A dying agents warning ‼️

[wyche1]

OK I have a unique situation. I own a brick and mortar Medicare agency in my home town that my wife ran for years. She made every client come in and meet with her face to face in the office. That attracted a higher income demo than most Medicare agents work with.

She sold 85% Med sups to 15% Advantage plans.

This year I am helping out in the office more and I am trying to cross some of them over to Advantage plans that have been calling in with their rate increases. (Med sup people always think they can only change during AEP no matter how many times you explain it to them.)

Hardly any of them will consider Advantage. I have one today that will change over. But it's hard to get people on Original Medicare to even consider it. They all have a "friend" on one of those Advantage plans with a horrible experience.

I'm a big believer in describing both and just going with what they choose. But I can tell you, people with a bit more money who are the type that want to come to an office rather than enroll over the phone or have an agent come to their home (and there is a huge number of these people who prefer the office) do tend to favor Original Medicare.

I'm in a similar situation as you. My issues with MAPD Plans:
I show both Med Supp & MAPD. Med Supp is about 82% of my book of about 600 Medicare clients (would be more but they keep dying). I would happily sell MAPD if the plans worked better in my area. Our local hospital was In-Network in 2016 & 2017 with only BCBS, BCBS bailed on my county in 2018 so our regional hospital was not In-Network with any MAPD plan in 2018. This was a QE which afforded clients a SEP back to Medicare+PDP+MED SUPP. In 2019 the hospital contracted with Humana, happy days, people again had options. The hospital left Humana 1/1/23 and hammered them in a letter to all MAPD patients stating due to denials, slow pay, constant appeals, etc. they were done with all MA plans. Humana still offered the same plans in my county so No QE, No SEP. Humana's $0 Premium plan Out of Network (OON) benefit had a co-insurance of 40% on almost everything except hospital & Dr visits which just have higher copays. NO ONE can have an outpatient surgery, MRI, PT, OT, etc. without paying 40% of the bill, however they can drive 70 miles and be in-network for that colonoscopy or knee scope, etc. I had 100+ clients with them, only about 30 of them could medically qualify and afford to roll to Medicare+Med Supp+PDP. 80 of them are stuck on a MAPD with a TERRIBLE OON benefit! The local hospital owns 93% of the doctors in my area and the outpatient surgery center, you have to leave town if you want In-Network benefits. Every Med Supp client knows at least one person who got screwed over in this fiasco. Of course they blame Humana and those "terrible Advantage plans" not the hospital that left the network.

Thankfully as of 1/1/25 our hospital is back In-Network with BCBS! Only BCBS & Humana offer MA plans in my county next year, only BCBS is In-Network. I'm happy to sell them (wrote one today) but I make sure the client understands it may be a forever choice they are making.

I have no issue with MA plans IF you are in an area with a lot of carriers to choose from and a lot of In-Network providers.

MA carriers are beholden to shareholders, Original Medicare is beholden to taxpayers. MA carriers need to make a profit to survive, Medicare/government can print money to survive.

If they bribe you to sell it and they bribe the client to enroll in it, is it really in the client's best interest?

Brick and mortar, in office appointments, 40 year veteran 3rd generation agent, my kid finally saw the light last year and quit his job as an engineer at Boeing moved back to his hometown and become the 4th generation agent.

Greatest job in the world!

 

[Midlevel]

This is not true. Good lord.

You're still in the Medicare program. You still have all the rights and protections that come along with having Medicare, but you will access your benefits through a private company with a Medicare contract. The plan has a network and there are rules. It is managed care. Your doctor may need to get permission before fixing you certain care.

That's not scary enough though so need to reword it. I have no idea why so many agents are against MA plans. I understand the ones who also do financial planning and P&C bc they don't want to bother with all the training. But the ones who call themselves Medicare agents make no sense to me, wouldn't you want to show the clients all their options? The only way to be 100% Med Sups is to try to scare people from taking anything else. Not sure why an agent would do that but to each their own I guess.

 

[rmhaire]

I have no idea why so many agents are against MA plans.

I've lost count of the conversations you and I have had on this over the last few years. But what the hell, what's one more.

It's obvious you prefer MA and it's obvious that I prefer OM. And we're both certified for both. So what's the difference?

One is that I'm on medicare. You're not. I prefer making my own decisions. Don't know about you.

Comparing the two is not scare tactics. Neither is stating the pros and cons of both. And both have pros as well as cons.

Our clients are grown-ass adults. Let them decide.

And BTW. Since you like golf. I'll play you for $100 a hole if you give me two Gotchas.

 

[Midlevel]

I've lost count of the conversations you and I have had on this over the last few years. But what the hell, what's one more.

It's obvious you prefer MA and it's obvious that I prefer OM. And we're both certified for both. So what's the difference?

One is that I'm on medicare. You're not. I prefer making my own decisions. Don't know about you.

Comparing the two is not scare tactics. Neither is stating the pros and cons of both. And both have pros as well as cons.

Our clients are grown-ass adults. Let them decide.

And BTW. Since you like golf. I'll play you for $100 a hole if you give me two Gotchas.

I would still lose, dropped 1200.00 on new Taylor Made irons and they don't work but they will not let me return them. lol

 

[rmhaire]

I would still lose, dropped 1200.00 on new Taylor Made irons and they don't work but they will not let me return them. lol

Back in the 80's I was working on a coffee machine at the local MacGregor plant when someone behind me asked a question. I turned around and it was Jack. (When he owned MacGregor)

I should have made him the same offer on the two Gotchas. I could be going around today telling folks that I beat Jack Nicklaus.

 

[LostDollar]

The ones like that are the hard-headed know-it-alls who think they have it all figured out.

I mean, no offense "Jane," but no matter how much research you've done, you still don't even know 1% about the industry or these plans.

They just heard some fear-mongering sensationalized nonsense and they are hard-headed and have their mind made up, regardless of what the truth is.

The people that come to me demanding a med-supp, I don't even bother trying to explain their other option anymore. They "know it all" and have it "all figured out," so they can enjoy wasting their money (in most cases).

Especially sad because I'm in a state where a carrier does absolutely zero underwriting for Medigap and will approve a unicorn with HIV.

Some people are just stubborn, stupid, and love wasting money to "feel" good. No, don't listen to the licensed expert advisor who does this day-in-and-day-out. Listen to Linda, your neighbor. Great strategy.

This sounds like a rabid rant by an insurance agent attempting to direct me to purchase a Medicare Supplement Plan.

 

[somarco]

I have said this before but it needs repeating.

Using attraction marketing techniques assures me that almost all of those who contact me have seen all the MAPD stuff and talked to agents who claim their plan is better without proof.

Most of my prospects have already decided they do not want MAPD and want to learn more about OM + Medigap . . . primarily because agents never explained it or simply dismissed it as "too expensive"

Sometimes they just say they want to understand the difference in the two options, so I point out the differences, good and bad, and let them decide. If they want MAPD I explain that I don't write MAPD and offer to refer them to an agent I trust.

Sometimes they call him, sometimes not. Not my problem.

I don't care which way they go but if they want the Medigap plan I expect them to let me be their agent. If I never hear from them I move on.

For some reason this year have produced a handful of folks who remind me that we talked some time ago and they need my help.

I remind them that I have no record of submitting an application for them and tell them, politely, they need to ask the agent they used to help them.


My "system" allows me to close xs of 95% of those I talk to and retain almost 100% year after year.

I don't have to offer both because the agents they talked to before contacting me did such a poor job of explaining options.

 

[MedicareWAA]

If you're on a MA plan and have an appeal, who handles that appeal? And if you're on a MA plan, can you still go to your state's ombudsman for help?

It starts with the plan. In 2035, the plan must process the redetermination request very quickly for certain high priority services.

As the process unfolds, there's the involvement of an independent review entity and eventually an administrative law judge.

 

[rmhaire]

As the process unfolds

And there's your problem.

If I ever find myself needing a heart transplant, I'm going to ask my doctor to get me one that came from an insurance company underwriter or claims processor. At least I'll know it's never been used.

 

[Ron Van D]

And all the while, as the appeal process moves on, so does the cancer growth.