MA's and Low Income

[gstew191]

Hi folks,

I am new to this forum. I would like to say, "Hello". I need some help from you guys.

I am marketing Today's Options through American Progressive in PA. I am licensed with PennLife.

I have a question regarding what to do when I encounter a certain type of prospect.

I am strictly Cold Calling off a general list of 66-85 yr old prospects. My main objective is to secure an appoinment. I introduce myself and my company and ask if they are familiar with Medicare Part C. They will usually respond by saying they have this or that already. Some hang up, but most will carry on a conversation. I find out what people are currently carrying to help fill in the gaps that Medicare does not cover. I ask what cards they show when they go to the Dr., etc., primarily to decide if I can benefit them, and to see if they are curious.

Sometimes I find an individual who will have nothing but original Medicare. These are my prime prospects. But, in some of these situations they will tell me that they do not have Medcaid; they do not have any medical assistance or the Access Card (in PA); they have no assistance of any kind that they are aware of. They will go on to tell me that they have no bills to pay when they get out of the hospital, that it is all taken care of. I had a guy the other day tell me that he did have some small co-pays, but overall things are usuallytaken care of. I do not know what they have other than Medicare. So how can the bills be taken care of? At this level a lot of these people are not super intelligent. It is possible that some of them have Medicaid or assistance and do not want to tell me, but some of these folks were on Medicaid, or getting some help and just got taken off at the first of the year. It is also possible that the 20% coinsurance with Medicare would be what they are talking about when they have a small amount to take care of. I do not know.

I saw on a post from back in December where somebody remarked about a prospect having his/her own $0 premium (LIS) plan but having no Cap on it and that the MA can give them that Cap. I have enrolled folks in this type of situation and they went through CMS with no problems.

Could somebody tell me about the LIS and the Medicare savings programs and how they might relate to eligibility for the Today's Options MA, or something along those lines. I do not know for sure if I could enroll somebody getting Medicaid or not either. I generally do not mess with them since they are Dual.

I hope this is not too broad of a question. I am familiar with various income levels and how folks can be designated as QMB, SLMB, etc., in the various Medicare Savings Plans, but I do not how to find out from people if they are part of it. I think many of them do not even know.

Thanks,

Greg

 

[event99]

From my experience, the first question that needs to be asked is whether they are a dual eligible. Here in Wisconsin, I ask "Do you have a forward card", or, if I know their medicare number, birthdate and zip code, I look them up on medicare.gov to see whether they are a dual eligible.

If they are a dual eligible, Today's options is not an appropriate plan. Here is Wisconsin we use Evercare and Wellcare instead. They are HMO Medicaid plans.

If they are not a dual eligible (medicare and medicaid) then you are safe to write the Today's Options plan, if it is a fit for them.

If you have any other questions about dual eligibles, feel free to pm me.
We do quite a bit of assistance for them in Wisconsin.

Tami

 

[arnguy]

Where in PA are you located and where in the state are you marketing? I would assume that the 191 in your User Name indicates you are in Philadelphia----is that correct?

 

[gstew191]

Hey,

I have to apologize. After I posted the original post I realized that the whole thing is sort of all over the place. I appreciate any attempts to respond to the post. After I read it I was not quite sure what I was even asking. I have not participated in a forum since 1998 I think. I'll need to proof read before I post.

Anyway, I live in Central PA and I have been working mostly in Lycoming County because it is a zero premium for the Today's Options MA. The "191" actually came from an account number that was given to me from a brokerage account and I just used it for other purposes.

Later,

Greg