No Commission on Dual Eligible Plans 2017 ?

[foxmfox1]

I was told Amerigroup already does this in TN.

I worked for Amerigroup for a couple of years, finally got fed up and left this spring. Now back to independent agent. I can confirm that AG was auto enrolling their duals beginning last year. Can't confirm if that has changed. Their network in the Chattanooga market sucks, but most duals go to Erlanger anyway, at least from my experience.

 

[agentjhc]

I think this is in full swing now. Did this apply to all new duals, or did they roll the existing members to DSNP? I assume all companies are now doing this...think this is happening in 35-40 states.....

 

[timeflies]

Yep. We have had it here in Ohio for several years. It was part of Obama Care and yes they are called Dual Demonstration projects. There is an agreement between CMS and the state Medicaid agency. I don't believe any legislation was required by the State Legislature. In Ohio, the dual eligibles can opt out, but they have to contact the Medicaid hotline to do so, or we even had a form they could fill out asking to keep their current plan as primary and the Coordinated Care plan just replaced their Medicaid as secondary. It has affected about 200,000 across the state and a huge damper on dual sales, but it is not in every county. Good luck.

 

[roadrunner]

The state of TN just did a major outreach to all existing DSNP folks. Each received a packet that they were to fill out with current assets etc. I know that as a result 40,000 members were kicked off of TNcare., which in turn generated a letter that they were losing their DSNP.

Keep in mind in TN if a member looses their full QMB status they can stay in the DSNP plan for 6 months. This allows them time to re qualify.

The state is currently assigning a PDP to DSNP folks at time of eligibility.

I just enrolled 4 members this week that are new to medicare, that are also full QMB, none had received letters or direct enrollment to any plan.

Some carriers are very proactive and if the member is on TNcare I know that they in fact send to the home a captive agent prior to their eligibility into Medicare. Thus getting the true up and enrolling them into a DSNP.

 

[agentjhc]

AmeriGroup benefits and network seem to be lacking compared to UHC and BCBS in Chattanooga.

 

[roadrunner]

It's official TN is now auto enrolling their Dual Eligible's across the board.

So if a QMB has Blue Care for Medicaid they will roll into Blue Care Plus DSNP when they become eligible for Medicare.

They are not auto enrolling T65's that may also be eligible for TNCare.

Hope that makes sense.

Bye Bye True Ups for the U65 market.

Dang it.

 

[agentjhc]

It's official TN is now auto enrolling their Dual Eligible's across the board.

So if a QMB has Blue Care for Medicaid they will roll into Blue Care Plus DSNP when they become eligible for Medicare.

They are not auto enrolling T65's that may also be eligible for TNCare.

Hope that makes sense.

Bye Bye True Ups for the U65 market.

Dang it.

It does. Thats I what I understand. They can opt out I believe after 60 or 90 days. That's a market that was the once productive. Less so now.