4800 Linglestown Road Suite 300 Harrisburg, PA 17112 www.RitterIM.comwww.RitterIM.com / 800-769-1847 Caremore Special Needs Plans Presenters: David Dietz.

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Presentation transcript:

4800 Linglestown Road Suite 300 Harrisburg, PA / Caremore Special Needs Plans Presenters: David Dietz & April Ford

About Ritter Insurance Marketing Ritter Insurance Marketing – Medicare Supplement, Medicare Advantage, Medicare Part D, Final Expense & Individual Health. – Online Services: Medicare Quote Engine Ritter CRM Online Licensing Events Calendar Medicareful.com – 27 Staff members in house

Special Needs Plan Basics Special Needs Plans (SNP’s) – Dual Eligible- Medicare and Medicaid – Chronic- Specific chronic diseases and conditions. – Institutionalized Who is Eligible to join a Chronic or Dual SNP? – Medicare A & B – Live in the plan’s service area – Meet one of the following Have one or more specific chronic conditions that are included in the plan Have both Medicare and Medicaid When can a Beneficiary enroll into a SNP? – Dual Eligible You can enroll or change at any time – Chronic Newly Eligible to Medicare (IEP) Annual Enrollment period (AEP) Have or develop a chronic condition (SEP) – Change at any time but once you enroll in a plan, this SEP ends.

Caremore Online – Summary of Benefits – Pharmacy search – Evidence of coverage – 2011 Drug Formulary – Training Schedule

Caremore SNP Prescription Benefit Included in all Caremore SNP plans – Prescription Drug Coverage Tier One - $0 co-pay with coverage through the gap Tier Two - $5 co-pay with coverage through the gap Tier Three - $0 co-pay with coverage through the Gap – Many types of Insulin included at this tier Tiers 4, 5 and 6 – No coverage through the Gap – LA and Orange Counties Full coverage through Gap

Plan Details –Arizona Maricopa County – Plan Availability Heart, Diabetes and ESRD – Plan Details Premium- $0 Inpatient Hospital $100 days 1-5 (Diab/Heart) $175 days 1-5 (ESRD) Doctor Co-pays: $0 PCP and $25 Specialist – $0 Co-pay Podiatry $100 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $80 every two years Dental (Package 1 $14.80 month) OTC Benefit Transportation $0 Co-pay to Caremore Care Centers *Dialysis Fitness – Shape Up, Levels Down Healthy Start program

Plan Details –Arizona Pima County – Plan Availability Heart, Diabetes and Breathe – Plan Details Premium- $0 Inpatient Hospital $100 days 1-5 Doctor Co-pays: $0 PCP and $25 Specialist – $0 Co-pay Podiatry $75 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $80 every two years Dental (Package 1 $14.80 month) OTC Benefit Transportation $0 Co-pay for up to 24 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Plan Details - Nevada Clark County – Plans Available Diabetes and Breathe – Plan Details Premium- $0 Inpatient Hospital $100 days 1-5 Doctor Co-pays: $0 PCP and $20 Specialist – $0 Co-pay Podiatry $25 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $80 every two years Dental (Package 1 $7.30 month) OTC Benefit Transportation $0 Co-pay for up to 24 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Plan Details – California Santa Clara and Stanislaus County – Plans Available Diabetes and Breathe – Plan Details Premium- $59 monthly Inpatient Hospital $100 days 1-5 Doctor Co-pays: $0 PCP and $15 Specialist – $0 Co-pay Podiatry $100 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $100 every two years Dental (Package 1 $12.90 month) OTC Benefit Transportation $0 Co-pay for Caremore Care Center visits Fitness – Shape Up, Levels Down Healthy Start program

Plan Details – California Riverside County – Plans Available Diabetes – Plan Details Premium- $0 Inpatient Hospital $45 days 1-5 Doctor Co-pays: $0 PCP and $0 Specialist – $0 Co-pay Podiatry $45 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $100 every two years Dental (Package 1 $9.50 month) OTC Benefit Transportation $0 Co-pay for up to 24 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Plan Details – California San Bernardino – Plans Available Reliance (Diabetes), Breathe, ESRD and Connect – Plan Details Premium- $0 Inpatient Hospital $75 days 1-4 Doctor Co-pays: $0 PCP and $0 Specialist $0 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $100 every two years Dental (Package 1 $9.50 month) OTC Benefit Transportation $0 Co-pay for up to 24 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Plan Details – California Los Angeles and Orange Counties – Plans Available Reliance (Diabetes), Breathe, ESRD, Heart and Connect – Plan Details Premium- $0 Inpatient Hospital $0 Co-pay Doctor Co-pays: $0 PCP and $0 Specialist $0 Co-pay Outpatient Surgery (Hospital Facility) $0 Co-pay for Diabetic Supplies Vision- $100 every two years Dental (Package 1 $9.50 month) OTC Benefit Transportation $0 Co-pay for up to 50 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Plan Details – California Los Angeles & Orange Counties – Caremore Connect (Dual Eligible) – Plan Details Premium- $0 Vision- $150 every two years Dental OTC Benefit Transportation $0 Co-pay for up to 50 one-way trips Fitness – Shape Up, Levels Down Healthy Start program

Marketing Special Needs Plans Marketing to Dual Eligibles – 21% of Medicare Beneficiaries are dual eligible Varies widely by state 12% in Utah 41% in Maine – – 36% of dual eligible are under 65, where as with all Medicare Beneficiaries only 16% are under 65 – Traditional Marketing does not work Successful marketing requires more of a “grass roots” approach. Building relationships with centers of influence such as low income housing will be more successful.

Marketing Special Needs Plans Marketing to Chronic SNP’s – Chronic SNP's require similar specialized marketing. Since the qualification to enroll in these plans requires a particular medical condition, keep this in mind as you develop your marketing plan. In some cases you may find events sponsored for those with Diabetes or similar diseases which would be a good place to market your services.

Question and Answer Contact Ritter Insurance Marketing Phone: Dave Dietz – 213 April Ford – 212 Carl Conrad – 223 Amy Shuman Post a comment on the blog