Resources to help sell UHC D-SNPs in upstate New York

Resources to help sell UnitedHealthcare D-SNPs in upstate New York

To help you maximize your sales potential, explore the extensive resources for selling UnitedHealthcare Dual Special Needs Plans (D-SNP). D-SNPs that are tailored for individuals eligible for both Medicare and Medicaid and may offer additional benefits like OTC, healthy food and utilities, dental, vision, hearing care and prescription drug coverage.

Certain consumers in New York have the option to enroll using the Integrated Care Special Election Period (SEP).

• Fully Integrated (FIDE) plans offer the highest level of integration for D-SNP beneficiaries. These plans must cover Medicaid primary and acute care services and Managed Behavioral Health (BH) Medicaid coverage and Managed Long Term Services and Supports (or LTSS) from the same parent organization. These plans are designed to coordinate the care management of these members and may also coordinate or integrate things like member communications and enrollment materials so it feels like the consumer is receiving services from one plan.
• Highly Integrated (HIDE) plans are for members with full Medicaid benefits. These plans have a contract with the state Medicaid agency to provide either BH coverage or LTSS, also known as Long Term Care Medicaid benefits. HIDE plans may only be offered within the same service area that the BH or LTSS Medicaid plan are offered in. HIDE plans are eligible for the Integrated Care SEP and can be sold during this SEP.

The list below shows which plans are eligible for the Integrated Care SEP and which are not:

• UHC Dual Complete NY-S002 (HMO-POS D-SNP) H3387-014-001 – (HIDE) Integrated Care SEP
  • As a reminder, this plan is for full dual eligible consumers (FBDE or QMB+). Only full dual consumers enrolled in UnitedHealthcare Community Plan of New York (UnitedHealthcare Medicaid plan) are eligible to enroll using the monthly Integrated Care SEP.
• UHC Dual Complete NY-S4 (HMO-POS D-SNP) H3387-017-000 – Special circumstance SEPs
• UHC Dual Complete NY-S001 (PPO D-SNP) H2001-063-001 – Special circumstance SEPs
• UHC Dual Complete NY-Q001 (HMO-POS D-SNP) H3387-015-001 – Special circumstance SEPs

Review your State-Level D-SNP Enrollment at a Glance Guides to learn more about limited special circumstances SEPs. You can also verify member eligibility using the Medicare & Medicaid Eligibility Lookup on Jarvis.

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