Medicare Special Needs Plans

[IndividualHealthGuy]

Does anybody have any info on the Medicare Advantage Plans that are advertised as Special Needs Plans? I ran across a lady who has Medicare due to disability, and is also bipolar, so she appears to qualify. I've never really worked in advantage plans before, so if there is a MO agent that wants this one, please let me know. I was curious if there were any thoughts on them, however.

 

[lmspeir]

I wouldn't say I am expert at SNPs, but I don't think bipolar is going to quality. Most of them are for things like diabetes, congestive heart failure, etc.

But, good luck.

 

[ksigmtsu]

In TN, anyone that has medicare for disability is eligible for a MA plan.

I assume most other states are the same.

 

[GreenSky]

Special Needs Plans come in two flavors:

1) Specific Chronic Diseases such as diabetes, heart disease, etc.

2) Dual Eligible - having both Medicare and Medicaid.

Rick

 

[goldthroat]

I am located in MO and sell Special Needs Plans. Unless the lady has diabetes or congestive heart failure she will not qualify. She can qualify for a special needs dual eligible by having both Medicare and full Medicaid.

Hope this helps.

 

[IndividualHealthGuy]

Thanks for your help everybody. She is going to be on Medicare only, so it looks like the SNP is out.

 

[djs]

Just curious, why are you asking about special needs plans? I want to make sure you are asking the right question.

Dan

 

[IndividualHealthGuy]

I'm only asking because that's what she said she wanted. I used to train standard Medicare, Part D and med supp all the time, and I never had any experience at all with the SNPs. If it was a better option for this person, I was going to pass them off to someone who knows that part of the biz.

 

[djs]

I'm not the expert here, but I would find out why she thinks she wants a special needs program. There may be a good reason, but in general, I think the single biggest advantage is the special enrollment period, which if she is just starting medicare, is a mute point.

It may be a bad case of she heard a term and thinks she gets something.

Dan

 

[GreenSky]

I'm not the expert here, but I would find out why she thinks she wants a special needs program. There may be a good reason, but in general, I think the single biggest advantage is the special enrollment period, which if she is just starting medicare, is a mute point.

It may be a bad case of she heard a term and thinks she gets something.

Dan

That would be moot point.

But you are correct. If she's just started to receive Medicare, there may not be a need for a SNP.

The companies will tell you that the chronice illness SNP plans provide more specific coverage, but I just don't see the need except for the opportunity of an SEP.

The dual SNP plans can be a great benefit as some of them include a very good dental, hearing, transportation, and vision benefit.

Rick