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Use either Jarvis or Vantage portals to verify Medicaid eligibility.
Click Here Richt-click and open in a new tab for the Jarvis (UHC) step-by-step guide.
Click Here Right click and open in a new tab for the Vantage (Humana) step-by-step guide.
Note - It is better to use Jarvis if possible because you may enter either the Medicaid or Medicare number to verify eligibility. Vantage requires the Medicaid or Social Security number along with the Medicare number.
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We are within the first 9 months of the year (the MDE enrollment code may not be used from Oct-Dec).
Verify they have not already used their quarterly SEP this quarter (only one MDE enrollment may be used per quarter).
Quarter 1: January 1 - March 31
Quarter 2: April 1- June 30
Quarter 3: July 1 - September 30
The enrollment quarters are based on the submission date, not the effective date. Example: If a customer submitted an application on March 15th for an April 1st effective date, this is considered a quarter 1 enrollment. The customer would still be able to change plans in quarter 2.
If a customer has Medicaid, this means they also qualify for LIS/Extra Help. When quoting Medications, quote the non-LIS pricing as well as the LIS pricing.
Example: “I am now going to quote you the prescription pricing that would apply if you did not qualify for Extra Help followed by the pricing you should expect to pay as long as you remain qualified for Extra Help.”
When quoting plans, check the Summary of Benefits (SOB) to verify what levels of Medicaid the plan accepts. Every D-SNP accepts FBDE. Use Ctrl+F to easily locate the levels of Medicaid the plan accepts within the SOB. The example below confirms this Anthem plan accepts FBDE, QMB, and QMB+.
Tip: Be aware that the Routine Costs within the Plan Features section of D-SNP plans will likely indicate a 20% Dr. coinsurance.
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Tip: Be aware that the application allows agents to indicate the participant does not have Medicaid. The agent must indicate Medicaid eligibility and enter the Medicaid number on the app for a D-SNP enrollment.
Enrollment Reasons
Plan | Medicare Code/Reason | Dialer Code/Reason | Uses |
|---|---|---|---|
MA/MAPD/PDP | IEP | IEP | May not be used again after the plan goes into effect |
MA-Only | ICEP | ICEP | May not be used again after the plan goes into effect |
Medigap | GI | GI | May be used multiple times until the enrollment window expires |
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