JOB Aid
What job aides should you open at start of shift that you will rely on most when selling SNP plans?
What sets our DSNP plans apart from our Competitors? What job aides will help you explain these benefits.
Wellness Extras
Evidence of Coverage
Summary of Coverage
What is a main difference between street plans and DSNP plan dental coverage?
Where do you look to review detailed plan coverage?
Many plans include an allowance for comprehensive dental services, and some even include coverage for dentures.
evidence of coverage.
On average, dual eligible consumers earn less than $XX per year.
$20,000
What is the impact of a lower star rating to our consumer?
Health Assessments have an impact on our star ratings, both positive and negative. If a star rating is lowered, this reduces our ability to reinvest in our plan benefits. We see this especially on our Special Needs Plan wellness benefit packages, that may not be as competitive as they once were.
Where can I find the Medicaid scripting to gain approval to review Medicaid eligibility? Provide job aide and tab.
How many plans should you present to the customer in your Solution Presentation?
one
Vision benefits may not be much different than street plans. Where do you go answer questions like: "If the consumer needs more specific information about what is included (for example, does the plan cover scratch-resistant coatings?) "
Summary of Benefits
Evidence of Coverage
What is the biggest driver of Medicare complaints surrounding the agents interaction with the consumer?
Incorrect provider information is the highest driver of Complaints to Medicare (CTMs) that result from an agent's interaction with the consumer. Let's review what you need to focus on when reviewing providers and how conversations with dual eligible consumers may differ. Not having access to their preferred provider(s) is the number one reason a member will rapidly disenroll from a plan.
Does UHC offer MMP Plans?
NO
What Job Aid and Tab do you refer to when determining cost share for out of network costs when a plan does not cover out of network providers?
Selling to Dual Eligible Consumers
Cost Share Tab
Depending on level of Medicaid and whether the provider accepts medicaid will determine member cost share
What is the top trending transactional error we received in March?
Updating Email
Lets take a look at Step 7: Demographic Changes and Updates - Breeze- Delta
What are the Three Levels of OTC benefits?
What percentage of dual eligible have three or more chronic conditions?
What may be the most important factor in choosing a plan for these people?
70%
Provider -- remember changing one provider can impact coordinated care.
If a dual eligible enrolls in a street plan will Medicaid still pick up the cost sharing?
Use the cost sharing tool for medical!
For wellness, no.
Unlike DSNPs, if a dual eligible consumer uses additional benefits (wellness benefits or other benefits that are not covered by Medicare) through a standard MA plan, their Medicaid benefits will not cover the cost-sharing.
What job aide do you use to verify Medicaid eligible if Mira does not provide it?
Selling to Dual eligible State tab
What is the biggest reason health assessments are not completed?
The agent
What is the easiest way for a member to use their Ucard, see balances, and what they can use it for?
UHC app on your phone.
Why is completing a health assessment at the end of all SNP calls imporant?
More risk means greater level of managed care:
The care management plan for high risk consumers include:
What are the six chronic conditions that qualify consumers for CSNP plans?
What job aid can you find if a diabetic supply is listed under Part B or D?
Prescription Coverage Part B vs Part D - Diabetic Supplies and Services
What are considered high transactional errors? (Two)
Updating demographics
Verifying mailing or email address when sending fulfillment items.
Seems pretty easy to avoid, don't ya think! ;)
What can a member use transportation benefits for on SOME plans, other than doctor visits?
Gym
Grocery
Pharmacy
Health assessment questions can give customers additional resources. Think of three things that could benefit those that go hungry, have trouble taking meds or have addictions preventing them from working.
referred to food resources
given drugs in pill packs
behavioral health for addiction
What are the unique benefits of CSNP?