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4800 Linglestown Road Suite 300 Harrisburg, PA 17112 www.RitterIM.com / 800-769-1847 PowerPoint PPT Presentation


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Caremore Special Needs Plans Presenters: David Dietz & April Ford. 4800 Linglestown Road Suite 300 Harrisburg, PA 17112 www.RitterIM.com / 800-769-1847. About Ritter Insurance Marketing. Ritter Insurance Marketing

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Caremore

Special Needs Plans

Presenters: David Dietz & April Ford

4800 Linglestown Road

Suite 300

Harrisburg, PA 17112

www.RitterIM.com / 800-769-1847


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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

      • 800-769-1847


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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.


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Caremore Online

www.caremore.com

Summary of Benefits

Pharmacy search

Evidence of coverage

2011 Drug Formulary

Training Schedule


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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


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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


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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


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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


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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


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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


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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


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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


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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


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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

www.statehealthfacts.org

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.


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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.


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Question and Answer

Contact Ritter Insurance Marketing

Phone: 800-769-1847

Dave Dietz – 213

April Ford – 212

Carl Conrad – 223

Amy Shuman - 224

Email: [email protected]

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