MAPD Plan for a Qmb with Spend Down

Feb 3, 2016

  1. csyjnapapa
    Offline

    csyjnapapa Expert

    Posts:
    73
    Likes Received:
    1
    State:
    Ohio
    I must have a mental block when it comes to these designations. If some one has a spend down, when they meet that, what happens to the MAPD plan. Does Medicaid take over and all co pays are paid for? Is it worth it for them to even get a MAPD plan? They do not qualify for a snp, so a MAPD plan is what they choose. It is a $0 premium plan and does have PCP co-pays etc.
     
  2. G.Gordon
    Offline

    G.Gordon Guru

    Posts:
    3,182
    Likes Received:
    4
    State:
    Missouri
    Depends on your state. In MO Medicaid does not coordinate with any MA plan unless they are full dual QMB with no spend down. If they have a spend down it is a consideration depending on how large the spend down is. If it is considerable, $800-1000/mo, then a MAPD might be best, but if it is small, <$500, then for some instances you could be exposing them to higher out of pocket than if they were left alone.
     
Loading...