Medicare Dual Eligibles Receive Worse Care

[somarco]

Medicare Advantage enrollees, specifically those dually eligible for Medicare and Medicaid and a low-income subsidy, received worse clinical care than those who didn’t fall under these plans.

That’s according to a report released on Tuesday by the Medicare & Medicaid Services’ Office of Minority Health (CMS OMH).

More than one in ten, or 13%, of those jointly enrolled in Medicare and Medicaid, also known as dual enrollees, lived in a long-term care nursing home or other institutional facility, according to a recent KFF report.

https://skillednursingnews.com/2023...in-nursing-homes-received-worse-clinical-care

 

[Chazm]

They complain the most too. So of course they will feel like they get bad care.

I had a lady call me a couple months ago asking about a grocery card she saw on TV. I told her you typically need Medicaid for that. She said said she has Medicaid, so I pulled her up on my CRM and I have her on a UHC PPO DSNP with $285/month in groceries.
She responded, “do they really expect me to live off of that?”
Thanks for confirming why I rarely do DSNP, lady.

 

[somarco]

They complain the most too. So of course they will feel like they get bad care.

Been there, done that, not going back.

 

[DonP]

They complain the most too. So of course they will feel like they get bad care.

I had a lady call me a couple months ago asking about a grocery card she saw on TV. I told her you typically need Medicaid for that. She said said she has Medicaid, so I pulled her up on my CRM and I have her on a UHC PPO DSNP with $285/month in groceries.
She responded, “do they really expect me to live off of that?”
Thanks for confirming why I rarely do DSNP, lady.

Yep when you give $1 they want $2 . I’ve gotten good loyalty from duals but it’s a lot of work . My referrals in all areas of My business have been big the last few months .

 

[Chazm]

Been there, done that, not going back.

Ditto, I might have 15 DSNP clients. It's a rare day.

 

[somarco]

By the time I graduated to the Medicare market I had long moved on from that group of folks. Lost too much $$ selling low face amount life insurance to them.

The poor will always be with us and social workers are happy to service that group.

 

[Northeast Agent]

Chazm said:

I had a lady call me a couple months ago asking about a grocery card she saw on TV. I told her you typically need Medicaid for that. She said said she has Medicaid, so I pulled her up on my CRM and I have her on a UHC PPO DSNP with $285/month in groceries.
She responded, “do they really expect me to live off of that?”

I recently enrolled my uncle's ex-wife into a DSNP with Humana. She's FBDE (due to her income being a bit higher), due to a waiver program. She wanted the coveted Aetna plan, but since a couple of doctors were OON, I enrolled her in Humana. Aunt is hopping mad as her SNAP benefits were cut back from over $200 month to pre-pandemic levels of $27 month. Humana gives a $150 card she can use at Walmart for her organic produce, but it's not cutting it.

She claims to spend $700 monthly on organic produce, but not meat as she "can't afford it." But her freezer is stuffed with bags of regular frozen veggies, and she treated me to a pepperoni pizza (non-organic) and a fresh salad (also non-organic).

I admired some beautiful jewelry she was wearing and she said it was from QVC. She also spends $300 month on sugar substitutes and other "supplements."

My uncle's bad was marrying her after just 3.5 months and staying with her for 27 years. She now gets half of his good transit pension and also half of a much smaller one.

 

[policywunk]

They complain the most too. So of course they will feel like they get bad care.

I had a lady call me a couple months ago asking about a grocery card she saw on TV. I told her you typically need Medicaid for that. She said said she has Medicaid, so I pulled her up on my CRM and I have her on a UHC PPO DSNP with $285/month in groceries.
She responded, “do they really expect me to live off of that?”
Thanks for confirming why I rarely do DSNP, lady.

I had a UHC dual snp client call me to complain that walmart raised the price on the groceries she gets there for free with her U Card. She was seriously upset that UHC couldn't do anything about Walmart raising their prices!

 

[DonP]

Theres 12 million dual eligibles I read . That’s 20% of total Medicare population . Unfortunately they pick of the phone 10-1 and fill out cards 30-1 over non dsnp’s . I have got a lot of referrals lately on people eligible for good lis plan that are on regular plans . We’ll see what mapd looks like for the agent in 3-5 yrs .Till then I’ll keep grinding .

 

[BillBateman]

It's math I think. Medicaid pays less. Less $ means less doctors. Fewer doctors meaner longer waits to get treated. It's bound to get worse.