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3 Ways for Health Insurers to Connect with Dual-Eligibles

• Author: Healthcare Team

hc insights-connect with dual-eligibles

Both Medicare and Medicaid play an important role in the lives of many Americans when it comes to their healthcare. Right now, there are approximately 12 million people who have both Medicare and Medicaid, according to an AHIP report. They are more likely to have chronic conditions, greater levels of disabilities, mental and physical impairments and are more likely to need nursing home care than typical Medicare enrollees. While many are entitled to coverage under both programs, AHIP cites the problem that “care is uncoordinated and fragmented between two programs that were not designed to work together.” Dual-eligible special needs plans (D-SNPs) can help bridge this gap and offer the opportunity of enhanced benefits by combining those available through Medicare and Medicaid. And now, thanks to the Bipartisan Budget Act of 2018, SNPs are now permanent. Here are some tips on how to connect with dual-eligibles, often referred to as “Duals.”

#1: Be active year-round

Duals have a Special Enrollment Period, (SEP) that begins the month they become dually-eligible and exists as long as they receive Medicaid benefits. Moreover, this SEP allows them to enroll in, or disenroll from, a Medicare Advantage plan once per calendar quarter during the first nine months of the year. As such, it’s important to be active throughout the year. Of course, when it comes to media tactics you’ll want to be as targeted as possible so you get the most out of your budget. Direct mail and paid search ads are both great for this purpose as, according to Deft Research’s 2019 Dual Eligible Member Study, “reading direct mail is the top shopping activity among Duals, followed by online research.” Other media tactics that can be targeted with some precision include transit advertising and social media. Tufts Health Plan in Massachusetts uses Facebook Live to educate beneficiaries on the ins and outs of Medicare.

#2: Focus on education and support versus selling

Many people already consider shopping for a Medicare plan to be a complicated process. Now add the dimension of financial assistance, and it becomes even more complex. This is just one of the reasons that you should focus on educating and supporting Duals rather than selling them. To that end, it’s important to simplify all information pertaining to eligibility requirements, plan options and enrollment. If you are effective in helping them understand the financial resources that are available, you will be well-positioned to earn their trust and business. Surprisingly, the Deft study found that only 10% of low-income seniors who applied for assistance were steered by a health plan representative, and agents accounted for just 7%. In contrast – and at the top of the list – nearly 20% were helped by someone at a social service or health agency. Clearly, health plans could do a better job on this front. It would be wise to be very intentional about staffing and training of sales reps, making sure they’re well-suited to serve Duals. It would also be worth looking for brokers/agents that are serious about the Duals market and making sure they’re properly trained.

#3: Engage with community resources

Grassroots and community-related marketing efforts are both key ways to connect with this audience, as noted in FierceHealthcare by the general manager for SCAN Health Plan. She recommends becoming a trusted member of the communities that your health plan serves and to communicate by sharing information in a way that makes your plan a health resource. Ideas include hosting town halls and health fairs in different local communities. Health plans can also set up booths at community events and become event sponsors. Perhaps the most effective way to connect with Duals is by partnering with community-based organizations (CBOs). A great example of this can be seen in what SCAN Health Plan did when it contracted with Aunt Bertha, a network of resource providers, to develop Community Connections, which is an online community resource directory and referral system. The site helps users search for free or reduced cost food, housing, transportation and more.

The dual eligible population is very diverse… and growing! According to The Gorman Health Group the D-SNP market should double (again!), exceeding 5 million, by 2021. We’ve already looked at a few D-SNP direct marketing tactics from leading insurers. Looking to launch (or grow) a D-SNP plan? Let’s connect! Contact Jim McDonald, Director of Business Development at 518-456-3015.

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