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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 The Routine Costs within the Plan Features section of D-SNP plans will likely indicate a 20% Dr. coinsurance.
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A screenshot of the Medical Benefits Description Plate is below. Notice the copay/coinsurance says either $0 or 20% depending on Medicaid level but participants with a D-SNP will have a $0 copay.
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Tip: Be aware that the 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.
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Utilize verbiage such as “a DSNP plan is a plan that will help coordinate your Medicare and Medicaid benefits.”
Focus on the extra benefits that a DSNP’s plans offer
Over the counter benefits
Dental
Vision
Hearing
Healthy food cards
Flex cards
Enrollment Reasons
Plan | Medicare Code/Reason | Dialer Code/Reason | Uses |
|---|---|---|---|
MA/MAPD/PDP | MDE | MDE | May be used once per quarter if shopper currently has Medicaid. |
Medigap | NA | NA | It is usually illegal to sell a Medigap to a Medicaid participant |