Question on how Medicaid works with Medicare in Las Vegas

[VegasMedicare]

I have been working some telephone leads in Las Vegas and have had a high percentage of contacts that have been on Medicaid. I am not aware of any dual-eligibility Medicare Advantage plans in Clark County, but I know that there are many $0 HMO's with extra benefits that people may be interested in. However, I don't want to sign people up for plans if they end up having to pay higher copays and copays for prescriptions and other coverage, if they could get everything picked up by Medicaid and Original Medicare. I do believe Medicaid does offer extra help with part D, but I don't know if it helps as well with copays on these plans. Is there any advantage to someone on Medicaid getting an Advantage plan in Las Vegas, or would it actually end up being worse for them? From other clients and brokers, I know that many people on Medicaid pick up these Advantage plans, but is it really worth it for the clients?

 

[YouGotMyMoney]

I have been working some telephone leads in Las Vegas and have had a high percentage of contacts that have been on Medicaid.

Are you willing to bet your career that these "telephone leads" are generated compliantly? The carriers will lay the blame at the feet of an agent, EVEN in an call center environment for submitting biz off a non-compliant marketing piece - with the full understanding that the Owners/Management have control over the leads, NOT the tele-sales agent.

I am not aware of any dual-eligibility Medicare Advantage plans in Clark County, but I know that there are many $0 HMO's with extra benefits that people may be interested in. However, I don't want to sign people up for plans if they end up having to pay higher copays and copays for prescriptions and other coverage, if they could get everything picked up by Medicaid and Original Medicare.

What did people do before D-SNP's "Dee Snips" were a "thing"?

I do believe Medicaid does offer extra help with part D, but I don't know if it helps as well with copays on these plans.

Incorrect. SSA aka Extra Help aka Low Income Subsidy pays for the Part-D portion of the MA(PD) premium.

Is there any advantage to someone on Medicaid getting an Advantage plan in Las Vegas, or would it actually end up being worse for them? From other clients and brokers, I know that many people on Medicaid pick up these Advantage plans, but is it really worth it for the clients?

Honestly, it depends. The more care someone needs, as in the more providers they need to see - the less attractive an MAPD will be. If the supplemental benefits are strong enough, and if there is the Care Improvement Plus DSNP with $0 in-network/$0 out of network benefits then it's almost a "No-brainer". YMMV.

 

[VegasMedicare]

Thanks for the info! I definitely was a little off on how the Extra Help pays for the Part-D side of things. And to clear things up on the leads, they were generated by a mailing campaign with people requesting info on Medicare supplements, and when asking for info on their current coverage, many do have Medicaid (which would make it pointless for them to pick up a supplement plan). I haven't had any experience with DSNP plans in the states I've worked, so I appreciate the help.

 

[GreenSky]

Humana has a D-SNP and also has a PPO that refunds some of the Part B payment.

Contact me and I'll put you in touch with the regional manager. She'll help you out.

Rick

 

[VegasMedicare]

Humana has a D-SNP and also has a PPO that refunds some of the Part B payment.

Contact me and I'll put you in touch with the regional manager. She'll help you out.

Rick

I am aware of the PPO, but when looking at the SNP plans offered by Humana in Clark County, I can only see a SNP for diabetes/ heart and a SNP plan for chronic lung disease. I am definitely interested in more info if you have it!

 

[GreenSky]

I am aware of the PPO, but when looking at the SNP plans offered by Humana in Clark County, I can only see a SNP for diabetes/ heart and a SNP plan for chronic lung disease. I am definitely interested in more info if you have it!

Contact me anyway. I have lots of experiences with duals. Moved to Henderson about 21 months ago.

Rick

 

[YouGotMyMoney]

And to clear things up on the leads, they were generated by a mailing campaign with people requesting info on Medicare supplements, and when asking for info on their current coverage, many do have Medicaid (which would make it pointless for them to pick up a supplement plan)..

Be careful!

You may need to leave this phone room to protect your future/current earning potential. If they are sending out Direct Mail for Med Supps, which I am assuming of course that they are not CMS approved since they are for Medigap. Then you say that many are on Medicaid, do you have "Transitional" phrasing in place to take it from a Medigap convo to MA/MAPD? The first "Escalation" you get they (the carrier) is going to ask for the Lead Card, and recordings - and that's a rabbit hole you don't want to go down.

If not, I would spend this weekend looking for new employment.

 

[VegasMedicare]

Be careful!

You may need to leave this phone room to protect your future/current earning potential. If they are sending out Direct Mail for Med Supps, which I am assuming of course that they are not CMS approved since they are for Medigap. Then you say that many are on Medicaid, do you have "Transitional" phrasing in place to take it from a Medigap convo to MA/MAPD? The first "Escalation" you get they (the carrier) is going to ask for the Lead Card, and recordings - and that's a rabbit hole you don't want to go down.

If not, I would spend this weekend looking for new employment.

This is a great point, but in the calls themselves, I am not looking to sign people up for a Medicare Advantage plan, I am calling to hopefully set up an appointment in person to discuss Medigap (like the client requested). Obviously if they request info on Advantage plans during the appointment, I can get a SOA and jump through the hoops necessary to be able to present a MAPD plan.