A Medicare Advantage Dilemma

[scottfree]

Re: A Medicare Advantage Dilemma …

Appreciate the feedback guys and gals, and I must say I was the most worried about Franks response LOL.

The PFFS plan Im talking about is one of Coventry's Advantra Plans...

What has been your guys experience with them?

Coventry in my neck of the woods has been one of the most consistent for PFFS in my area of MO. I work the SW corner of Missouri (but mostly NW AR) and last year I did have about 10 clients go on their MA only plan and a separate Rx plan mostly because they were LIS and only had to pay around $2 for their drug plan. They were not as strong in AR. My only problem with them was they are slow to pay commissions.

This year they have an excellent $0 PFFS and an even better $0 PPO. The only problem is that the PPO is Joplin based and most come down to the Drs. and Hospitals in AR.

Even though they are slow paying me, they will be for both AR and MO one of the top 2 options for my clients that need a $0 premium plan.

If you do call some providers and they will bill Coventry, and they do have good benefits in your area I wouldn't have any problem enrolling clients on their plan.

 

[Hank]

Here in Upstate and Western New York, Coventry Advantra Freedom 4 is one of the best PFFS plans for people. Closely followed by Wellcare and Today's Options.

Most people would rather have them and add a Hospital Indemnity Plan than have a Med Sup. It saves them money.

Make sure your MD's accept it before you sell it and you'll be OK !

 

[jdeasy]

Here in Upstate and Western New York, Coventry Advantra Freedom 4 is one of the best PFFS plans for people. Closely followed by Wellcare and Today's Options.

Most people would rather have them and add a Hospital Indemnity Plan than have a Med Sup. It saves them money.

Make sure your MD's accept it before you sell it and you'll be OK !

PFFS plans are fantastic here in Western Ky and Southern, In. They are all accepted universally. I don't have to call doctors anymore as I know it's accepted.

The point that Frank keeps making, and it's a valid point, is that all those doctors, hospitals and medical facilities could wake up tomorrow and decide to not accept them and there is nothing we, or the clients, could do about it. Now, is that going to happen? I don't think so, but, it's an unknown and it's not an SEP for the members if it did happen.

That's one of the reasons behind CMS's move to do away with the PFFS and steer people and plans into PPO and HMO plans. If the providers would join those plans, I would be all for it as they are easier to explain and gives the client a small measure of guarantees. The problem fo my part of the country is that providers will not join and we will have only the choices of original medicare with or without a med sup and for the poor, medicaid.

 

[dandan]

nasty

 

[Dowejonez]

No dilemma I can see. YOu mean cuz you'll have to rewrite all those HMOs? Poor baby. Haha. I feel one of the most important steps in placing this type of business is calling their providers to make sure. Then explain the difference between the PFFS and managed care options to your client as you should anyway. I'm in agreement with the poster above that I doubt a Dr will pull out in the middle of the year. If they do, they often will grandfather existing coverage in till years end. If at all possible....I'll write a stand alone PDP just to give myself the option to change their health through March. The worst thing about this is you leave the door cracked open for another agent to come in behind you to rewrite your MA a little easier. I mean 90% of the time Humana Enhanced with the best MA is the best for them anyway. What I sweat out the most is which combination of hosp stay copay / OOP max they should have . A crap shoot to say the least.