Myths of the DSNP Market – Debunked!

Author: Chris Hagerstrom

It’s no mystery, the Annual Enrollment Period (AEP) is the busiest time of the year.  That’s what happens when you allow all 59+ million Medicare beneficiaries to make a decision with their health care coverage, and limit them to just 54 days to make it happen.  So what do we for the other 311 days of the year?  Yes, there are 10,000+ individuals aging into Medicare each day but there is another huge opportunity that exists in the Medicare Market right now, DSNP consumers.  Individuals that qualify for Medicare and Medicaid have special needs for their special circumstances, but there are some inaccurate beliefs about this sales opportunity that are preventing many agents from taking advantage of it.  It’s time we debunk those myths!

Myth: Everyone that qualifies for Medicare & Medicaid already has a Dual Special Needs Plan (DSNP).
Truth: Only 25% of Medi-Medi beneficiaries that live within a DSNP service area are enrolled in a plan nationwide.  In some states like Virginia, for instance, only about 6% of duals are enrolled in a DSNP plan.  That leaves millions of consumers without the added benefits that DSNPs offer, and all of them are our potential clients.

Myth: DSNP members are high maintenance.
Truth: While DSNP members typically have greater medical needs, the carriers are dedicated to providing more support including enhanced member welcome kits, telephonic health risk assessments, dedicated customer service specialists and sometimes calls to members just to check in with them throughout the year.  Rest assured that once your client’s are enrolled in a DSNP the carriers work hard to retain those members so you can focus on client referrals and new business.

Myth: DSNP members live in nursing homes.
Truth: Only about five percent of DSNP members live in nursing homes.  Most people who reside in nursing homes qualify for coverage other than a DSNP.

Myth: DSNP members must be 65 to qualify.
Truth: Consumers can qualify for Medicare with age or with a disability, and their Medicaid qualification is based on their income.  Nationally, 40% of DSNP members are under the age of 65 and this varies by state.  Regardless, the majority of DSNP members do not need to be 65 to qualify (Massachusetts is an exception).

Myth: DSNP consumers are homebound.
Truth: Over 30 percent of DSNP members own or have access to a vehicle covered by the cheapest car insurance guaranteed and those who don’t use transportation services to shop, attend faith centers, visit the doctor, see friends and family, etc.  You can find DSNP clients almost anywhere!

Myth: DSNP clients change their plan every month.
Truth: The nation’s leading DSNP insurer reports that, on average, only 2% of DSNP members change their coverage each month.  Where you can help to retain your clients (over and above what the carriers are already doing) is to encourage them to use the ancillary benefits; whether that be dental, vision, hearing, transportation, fitness, over the counter products or chiropractor services.  Once the client sees the value of their plan you’ll create members for life.

Myth: It takes a special agent to work with this population.
Truth: Anyone can sell DSNP!  JSA and our carrier partners have numerous trainings and tools available to help agents understand Medicaid, the DSNP products, how and where to prospect and so much more.  It takes a professional agent who takes their career and clients seriously – an agent who is willing to help all who need access to care, to be successful with the DSNP market.

It can be said there is no better opportunity to continue your Medicare sales throughout the year than working in the Dual Special Needs Plans market.  To find out how you can get started and which carriers are a must have in your area, please reach out to the JSA Marketing Team at 1-800-203-0433.  We can also connect you with the local carrier contacts that will be a vital part of your Dual SNP success by providing training and marketing support.

Chris Hagerstrom is the Marketing Vice President at Jack Schroeder and Associates, LLC. Through years of experience he has become an expert with Medicare, Life Insurance, Annuities and Supplemental Health and how to successfully navigate the senior market.

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