Best Way to Handle those Eligible for Extra Help and MSPs?

[yogooglethis]

So they apply for both medicaid and MSP at the same time ?

Is there a way to apply for only MSP if the person does not want medicaid ?

Another factor I am considering is that some counties sign the Medi-Cal beneficiary up for a dual eligible plan with no agent involvement.

I don't know anything about those plans. I would think there is not much incentive for the agent.



Does applying online for LIS or elsewhere trigger anything regarding Medicaid & MSP application to be sent to the client?

Or is it just for LIS only ?

MSP's ARE Medicaid programs for people that have Medicare so just explain it that way to try to minimize any negative connotations in some seniors minds to receiving Medicaid benefits. Not positive about this but I thought I read somewhere that the help with the part B premium is exempt from Medi Cal's asset recovery. I don't think the folks who qualify for full dual benefits for premium, deductibles and co ins. are too concerned about asset recovery.

In Florida when a MSP is sent to the DCF they automatically process an application for LIS to SS and I'm sure you already know that if a person qualifies for any level of MSP then 99.99% of the time they will qualify for LIS.. A different way to help your client get both LIS and MSP without leaving your home is if you do an application online for LIS on the SS.gov website there is a field on application that ask if you would like SS to initiate a MSP application to whatever state the client resides. The issue with using this method to get your client the full suite of benefits (in Florida anyway) is that the MSP application initiated this way is an application that ask more questions about living expenses, income of other non spousal residents in their home and often require the applicant to send copies of bank statements etc. Of course you can just apply for LIS on SS.gov and answer that question no so that no application for a MSP is initiated.

I'm not sure what the deal is with the Medi Cal managed care programs that they auto enroll full duals in but in Florida we have something called MMA plans that a full dual will be auto enrolled in if they are not already enrolled in an SNP MA plan but they have the choice of opting out of these for a SNP MA plan if they want. I advise you learn the rules about these plans in Ca. and learn about the benefits of the plans so that you will know if the SNP MA plans you sell are a better fit then the plan that Medi Cal auto enrolled them in.

 

[CALTCAgent]

Thanks, this is what I was wanting to know about.

MSP's ARE Medicaid programs for people that have Medicare so just explain it that way to try to minimize any negative connotations in some seniors minds to receiving Medicaid benefits.

OK, to clarify, they try for a MSP (easier qualification) as well as Medicaid/Medi-Cal (a bit harder qualification) at the same time ?

Not positive about this but I thought I read somewhere that the help with the part B premium is exempt from Medi Cal's asset recovery. I don't think the folks who qualify for full dual benefits for premium, deductibles and co ins. are too concerned about asset recovery.

This is interesting. I guess they don't have much to protect from asset recovery.

A different way to help your client get both LIS and MSP without leaving your home is if you do an application online for LIS on the SS.gov website there is a field on application that ask if you would like SS to initiate a MSP application to whatever state the client resides.

Do they send a paper application?

The issue with using this method to get your client the full suite of benefits (in Florida anyway) is that the MSP application initiated this way is an application that ask more questions about living expenses, income of other non spousal residents in the home and often require the applicant to send copies of bank statements etc.

I wonder why for LIS only they do not ask for documentation ?

I know less risk, but a good benefit it seems with no documentation.

 

[yogooglethis]

Thanks, this is what I was wanting to know about.



OK, to clarify, they try for a MSP (easier qualification) as well as Medicaid/Medi-Cal (a bit harder qualification) at the same time ?




This is interesting. I guess they don't have much to protect from asset recovery.



Do they send a paper application?



I wonder why for LIS only they do not ask for documentation ?

I know less risk, but a good benefit it seems with no documentation.

MSP AKA as Medicare/Medicaid buy-in are Medicaid programs. In Ca. when you apply for an MSP you are applying for a variation of a state Medicaid here is Ca. MSP eligibility grid: Medicare Savings Programs | California Health Advocates


If the MSP application is initiated by SS when you apply for LIS for Florida residents DCF (after being provided with the social security income from SS)sends a letter to beneficiaries and an application for them to provide all the necessary financial data and sometimes they ask for copies of 3 months of bank statements etc. At this point the applicant could go to the Fl DCF website and complete the application with the access code they are given in the letter DCF sends but they still may need to send financial statements

If you want to help a client fill out a paper application for a MSP or Medi cal ( which ARE THE SAME THING for Medicare beneficiaries ) and initiate the process this way ( which I recommend is usually the best way for you to stay in the loop through the process) according to Mr. Google there is a paper application for MSP that can be mailed in: http://www.dhcs.ca.gov/formsandpubs/forms/Forms/mc14a.pdf

This and much more about Ca. medi cal is available at :Medicare Savings Programs | California Health Advocates


Yes there is definitely less scrutiny to qualify for LIS because the most important piece financial information needed to qualify - SS income is owned by the agency that approves it- Social Security. If someone wants to lie about assets or even additional income if no taxes are filed it fairly easy to get away with I imagine but if you get caught it's a federal offense of purjury and fraud that could mean years in prison. Granny shouldn't commit the crime if she can't do the time - don't do it, don't do it