Selling Dual Eligible Special Needs Plans (D-SNPs) might seem “too complicated,” but just a little information can go a long way toward developing a better understanding of these plans. We’re laying to rest some common myths about D-SNP sales so you can learn how to best position these specific plans in your Medicare portfolio.
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Understanding D-SNPs
D-SNPs are special Medicare Advantage (MA) plans only available for Medicare recipients who are also eligible for their state’s Medicaid assistance. These plans utilize the benefits of both Medicare and Medicaid to create a well-rounded form of health insurance for those who need it the most. These beneficiaries are typically the impoverished, disabled, or a combination of both, and also less likely to be over 65 years of age, since age isn’t a requirement to qualify for this coverage.
Unlike the enrollment practice for traditional MA plans, D-SNP recipients can refresh their plan choice once every month (depending on the state where they live, their Medicaid status, and the type of D-SNP), raising the possibility for sales outside of the Annual Enrollment Period (AEP) and allowing business to boom all year long.
There are five types of D-SNP plans available with different eligibility guidelines:
D-SNP Cheat Sheet
| Type of D-SNP | Who’s Eligible to Enroll |
|---|---|
| All-Dual | Any dual-eligible beneficiary |
| Full-Benefit | Dual-eligibles who qualify for full Medicaid benefits for the month under any eligibility category or Medical assistance for any month if the individual was eligible for assistance in any part of the month |
| Medicare Zero Cost Sharing | Dual-eligibles who aren’t responsible for cost-sharing for Medicare Parts A or B (QMB, QMB+ beneficiaries) |
| Dual Eligible Subset | Members of certain groups of dual-eligibles determined by a carrier’s coordination with a State Medicaid Agency |
| Dual Eligible Subset Medicare Zero Cost Sharing | Members of certain groups of dual-eligibles determined by a carrier’s coordination with a State Medicaid Agency who aren’t responsible for Medicare cost-sharing |
Additionally, D-SNP benefits and supplemental perks vary from state to state and carrier to carrier, but typically, beneficiaries can expect to receive the following from these comprehensive plans:
- Low or $0-premium plans (mostly HMO but PPO as well)
- Dental, vision and hearing coverage with product allowances, usually received quarterly
- Part D benefits included with most plans
- Over-the-counter benefits, usually received quarterly
- Transportation benefits
- Fitness benefits or gym memberships
- Telehealth access and more!
These plans almost sell themselves by being so inclusive while also remaining affordable. All it takes is a knowledgeable, plugged-in insurance agent to connect clients with the right D-SNP plan to meet their needs!
These plans almost sell themselves by being so inclusive while also remaining affordable.
Common Myths About Selling D-SNPs
Let’s review and bust some of the common misconceptions about selling D-SNPs.
Myth #1: Finding Dual-Eligible Clients is Hard
We’ve heard it before — “these clients are hard to find or communicate with” or “they reside outside of areas where I typically network or advertise.” The list goes on. While successful sales are typically always accompanied with some sort of challenge, it can be rewarding and lucrative to put in extra effort, as it would be for sales with any type of client!
You also have a great opportunity to expand your networking radius and diversify your marketing tactics by targeting ads in certain areas where D-SNP clients are more likely to live.
While it’s no secret that dual-eligible beneficiaries are either at a lower income level or more severely disabled than most recipients, we do recognize that these people may live and frequent areas you might not always be familiar with — particularly in lower-income neighborhoods. However, these clients really can be found anywhere, and its best to use both traditional and digital marketing techniques to keep a look out for prospects.
By positioning yourself as a resource within the community where D-SNP clients reside, perhaps that’s even your own community — you can be a trusted leader for dual-eligible individuals (and others) and help them secure the health care coverage they need.
By positioning yourself as a resource within the community where D-SNP clients reside, you can be a trusted leader for dual-eligible individuals (and others) and help them secure the health care coverage they need.
There is, however, a stigma surrounding the sales efforts for finding these clients, which brings us to our next myth.
Myth #2: D-SNP Clients are Challenging to Work With
This stereotype is one that we’d like to squash sooner rather than later, as it’s harmful to both clients and agents alike. Associating low-income housing or certain areas of your town or city as being “unsafe” or dangerous can be harmful to communities who may need the most help from agents like yourself! Don’t allow misconceptions to prevent you from making new connections and perhaps even increasing your sales. We encourage you to always use your best judgment, but don’t let someone else’s opinion stop you from fully doing your job to the best of your ability!
We encourage you to always use your best judgement, but don’t let someone else’s opinion stop you from fully doing your job to the best of your ability.
There’s also the assumption that D-SNP enrollees are “too” disabled to work with, and that’s just simply not the case. However, there’s certainly a higher chance of encountering clients who need extra attention and care from their insurance agent to ensure they aren’t being unfairly taken advantage of at the expense of their disability. If you would feel uncomfortable in these situations, then D-SNP sales just might not be for you.
Myth #3: The D-SNP Market is Too Small to Pursue
As of 2019, approximately 18 percent or 10.9 million Medicare beneficiaries were dual-eligible according to KFF — almost a fifth of the market! With Medicare enrollment only projected to grow over the next decade, this percentage is likely poised to increase. By not pursuing the D-SNP market, especially if you live in or near an area where dual-eligible clients live, you’re quite literally shutting yourself off to a large portion of the potential sales market.
By not pursuing the D-SNP market, especially if you live in or near an area where dual-eligible clients live, you’re quite literally shutting yourself off to a large portion of the potential sales market.
Not only that, but some clients might not even realize their dual-eligibility status, so as their insurance agent you should always double-check someone’s Medicaid status when enrolling them in a new plan!
Myth #4: My Clients Will Leave After One or Two Months
Part of the excitement of selling D-SNP plans is the potential for clients in certain states to enroll or change plans every month. This gives you the opportunity to gain new customers all year long, even outside of AEP! Additionally, you’re given the opportunity to form close bonds with these clients by checking on them throughout the year to update their plans or ensure they’re satisfied with the coverage you’ve already sold them!
However, a more pessimistic outlook of this advantage is that your clients could decide to disenroll from their plan shortly after signing up, or arguably worse — your client could fall into the hands of another insurance agent. While we realistically can’t say that this won’t happen, if you are a reputable, customer-service oriented insurance agent who your clients can trust, then the chances are certainly low!
You’ll get out what you put in with D-SNP sales, as you would with selling any type of plan. This gives you an opportunity to not only increase the quantity of your sales, but the quality of each client interaction as well.
We hope you’ll see the benefits of selling these vital and comprehensive D-SNP plans in your community. By selling them, you increase your sales and become an important figure for those in your area to rely on for their insurance needs. So, toss your hat into the D-SNP market and contact a Ritter sales specialist today to get started!
Not affiliated with or endorsed by Medicare or any government agency.
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