Understanding Special Needs Plans
Laying a Solid Foundation | Lesson 4

D-SNP Enrollment

D-SNPs are not only valuable to your qualified clients, but also valuable for your business.

D-SNPs can open more sales opportunities during slower months for Medicare Advantage sales. So, when can you enroll dual-eligible clients into a plan?

Well, you’ll have the same enrollment opportunities as other Medicare Advantage plans, like the initial coverage election period, Annual Enrollment Period, and various Special Enrollment Periods.

But there are unique Special Enrollment Periods, or SEPs, for individuals who are eligible for Medicaid.

The first SEP I want to cover is the ongoing SEP for dual-eligible individuals. This SEP allows qualified individuals to make one change during each of the first three quarters of the year. So, your clients could make one change from January to March, one change from April to June, and one change from July to September using this SEP.

If they use this SEP, their effective date would be the first of the month after the plan receives the enrollment request.

If you have someone who wants to make a change during the fourth quarter, they will need to use the Annual Enrollment Period, which runs from October 15 to December 7.

Just like normal AEP enrollment, changes made during this time will become effective on January 1.

Now, they might not use each of those enrollment opportunities, but it is nice to know they have the option to make a switch if their health needs change during the year.

In addition to this ongoing SEP, clients will have an SEP when they first become dual-eligible. This SEP can be used within three months of becoming eligible for Medicaid or within three months of being notified of their eligibility, whichever is later.

They’ll also have this same SEP if they lose their dual-eligible status.

Like the ongoing SEP, enrollments made with the status-loss Special Enrollment Period will be effective the first of the month after the plan receives the enrollment request.

As you can see, breaking into the D-SNP market can present new opportunities to keep your business thriving in slower months.

But how can you keep your sales pipeline full all year?

In the next lesson, we’ll cover some prospecting considerations for the dual-eligible market. We’ll see you there!

Watch the Next Lesson