DSNP Dual Special Needs Plan 1 Plan designs












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DSNP Dual Special Needs Plan 1
Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other limitations and exclusions may apply. Confidential property of United. Health Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of United. Health Group. © 2017 United Health. Care Services, Inc.
New York DSNP Market Overview Dual Special Needs Plan H 3387 -010 Service Area 2018 Market Landscape* Estimated Dual Eligibles 706, 810 Total Dual Enrollees All Plans 224, 624 Total UHC Enrollees DSNP Penetration All Plans Estimated Dual Eligibles w/ out DSNP Eligibles in Expansion Area 45, 926 31% 482, 186 79, 707 MARKET HIGHLIGHTS Current Footprint Expansion * As of 6/1/2017 3 Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other limitations and exclusions may apply. Confidential property of United. Health Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of United. Health Group. © 2017 United Health. Care Services, Inc. • Increased Debit Card benefit $125 month/$1, 500 annual • $3, 000 Dental benefit – increased for 2018 • Increased Hearing benefit • Added Personal Emergency Response System (PERS) • Added Acupuncture benefit • Added Meal Program following facility discharge
The United. Healthcare Experience We believe every DSNP eligible consumer should understand their plan choices. A DSNP can help coordinate care and maximize plan benefits so they can live a healthier life. You can trust United. Healthcare to be there for members. Plan Design Resources When it comes to DSNP, United. Healthcare offers clinical programs and special expertise to serve the dual population. History Members have access to online tools and resources to help them manage their plan and live a healthier life. Renew by United. Healthcare is an exclusive perk for United. Healthcare members that provides healthy living tips, healthy learning opportunities and rewards for healthy behaviors. With over 30 years of experience serving Medicare and Medicaid beneficiaries, United. Healthcare is a company committed to being there for members. Coordinated Care Next Level Service Our care model is designed to coordinate care between Medicare and Medicaid to help maximize member benefits and deliver better quality outcomes. We offer service that is setting the bar in the industry by combining personal service with technology to connect members to the right resources for their specific health needs. Providing More We’ve listened to our agents and members to develop and offer plans that include extra benefits and programs they want — from in-home wellness visits to dental coverage and catalog benefits depending on where the member resides. When you enroll your customers with United. Healthcare, you can have confidence they will be with a company you can trust. We’re also committed to providing you with resources and tools that simplify and enhance the agent experience. Market Leader We serve over 11 million Medicare beneficiaries and almost 6 million Medicaid members nationwide. * As of 6/1/2017 4 Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other limitations and exclusions may apply. Confidential property of United. Health Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of United. Health Group. © 2017 United Health. Care Services, Inc.
Confirm Medicaid Status Call the Producer Help Desk (PHD) to verify Medicaid status. 1 -888 -381 -8581 option 1 / option 3 (pre-enrollment support) Obtain consumer’s first and last name Medicare number Medicaid number Social Security number Date of birth Date on which you obtained the consumer's permission to contact the PHD. * As of 6/1/2017 5 Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other limitations and exclusions may apply. Confidential property of United. Health Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of United. Health Group. © 2017 United Health. Care Services, Inc. 5
New York DSNP Benefit Overview Dual Complete Plan H 3387 -010 Plan Type HMO Service Area Albany, Bronx, Broome, Chautauqua, Dutchess, Erie, Jefferson, Kings, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Orange, Queens, Rensselaer, Richmond, Rockland, Tioga, Ulster, Westchester Additional Benefits* OTC Debit Card Debit card for retail use: $125/month $1, 500/year; monthly expiration Dental $3, 000 annually; covers implants, fixed bridgework, full and partial dentures and root canals Vision Annual exam and $300 credit every two years for eyewear Hearing Annual exam and $2, 000 credit every two years for hearing devices Transportation 48 one-way rides for health care visits and prescription needs Nurse. Line Available 24 hours a day/7 days a week PERS Personal Emergency Response System (PERS) available 24 hours a day/7 days a week at no additional cost — service includes wireless/landline compatibility, assisted or self-set-up and available anywhere in the U. S. Acupuncture services covered; up to 20 visits for $0 per visit Meal Program $0 co-pay for up to 2 weeks meals following discharge from a facility one time per year Improved for 2018 Degraded for 2018 No changes for 2018 * As of 6/1/2017 6 Plan designs and service areas described in this document are pending government approval and are subject to change. Benefits reflect pending in-network cost sharing. Other limitations and exclusions may apply. Confidential property of United. Health Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute, reproduce, edit or delete any portion without the express permission of United. Health Group. © 2017 United Health. Care Services, Inc.
Local Area Marketing Primary Source of SEP Business Self Generated Business Ø Event Marketing (Informal/Formal) § Informal Tabletop Events (grassroots approach/boots on the ground) • Build relationships in the community and set up a schedule of periodic kiosk event sites (Event Site Database & Physician/Dentist Offices) • Research future events (health fairs, committees, boards, etc. ) • Notify 14/21 days in advance • Post flyers (Agent Toolkit) at all event sites, leave brochures and business cards § Formal Community Meetings • Book formal meetings 2 -3 months in advance to be included in corporate advertising efforts • Notify • booking events to be included in advertising 7 Proprietary Information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.
Finding Dual Eligible Consumers Work with Agent Manager to identify the DSNP population in your market Friends and Family Doctor Dentist/Vision/Hearing Connect with People who may become a Resource or a Referral Build Relationships to foster referrals Food Banks Low Income Housing Local/State/Federal Entities Marketing Members
Marketing Locations 1 Office of Aging 2 Senior Centers 3 Chamber of Commerce 4 Senior Housing 5 Health Fairs 6 Health Centers 7 Pharmacies (Local & Corporate) 8 Dollar Stores ( Dollar General, Dollar Tree, Family Dollar) 9 Grocery Stores (Tops, Budweys, Save-A-Lot) 10 Big Box Stores (Walmart/Target/Kmart) 11 Farmer's Markets 12 Churches 13 Community Action Committees/Organizations LIS/Medicaid 14 Thrift/Second Hand Stores (Amverts, SA, Goodwill) 15 Subsidized Housing 16 Food Pantries 17 Drop-In Centers 18 Check Cashing Locations 9 Proprietary Information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.
Agent Tools & Resources • Agent Materials • Promotional Items • Provider Lookup Tool/Drug Search Tool • Agent Toolkit • Monthly Training Calendar (via e-mail) 10 Proprietary Information of United. Health Group. Do not distribute or reproduce without express permission of United. Health Group.
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