Why Should Medicare Medicaid Dual Eligibles Join a MAPD?

sam816

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I am in AZ and I have met a couple people lately that were on AHCCCS (AZ's Medicaid program) before they become eligible for Medicare. They have become so comfortable with Medicaid that they are hesitant to consider MAPDs for dual eligibles. Other than benefits such as dental, vision and OTC stuff that are offered by MAPDs for the duals, are there any other reason why these people should consider signing up for a dual program?

TIA.
 
I don't see any major reason as it adds an extra layer of red tape. There was another thread about this a few months ago.

I think the reasons, which are really only what you stated(like the OTC), aren't worth much in my opinion. Granted my situation is different than a dual eligible but I feel like it is a frustrating market to deal with and try to avoid it.
 
I can't specifically address AZ, but the reason that medi-medis might benefit are the ancillary coverages that are not included under Medicaid. In some (and I mean some) instances they may have a better network of doctors inside an MA plan than trying to find someone that accepts Medicaid.

I write a good number of duals and 99% of the time it's for dental, transportation and glasses.

Rick
 
To get your gas money back for helping them out with the qmb ap.

And a pat on the back from me before the guy behind you moves them next month and hits the reset button.
 
To get your gas money back for helping them out with the qmb ap.

And a pat on the back from me before the guy behind you moves them next month and hits the reset button.

Yeah, it's hard to make a living when only 85-90% remain on the books from year to year.

At least that's my experience. Those that have your attitude probably don't sell duals.

Rick
 
Yeah, it's hard to make a living when only 85-90% remain on the books from year to year.

At least that's my experience. Those that have your attitude probably don't sell duals.

Rick

Actually my attitude sells quite a few duals, but when I mail out the extra help info I'm not always convinced Im helping them out with a dual plan vs. being on their own. Those that have the capacity to manage their own affairs are better without them in my opinion. Thats why I don't make the drive every time anymore. If they call me back, then I'll go do it.
 
Actually my attitude sells quite a few duals, but when I mail out the extra help info I'm not always convinced Im helping them out with a dual plan vs. being on their own. Those that have the capacity to manage their own affairs are better without them in my opinion. Thats why I don't make the drive every time anymore. If they call me back, then I'll go do it.

Can you elaborate? what do you mean by "being on their own" or "manage their own affairs"? can they rely solely on Medicaid after becoming eligible for Medicare?
 
I am in AZ and I have met a couple people lately that were on AHCCCS (AZ's Medicaid program) before they become eligible for Medicare. They have become so comfortable with Medicaid that they are hesitant to consider MAPDs for dual eligibles. Other than benefits such as dental, vision and OTC stuff that are offered by MAPDs for the duals, are there any other reason why these people should consider signing up for a dual program?

TIA.

Because that crowd values their "free sheet". Give them a few FREE blood pressure monitors, diapers and enemas and they'll be quite happy.
 
I can't specifically address AZ, but the reason that medi-medis might benefit are the ancillary coverages that are not included under Medicaid. In some (and I mean some) instances they may have a better network of doctors inside an MA plan than trying to find someone that accepts Medicaid.

I write a good number of duals and 99% of the time it's for dental, transportation and glasses.

Rick

Rick pretty well nailed it, and without a hint of sarcasm... you feelin alright?

I've always considered the managed care network to be an asset for duals. They know exactly who they can see and who they can't instead of hunting around for docs that accept medicaid. The extra benefits are nice too...
 
Can you elaborate? what do you mean by "being on their own" or "manage their own affairs"? can they rely solely on Medicaid after becoming eligible for Medicare?

Yes they can. I don't mess with some of those people because Medicaid can better serve them sometimes. Like with home healthcare.

But if the are really unorganized, or have no one to help them, then I think a dual plan can help them.
 
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