jtow11
Expert
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Is it better for a person on Medicaid to go with a DSNP if the DSNP has a zero premium?
Medicaid Vs DSNP Plan
- Thread starter jtow11
- Start date
- 709
Whoa. Hold on folks. The Medicaid plan is a PPO giving them the right to see any doctor, specialist, clinic or hospital in the U.S. who accepts Medicare.
I dealt with Medicaid patients exclusively for almost 3 years. Most were on Medicaid because of severe health problems. Most had several specialists. Finding a plan that included their primary care physicians, specialists, hospitals and all medications was no easy task.
On the plus side, I was able to offer them free dental, vision & transportation.
Getting them to change doctors was a killer of a task.
Ms. Jones. Are you married? ..... So, you divorced your spouse but you won't give up your doctor to get free dental, vision & transportation!!!
I dealt with Medicaid patients exclusively for almost 3 years. Most were on Medicaid because of severe health problems. Most had several specialists. Finding a plan that included their primary care physicians, specialists, hospitals and all medications was no easy task.
On the plus side, I was able to offer them free dental, vision & transportation.
Getting them to change doctors was a killer of a task.
Ms. Jones. Are you married? ..... So, you divorced your spouse but you won't give up your doctor to get free dental, vision & transportation!!!
- 3,165
They get Free FULL dental thru Medicaid (at least here in Calif), so besides your married analogy being dumb & irrelevant, you're also misleading them about dental being free only if they join the MAPD plan!
And Rick mentored you? I may have my differences with Rick, but he knows his stuff, how did u turn out this way?
- 15,319
And you still have a license?
Medicaid is state specific. Meaning if someone has Medi-Cal in CA that's the only place he can get care. There is no coverage out of the state.
How is it you still are in the business with just about zero knowledge?
Rick
The merits of enrolling a beneficiary in a DSNP compared to staying on original Medicare should be evaluated on a case by case basis. You need to consider what extras the DSNP offers compared to what benefits extra benefits the beneficiary is interested in. If the person only receives help paying Medicare co insurance and deductibles, the DSNP can offer substantially better benefits. DSNP benefits include coverage for dental,vision transportation and usually over the counter items. In every appointment, you need to be certain that the plan covers their providers and their medications. Seldom are dual eligibles better off on the zero premium plans that using original Medicare.
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I agree.i would say its often that they are better off with a dsnp because of the coordination of benefits,case management, specified network of providers and the hand holding they can get by calling their agent.This population seems to need a " plan " more than most.
I you enroll a person that has Medicaid as secondary into a zero premium, or any MAPD plan that has co payments listed on the card, the receptionist at the providers office may try to collect that fee, even if the the beneficiary shows their Medicaid card at the appointment. I have seen it happen numerous times. That is why agents should stick to enrolling duals into the DSNP plans and not the zero premium MAPD plans.
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