2025 AEP for PDP - Process

[Yagents]

I agree, if every plan has 2k OOP, and they have to pay 60% after catastrophic phase, not many ways to cut expenses. So pdp commish can easily be on the table when they really don't want this ugly biz in 2025 to begin with. Writing is on the wall with MOO and BCbS AZ running away from pdp market. Only 4 carriers left in AZ.

I see it being pretty easy. Match up drugs to formulary and pharmacy. Most ded, coins, and OOP structures will be similar. Tell them to avoid payment plan if possible.

Send clients instructions a manual on how to do it on their own in their mc.gov account, for those on no rx or generics, pick lowest premium pdp. Call if you have questions. Avoid those commercials and links promising the world w mapd

 

[somarco]

@BK64 run reports like you normally do, give them to your client, encourage them to ask questions. Enroll them via mcare dot gov and send them a copy of the submission form. Keep a copy of the "app" + submission form for your files along with any notes, email, PDP reports.

 

[Special Agent]

@BK64 run reports like you normally do, give them to your client, encourage them to ask questions. Enroll them via mcare dot gov and send them a copy of the submission form. Keep a copy of the "app" + submission form for your files along with any notes, email, PDP reports.

yes but technically you are commiting fraud when submitting on beneficiaries behalf if you read the disclaimer on medicare.gov

 

[hockeyday]

yes but technically you are commiting fraud when submitting on beneficiaries behalf if you read the disclaimer on medicare.gov

Ya publicly telling people to do that , which is obviously what he does is one of the dumbest thing I have ever seen someone admit too

 

[straightnochaser]

I haven't seen anything that says PDP commissions will be zero. Right now they will be $109 and $55 per CMS for 2025

CMS sets a maximum commission it doesn’t say that commissions HAVE to be paid.

 

[somarco]

I am the person joining the plan (or I am helping the person join the plan)

 

[sshafran]

I am the person joining the plan (or I am helping the person join the plan)

Yep, I'm not sure where they're getting that you can't do it. You are helping the person join the plan. That's not fraud.

 

[sshafran]

yes but technically you are commiting fraud when submitting on beneficiaries behalf if you read the disclaimer on medicare.gov

Source? So we can't help people enroll?

 

[rmhaire]

Yep, I'm not sure where they're getting that you can't do it. You are helping the person join the plan. That's not fraud.

Not just PDP but also Medicare and Social Security.

 

[Millwood]

2025 you will have to put down your NPN number if you are an agent assisting. Maybe for 2025 season.