For those that work D-SNP: How are you checking eligibility?

[straightnochaser]

This question is for the few who work the dual-eligible market. How are you guys currently confirming eligibility with this Change Healthcare hack affecting every carrier portal? Is there a workaround? I just waited on hold with Aetna for 90 minutes only for them to say they can't help in that state (but wouldn't give me a list of states that they do help)!

 

[straightnochaser]

Despite this being risky, Ive pointed agents in my downline in the direction of knowing which plan they currently have, knowing that plans requirements, then assuming their eligibility has not changed, going with something that fits in that eligibility. If it kicks back just rewrite. Not my favorite but have not seen any kickbacks yet.

Are you using SSN in place of Medicaid # if they for whatever reason don't have it to hand?

 

[yorkriver1]

Some of the major carriers have an online lookup. Generally will need their SS# or Medicaid ID and Medicare #.

 

[straightnochaser]

Some of the major carriers have an online lookup. Generally will need their SS# or Medicaid ID and Medicare #.

Online verification is down and has been for almost a week. We are being told up to 45 days for it to come back..

 

[DonP]

UHC will tell you if your state has manual lookup . You can give them your list at one time and they call to check them all . United told me you give them the plan your looking at and they’ll tell you if they qualify . But they wont give you the Medicaid level . My friend said anthem will tell you if there slmb or Qmb . One near ago if they had a dual plan already it was 98% chance they were still dual eligible . Now that’s not the case as millions have been disenrolled . Millions of duals could be on dual plans and on there 6 month deeming period and not have Medicaid . If your a silver , gold or platinum United agent you get threw in 30 seconds

 

[Surancedawg]

"One near ago if they had a dual plan already it was 98% chance they were still dual eligible . Now that’s not the case as millions have been disenrolled . Millions of duals could be on dual plans and on there 6 month deeming period and not have Medicaid"

This whole custerfluck with the D-SNP verification system couldn't have happened at a worse time. Our big go-to MA carrier just informed us that, because of the uncertainty around how long the verification system will be down for, as well as the upheaval in the Medicaid program with lots of members losing their status this year, they're going to stop giving them the deeming period of several months before their plan is termed. Been dealing the last 2 days with a flood of angry Duals whose plans ended on 2/29 and also only just got the letter from the carrier informing them they were dropped due to "loss of qualifying level of medicaid".

 

[DonP]

Surancedawg what carrier is that that’s terming immediately ?I got at least 25 terming duals i got lined up i have to move in the next 4 months . Humana calls you the month before and tells you who will be disenrolled but almost all my clients have called me . United doesn’t seem to be notifying the agent as I’ve seen nothing but not had any disenrollments yet . Bottom line we can only do what we can do . If they get disenrolled can only rewrite when you see it . One reason i never moved people immediately even if i knew they lost their Medicaid i knew no phone rep could move their dual plan . All this chaos with Medicaid has changed my view of working as much with duals . For 3 yrs there nobody was knocked off . Know every yr if they don’t fill form out it will be constant knocked off then back on and back and forth . It’s going to be very hard to maintain that dual book