Full Medicaid: Pays Medicare Part B premium and most eligible medical expenses.
Partial Medicaid: Covers all or part of Medicare Part B premium, but covers no medical expenses.
Usually Medicare beneficiaries with Medicaid at either level will also have Extra Help.
Any level of Medicaid will qualify participant for an SEP (1/1 to 9/30).
Medicare beneficiaries must have Full Medicaid to enroll into a D-SNP Plan
Soft Verification
It helps to get a “Soft” verification earlier in the call to know what enrollment reasons and plans are likely available for the customer. Often the simplest way to verify is by simply asking: “Are you eligible for Medicaid in addition to Medicare?”
If unsure, ask:
“Do you pay a monthly premium for your Medicare part B?”
“Do you have a Medicaid Card?”
“When you go to the doctor or hospital, do you ever have a copay?”
Be sure to ask about Medical, not Rx copays. Reduced Rx copays may indicate Extra Help, not Medicaid eligibility.
Firm Verification
A definitive verification must be obtained to complete the enrollment. For D-SNPs, the participant must qualify for Full Medicaid. This can be verified on Jarvis,