Medicaid Eligibility Specialist

[bluediamond]

So let me ask the group: Do you think an medicaid eligibility specialist working within the confines of a hospital, license to sell insurance, leads them to the marketplace to sign up and accepts commission is skirting the law or possibly acting in the role of navigator and breaking the law? Or simply using their brains god gave them?

 

[FLM2]

Yes to all of the above...

The honest answer, of course, is no one knows if it is legal or not and no one is going to get in the way of an agent taking this route.

It would certainly be a Medicare violation.

The real question, of course, is can someone make a living doing this, is this something you are considering in order to get away from your CGA?

If so, go for it and don't have second thoughts...

 

[houcoogster]

I think they are doing what they're told.

Have you noticed online the question that pops up "would you like help paying for medical bills in the last 3 months?"

I think it was designed this way just for this reason.

 

[unic.consulting]

I am actually in a situation similar to that. I work in a doctor's office, and do insurance on the side. Here are the things I do to make sure I stay legal: I don't solicit patients in the office, (if they ask me for my card I give it to them); I do not sell in the office; I have all of my clients fill out the SOA in advance before the appointment as is legally required; I don't require that they pick a plan that is accepted by the doctor I work for. If the person you are speaking of does any of those, they are in risk of breaking the law.

Basically, I work exactly as I would if I didn't have my main job, except I don't have to worry as much about how many sales I make each month.

 

[somarco]

BlueD, are you thinking about becoming a Medicaid specialist?

 

[LGilmore]

"Do you think an medicaid eligibility specialist working within the confines of a hospital, license to sell insurance, leads them to the marketplace to sign up and accepts commission is skirting the law or possibly acting in the role of navigator and breaking the law? Or simply using their brains god gave them? "


First question, what does brains have to do with any of this?


I would check your insurance laws and the rules established by your exchange. IF you're not following those laws and rules, you're putting yourself at risk. You might get 10 or more through as the process is probably slow, but eventually if you're doing something wrong, they find you and fine you. The longer they go, the bigger the fine.


YOUR brain should be telling you to double check with your OIC and exchanges and leave no doubt about what you're doing. It's cheaper that way.
Always remember it is hard to earn commissions, it is doubly hard to give them back later. Do it right from the beginning, chances are good, you won't have to give anything back.

 

[bluediamond]

Yes to all of the above...

The honest answer, of course, is no one knows if it is legal or not and no one is going to get in the way of an agent taking this route.

It would certainly be a Medicare violation.

The real question, of course, is can someone make a living doing this, is this something you are considering in order to get away from your CGA?

If so, go for it and don't have second thoughts...

No, I never thought about this much less knew that a major hospital in town had these specialists. One of the agents at the office is doing this and I just found out today. She is writing a hell of a lot of business from it. But I also know she is signing subsidy apps over the phone for people and said it was ok if they gave her permission. There are some other questionable things she does. I suppose if it's not a true navigator position it's legal from that standpoint, but I bet the hospital would not care for it since she was hired for one thing and doing another.

I wonder how last I would last sitting in an er approaching sick people before the hospital kicked me out. I wouldn't do that right now anyway the flu is running rampant here, but have thought about it.

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BlueD, are you thinking about becoming a Medicaid specialist?

Nope never thought about it, but the one that is doing this is writing the hell out of under 65 apps. I am also wondering (since they were applying for medicaid) if she isn't giving them a little more income to qualify for subsidy.

LGilmore we're in the fed exchange

 

[houcoogster]

I wonder how last I would last sitting in an er approaching sick people before the hospital kicked me out. I wouldn't do that right now anyway the flu is running rampant here, but have thought about it.

Just do what I do.. go in the er look around grab a seat pass out a few cards then go to the gift shop pass out a couple in there then head back over to the er. Rinse and repeat.

Tip: Carry a tissue in your hand just for appearance sake.... ya know ;-)

 

[Ann H]

The most disliked sales person is an insurance sales person. Anyone wanna guess why?

 

[houcoogster]

The most disliked sales person is an insurance sales person. Anyone wanna guess why?

Hey c'mon now Ann, can't we have a little fun every now and then....lol....it was a joke.

Cite me source for that statistic anyway I'd like see it....lol