Most agents hear the buzz about Dual Eligible Special Needs Plans (D-SNPs.) D-SNPs provide a valuable sales cycle that is not limited to Medicare’s AEP. But what are they? And how can they help expand your business?
Defining D-SNPs
D-SNPs are a form of Medicare Advantage Special Needs Plan. There are five types of D-SNPs: All-Dual, Full-Benefit, Medicare Zero Cost Sharing, Dual Eligible Subset, and Dual Eligible Subset Medicare Zero Cost Sharing. While the majority of D-SNPs are HMO (health maintenance organization) plans, some are offered as PPO (preferred provider organization) plans. While the individual state governs which D-SNPs a carrier can offer, and the benefits they can include, most D-SNPs include:
- Care coordination
- $0 monthly premiums
- Dental, vision and hearing benefits
- Transportation benefits
- Over-the-counter credits
- Gym memberships
- Telehealth services
- Part D coverage
Who is eligible?
Beneficiaries who meet eligibility requirements for both Medicare and Medicaid and are enrolled in both programs are considered dual eligible and therefore qualify for D-SNPs.
The type of plan a dual eligible can enroll in depends upon which category of Medicaid they qualify for. These individuals may have a higher incidence of chronic conditions, cognitive impairments and functional limitations. These plans provide beneficiaries with more intensive coordination of care and services than those offered by traditional Medicare and Medicare Advantage plans. Agents should be sure to verify a client’s Medicaid eligibility before enrolling him or her in a D-SNP.
Is there an enrollment period?
Unlike regular Medicare Advantage plans, D-SNPs do not have a set enrollment period. Once an individual becomes eligible for a D-SNP, they qualify for a Special Enrollment Period in order to join one. Provided they maintain eligibility for Medicare and Medicaid, they have an SEP to join or switch D-SNPs once during each of the first three calendar quarters of the year. This is a great opportunity for insurance agents to make sales outside of Medicare’s AEP.
How do I connect with prospects?
One of the most effective ways of meeting individuals who qualify for a D-SNP is by working in the communities where these individuals often seek assistance, as well as connecting with professionals who serve this group who can act as a referral source. Consider volunteering at a food bank or soup kitchen, visiting low-income housing or retirement communities, or hanging fliers in thrift stores or churches who serve the needy. If you are a resource to this community, you will have a leg up in earning their business.
Why should I sell D-SNPs?
Beyond the opportunity to earn commissions outside of Medicare’s AEP, the majority of those who qualify for D-SNPs are individuals who are truly in need. By serving this group, you are helping those who need it most – which can make it also a personally rewarding job. However, keep in mind that this population requires extra patience, as you may have to explain things to individuals who could be confused by their insurance options.
Do you want to make the most out of your business with D-SNPs? As a North Carolina based full service Insurance FMO, we can help! Give us a call at 919-460-6073 or email us at [email protected].
