Does "Full Dual Eligible" Always Mean A Client Has Full Medicaid?

[Northeast Agent]

Edward, not only is your grammar and punctuation reprehensible - you are also just plain rude and disrespectful. I was just stating that not everyone on Medicaid qualifies for a SPAP. And yes, I have sold plenty of MA plans and am well aware of the many SEPs.

 

[20th Maine]

What are the income requirements for each eligibility level? Federal Poverty Income Level

QMB Only At or lower than Resources not more than two times
QMB Plus At or lower than Resources not more than two times
SLMB Only Between 100% and 120% Resources not more than two times
SLMB Plus Between 100% and 120% Resources not more than two times
QI Between 120% and 135% Resources not more than two times
QDWI Below 200% Resources not more than two times
FBDE Based on Medical Need status, institutionalized income levels, home/community
based waivers

This wont copy well from UHC Kit--FBDE is a combination of things and there seems to be no rational way for the normal mortal to tell. No one in my UHC regional office can answer what goes into FBDE

Also CAUTION--Help Desk will tell you the person is eligible--but they are only checking MEDICAID--Ive had it happen a time or two the person THOUGHT they had Medicare and they did not. Got to start with the Red White and Blue card--as always

 

[20th Maine]

AHA ONE MORE SURPRISE!!! Called and got OK for Full Dual Eligible April 29th--went over and got the app 5/2---apparently 5/1 she had a spend down or had to re-qualify or something--now its pended and no doubt will be denied. My mentor taught me "Selling something is easy--KEEPING it sold it hard!"

 

[Chazm]

Exactly why I try to stay away from medicaid as much as possible.

 

[springbokhouston]

I wouldn’t recommend building a business on duals.

 

[wallstwizard]

It’s not that complicated, if they are qmb or qmb plus they qualify, most carriers can tell you this before you do app. Single and under $1,034 and no assets to speak of, they qualify! Possibility you may have to do Medicare savings app if they qualify but don’t have qmb status. The fbde situation, same thing, if income below 1034 do Medicare savings app with state and they will change the status to qmb. Whether or not they have plus behind the qmb is by state and income related, and may or may not indicate additional benefits.

 

[20th Maine]

I wouldn’t recommend building a business on duals.

Didnt say I was.

 

[springbokhouston]

Didnt say I was.

Didn't say you were mate. I train a lot of people and find that many are eager to jump all over the "snips" because they're so easy to write year round. UHC claims their average DSNP stays on the books for 4.5 years while the average MAPD is good for 7.6.

I certainly wouldn't shy away from any simple sale but I wouldn't target that market. Final Expense agents happen to be in front of many SEP opportunities on a daily basis, and I prefer to help train those people to do this as a true value add while building a real book of business.

Simple thinking really, ask a few more questions and make a lot more money while doing right by people.