Aetna will not verify my Dual Complete QMB applicants

[GoPokes]

They are still jacking around with one of my 4-1-24 DSNPs. The # that mbs are asked to call doesn’t know about the new guidance of not needing the paper award letter. The local Agent Managers are also short of information. I hate that it is the ONLY Dual option with my doc’s office that I have to use.

I am gettting the same. I called agent support on Friday, asking what the deal is. They said.. oh there is an RFI, we mailed to the applicant... to which I respond, the applicant is not going to respond to your RFI, why dont you just let me, the agent, know there is an RFI??? He sounded like he didnt really care.

Of all the carriers, I am having the most issues with Aetna since the start of 2024. Issues Ive never had before.

 

[DonP]

I am gettting the same. I called agent support on Friday, asking what the deal is. They said.. oh there is an RFI, we mailed to the applicant... to which I respond, the applicant is not going to respond to your RFI, why dont you just let me, the agent, know there is an RFI??? He sounded like he didnt really care.

Of all the carriers, I am having the most issues with Aetna since the start of 2024. Issues Ive never had before.

Thats because Aetna gave the whole store away and crushed the competition in 2024. They est they’ll have 800k new enrollees in 2024 which is more then the next 5 CO’s combined . The regional told me today they weren’t ready for such an influx of business . My question is will they reverse some of the benefits in 2025 as they feel the sting of buying so much business

 

[wehotex]

Thats because Aetna gave the whole store away and crushed the competition in 2024. They est they’ll have 800k new enrollees in 2024 which is more then the next 5 CO’s combined . The regional told me today they weren’t ready for such an influx of business . My question is will they reverse some of the benefits in 2025 as they feel the sting of buying so much business

Thats because Aetna gave the whole store away and crushed the competition in 2024. They est they’ll have 800k new enrollees in 2024 which is more then the next 5 CO’s combined . The regional told me today they weren’t ready for such an influx of business . My question is will they reverse some of the benefits in 2025 as they feel the sting of buying so much business

What a strange comment to say that they weren’t expecting it. All they had to do is look at what Humana did the AEP before to get a clue.
If Humana degraded their offerings the following year (24), I fully expect Aetna to do the same.
Meanwhile, my 4-1-24 effective is still in the never-ending pending status.

 

[DonP]

What a strange comment to say that they weren’t expecting it. All they had to do is look at what Humana did the AEP before to get a clue.
If Humana degraded their offerings the following year (24), I fully expect Aetna to do the same.
Meanwhile, my 4-1-24 effective is still in the never-ending pending status.

Unfortunately after bragging about United dsnp speed of approval i got a dnsp’s i did Friday and Saturday in pending status . Humana seems to take a week to do

 

[Chazm]

How are you guys getting Medicaid IDs? I’m out of the loop. A referral asked me to move her MAPD.

 

[wehotex]

How are you guys getting Medicaid IDs? I’m out of the loop. A referral asked me to move her MAPD.

If they don’t have their Medicaid cards, I think that most carriers can get it for you with SSN, name DOB and prospect’s address.
UHC producer desk is the easiest, most polite and helpful. I wish that they were all like that.

 

[DonP]

If they don’t have their Medicaid cards, I think that most carriers can get it for you with SSN, name DOB and prospect’s address.
UHC producer desk is the easiest, most polite and helpful. I wish that they were all like that.

United can only tell you if they’re eligible for the dsnp plan you give them . So if you give them a full dsnp plan they’ll run it and say “ they’re eligible “ . United can’t give you the level of Medicaid they have nor the Medicaid #. Only Anthem that I’ve seen can give you the Medicaid # and the level of Medicaid .

 

[wehotex]

United can only tell you if they’re eligible for the dsnp plan you give them . So if you give them a full dsnp plan they’ll run it and say “ they’re eligible “ . United can’t give you the level of Medicaid they have nor the Medicaid #. Only Anthem that I’ve seen can give you the Medicaid # and the level of Medicaid .

That might depend on the state that you are in?
UHC gives me the Medicaid # if it is QMB. It is not able to look up SLMB or QI-1. (Texas)

 

[Chazm]

If they don’t have their Medicaid cards, I think that most carriers can get it for you with SSN, name DOB and prospect’s address.
UHC producer desk is the easiest, most polite and helpful. I wish that they were all like that.

I’ve always gotten Medicaid IDs by using their SS# and DOB but I assumed that was down with the hack.
Also, in FL their Medicaid ID isn’t printed on their card. But, FL hates the Medicaid system.

 

[wehotex]

I am gettting the same. I called agent support on Friday, asking what the deal is. They said.. oh there is an RFI, we mailed to the applicant... to which I respond, the applicant is not going to respond to your RFI, why dont you just let me, the agent, know there is an RFI??? He sounded like he didnt really care.

Of all the carriers, I am having the most issues with Aetna since the start of 2024. Issues Ive never had before.

At this point (Friday the 5th), I still have heard nothing about Medicare approval!! I am wondering if I should just instruct the member to cancel the 4-1-24 app, stay on her current plan for April and shoot for May 1.

If she has to use services, they are completely different networks (IPAs), so she might have to use her current plan benefits instead. What have you done with your remaining ones?