2010 MAPD Plans...Oh My

[insurance0707]

I just saw the new premiums for 2010 MAPD plans for a major carrier in our state and they are high. This carrier used to offer 4 MAPD plans, they've limited it to two plans for 2010. Just wondering, for people that were enrolled in the other 2 plans that are ending, will they have a SEP to go to any other carrier on a guaranteed issue basis or because there's two other plans to choose from, will they not have a guarantee issue with other carriers?

Anyone else seeing the new premiums or copays for 2010?

 

[Tom Highway]

I thought that MAPD, by definition, IS a guaranteed issue. As far as I know, the only thing that would preclude someone from getting on a MAPD plan is ESRD.

I thought that AEP was for just this type of situation.

Also, how are you seeing the rates before Oct. 1?

 

[jdeasy]

I just saw the new premiums for 2010 MAPD plans for a major carrier in our state and they are high. This carrier used to offer 4 MAPD plans, they've limited it to two plans for 2010. Just wondering, for people that were enrolled in the other 2 plans that are ending, will they have a SEP to go to any other carrier on a guaranteed issue basis or because there's two other plans to choose from, will they not have a guarantee issue with other carriers?

Anyone else seeing the new premiums or copays for 2010?

Yes, the speacial SEP that begins Oct. 1 and runs thru Jan. 31, 2010 would apply to those plans that are ending. Of coure, they don't need an SEP to go toanother MAPD during AEP. They would also have the GI right to a med sup.

Personally, I wouldn't use the speacial SEP just because of the timing and the sure to come enrollment/disenrollment problems with CMS and the carriers, but, it is there is you and/or the clients chose to use it.

 

[insurance0707]

I thought that MAPD, by definition, IS a guaranteed issue. As far as I know, the only thing that would preclude someone from getting on a MAPD plan is ESRD.

I thought that AEP was for just this type of situation.

Also, how are you seeing the rates before Oct. 1?

I was talking about a SEP for Med supp not Med advantage.

Some of the insurance companies are showing their rates and copays on MAPD plans before 10-1-09, you just can't mention it to your clients

 

[Tom Highway]

I was talking about a SEP for Med supp not Med advantage.

Some of the insurance companies are showing their rates and copays on MAPD plans before 10-1-09, you just can't mention it to your clients

Sweet.
I didn't mean to insult you or anything, btw. I hope I didn't come off sounding condescending or anything - sorry if I did, ok?

 

[jdeasy]

I was talking about a SEP for Med supp not Med advantage.

Some of the insurance companies are showing their rates and copays on MAPD plans before 10-1-09, you just can't mention it to your clients

For a med sup, you could use the SEP and disenroll them as early as Oct. 31 and the med sup could start Nov. 1. You will need the letter from the plan that it is ending to send to the med sup company for the GI.

I still wouldn't use it. I would let the plan run out on Dec. 31 and start the med sup on Jan. 1. I just see too many potential problems with CMS and the current carrier getting them disenrolled before Dec. 31. If they are not disenrolled properly from the MA plan, their med sup won't pay. Of course, they would have to pay retro actively after the problems were fixed, but, you would have very unhappy clients during the interim. I'm moving several of my Wellcare and Coventry clients to med sups and we have already discussed waiting until Jan. 1 for effective dates of the med sup. I've warned them that others will be contacting them telling them not to wait. So far, they all seem to agree with me.

We have already had Humana agents out there trying to get people to switch to the PPO before the end of the year.

There may not be a problem with early disenrollments, but, experience tells me otherwise.

 

[MedSuppPro]

For a med sup, you could use the SEP and disenroll them as early as Oct. 31 and the med sup could start Nov. 1. You will need the letter from the plan that it is ending to send to the med sup company for the GI.

I still wouldn't use it. I would let the plan run out on Dec. 31 and start the med sup on Jan. 1. I just see too many potential problems with CMS and the current carrier getting them disenrolled before Dec. 31. If they are not disenrolled properly from the MA plan, their med sup won't pay. Of course, they would have to pay retro actively after the problems were fixed, but, you would have very unhappy clients during the interim. I'm moving several of my Wellcare and Coventry clients to med sups and we have already discussed waiting until Jan. 1 for effective dates of the med sup. I've warned them that others will be contacting them telling them not to wait. So far, they all seem to agree with me.

There may not be a problem with early disenrollments, but, experience tells me otherwise.

Once again I agree with JD. Except I'm taking my "A" clients and moving them early. Makes my work a whole lot spread out.

An "A" client is one that I already know wants to move to a MedSupp. They will know the potential problems with early release and we can work through it. If we need to bump up a month, my MedSupp carriers will work with us.

​

 

[policy doctor]

Another reason why I hate this business. You bet your biffy that these clients are being contacted NOW to change in Oct once they get those letters.

Heck I've warned some new prospects about this myself and told them to take care of buiness soon as possible. Why wait? Esp if you won't renew with the same carrier they'll undersell you. Easier for senior to renew their plan with an existing co once they get CSR calling them.

Hey this group doesn't even buy green bananas you think they'll wait on you to show up with Santa during Christmas to change them?

Haven't you noticed the frequency of Humana Med Advantage ads already? Yeah they're waiting alright...lololol

 

[MrMack]

Also, how are you seeing the rates before Oct. 1?

Ritter has most of the rates on his website. The only one he doesn't have is Humana yet.

www.ritterim.com

 

[Ice Cold]

As far as I know, the only thing that would preclude someone from getting on a MAPD plan is ESRD.

Yes, End Stage Renal disease and that's it.