< Agent Blog
Oct
12
,
2022

Wellcare: Reminder - Important Update on Eligibility Change for Tennessee Wellcare Dual Access (HMO D-SNP) H1416-035

October 12, 2022

Important Update on Eligibility Change for Tennessee Wellcare Dual Access (HMO D-SNP) H1416-035

In accordance with a new requirement by the State of Tennessee Medicaid Program (TennCare), Wellcare would like to inform agents of a mid-year change in the eligibility criteria for the Tennessee Wellcare Dual Access (HMO D-SNP) H1416-035 plan.   

  • Effective August 1, 2022 and moving forward, only beneficiaries with Medicare Savings Program (MSP) Levels of Qualified Medicare Beneficiary Only (QMB-only) will be allowed to enroll for Plan Year 2022. This means that any application for August 1, 2022 where the enrollee has an MSP level of FDBE, QMB+ and SLMB+ will be denied as ineligible. Only enrollees with QMB-only levels will be approved moving forward, including during the 2023 AEP season.    
  • Members with effective dates prior to August 1, 2022, will continue to be covered at their current MSP level, including FDBE, QMB+ and SLMB+. As these members were enrolled prior to August 1, there is no action required from you. The member will continue to enjoy their benefits as long as their MSP level does not change.
  • After August 1, 2022, any member in the plan whose eligibility level changes to any MSP level other than QMB only will be disenrolled from the plan and be placed on Original Medicare. These members may exercise their special elections to enroll into an alternate Medicare Advantage plan.

What you should do:

  • Please ensure prior to enrolling future members in the Tennessee Wellcare Dual Access (HMO D-SNP) H14163-035 plan that the MSP level has been confirmed as QMB-only. Applications for MSP levels other than QMB-only in this plan will result in a denial. There is no change to eligibility criteria in other Wellcare plans in the state.  
  • Disregard the current Summary of Benefits (SB) and Evidence of Coverage (EOC) for this plan, as these are being updated to include the new eligibility criteria. Please destroy any current printed copies of the SB and EOC for this plan.
  • We will inform you when the updated SB and EOC are available and ready for use.

Please Note:

  • If an existing member’s MSP level changes, to other than QMB-only after July 1, 2022, the member will be disenrolled from this plan to go back to Original Medicare and Medicaid. They will need to be enrolled into a different plan.    

View Details >View Details >

Questions? Call us at 855-888-8326.

Don't have a MedicareValue page yet?

Get Your FREE Site >

Posts you may be interested in...

Read More

Use GTL's Text-to-Sign Feature for Even Faster Submissions!

November 21, 2022
Agent Blog Icon - Indicates this is a blog article.

Save time and bypass the Voice Verification Call! Text-to-Sign is available on the Agent Portal only

Read More

Compare The Benefits Today! See How The Difference is Clear with Clear Spring!

November 16, 2022
Agent Blog Icon - Indicates this is a blog article.

Help your clients meet life where it is at, secure and confident with Clear Spring Health!

Read More

See how Aetna is making it easier for members to stay informed

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

An enhanced member experience is coming in 2023

Read More

Excellus BCBS Medicare Broker News - Vol. 4 No. 10

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

Final Reminders For AEP | Medicare Supplement Update

Read More

Important updates to Humana’s Rx Calculator and Humana.com

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

It was recently discovered that Humana’s Rx Calculator and Humana.com were incorrectly quoting the $0 Rx Copay Benefit Model incorrectly for DSNP plans.

Read More

Wellcare Increased Payments and Network Additions!

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

Your Wellcare NY Sales team wanted to remind you of an increase to the payment amounts for our Health Risk Assessment's (HRA's) and inform you of two important NY network additions.

Who we are & what we do.

Choosing an FMO to work with is not just about having access to top insurance products and commissions, it’s about finding a one-on-one agent service that is prepared to meet your needs.  

Get to know us, and see how we can help you take your business to the next level.

Learn More

Helpful Links

New Here?

We love meeting new people! Fill out the form below, and one of our sales directors will get in touch with you shortly.

Thank you! Your form has been received!
Oops! Something went wrong while submitting the form