we have to get into what level they are between the 25 and 100%.

I got a call this morning from a client in Indiana. She was calling about her mother whom is full medicare/medicaid. She got a letter from her part D carrier saying she will have a premium for '09. The daughter wasn't clear on the details, but, you catch my drift.

This mess just got messier.

 

[theinuranceguy]

Right, that's how it has been. Those rules have changed for '09. I know the rules have changed, I just don't know what they changed to. If you go to the medicare.gov site and enter your state for part D plans, it will tell you "yes" or "no" as to whether or not the full premium is paid for 100% LIS folks.

I looked at it for Ky and there is only a handful of "yes" plans for '09. This year, ost all of them were. Even Coventry's $24/mo plan for '09 is marked "no".

Our clients are getting their info now from the companies, but, the agents do not have the same info, or, at least, this one doesn't.

And, that's before we have to get into what level they are between the 25 and 100%.

I got a call this morning from a client in Indiana. She was calling about her mother whom is full medicare/medicaid. She got a letter from her part D carrier saying she will have a premium for '09. The daughter wasn't clear on the details, but, you catch my drift.

This mess just got messier.

For part D in IN I show First Health Part D, SilverScript Insurance Company, Aetna Medicare, UnitedHealthcare, Cigna, Universal American, RxAmerica, HealthSpring PDP, Medco Medicare PDP, Unicare, and PennLife all having stand alone PDP's that would be $0 premium for dual eligibles.

 

[jdeasy]

For part D in IN I show First Health Part D, SilverScript Insurance Company, Aetna Medicare, UnitedHealthcare, Cigna, Universal American, RxAmerica, HealthSpring PDP, Medco Medicare PDP, Unicare, and PennLife all having stand alone PDP's that would be $0 premium for dual eligibles.

Yep, I saw that too. What I don't know is how much will the clients have to pay for the plans that have a "no" on there.

Should we steer our LIS clients to those plans that have a "yes"? Are the co-pays the same with all plans for an LIS and the only varible is the premium?

I just got off the phone with an agent and he is of the understanding that the co-pays will be different. He wasn't sure as he said that told him so much mumbo jumbo.

 

[theinuranceguy]

Yep, I saw that too. What I don't know is how much will the clients have to pay for the plans that have a "no" on there.

Should we steer our LIS clients to those plans that have a "yes"? Are the co-pays the same with all plans for an LIS and the only varible is the premium?

I just got off the phone with an agent and he is of the understanding that the co-pays will be different. He wasn't sure as he said that told him so much mumbo jumbo.

I dont see where it says a yes or a no. What do you mean by that?

 

[jdeasy]

I dont see where it says a yes or a no. What do you mean by that?

At the Medicare.gov site, when you look at Part D plans available in a State, it has a statement something to effect of-$0 premium for full LIS.

In that box, it will have a yes or no for all plans. If "yes" is in the box, that plan is $0 premium for a full LIS. If "no", there is a premium. What it doesn't tell you is what that premium will be for an LIS person.

I hope that explained what I'm talking about.

 

[GreenSky]

Hope this helps. (Just another reason I really like working with Craig Ritter).

2009 Low Income Subsidy (LIS) Premium Benchmark Subsidy Amounts « Ritter Insurance Marketing

Rick