Calculating Open Enrollment

[bourbonlegend]

I don't even bother taking a part D app from a new client taking lots of drugs. I take their list of drugs home with me then run it through med.gov. The next morning (or later that afternoon) the client gets a call from me with the name and # of the plan that best fits them. If it's one of the plans I carry then great.

I NEVER put a client into a MA/MAPD plan unless they aren't healthy enough for medigap or they simply can't afford medigap. If a client insists on ma/mapd then I'll write it but I don't like doing it.

 

[MedSuppPro]

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Can you give me one instance where an MAPD would be better for the client than a stand alone MA and a stand alone PDP? If you are doing all this expert service, you should be able to come up with one instance.

It would seem that the one not doing due diligence is the agent that's slamming people into MAPD plans under the guise of doing the right thing.

Thanks for the slamming part...

As in 2008, MAPD were underpriced by alot of carriers and some of that marketing prowless poured into the 2009 plans. Going into 2010 I doubt the MAPD "Combo" plans will have that sizzle.

Sure I'll give you an example:​

A T-65 prospect came to me with no prescription drug usage and one office call per year Hx. When I quoted her the MedSupp PDP combo she became agitated and declared she would rather go without coverage. She defiantly stated: "I'll let the government take care of me"!

When I showed her an MAPD zero premium plan she was all over it. She was so happy to get prescription drug coverage and didn't have to worry about the 1% penalty.

Did I slam her? Did I give her 3 or more choices? Did I do the right thing?

JD there's plenty of room at the table for your happy butt , but, it appears ya don't like Bud nor Red Stripe! Do ya like Falstaff instead?

 

[policy doctor]

Can you give me one instance where an MAPD would be better for the client than a stand alone MA and a stand alone PDP?

Sure...people who have very little/none drug usage (generic mainly) and in good health and can't or won't pay med supp premium. Why pay $38/mo for a drug plan when you're paying $4 per generic drug at Walmarts?

 

[jdeasy]

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Thanks for the slamming part...

As in 2008, MAPD were underpriced by alot of carriers and some of that marketing prowless poured into the 2009 plans. Going into 2010 I doubt the MAPD "Combo" plans will have that sizzle.

Sure I'll give you an example:​

A T-65 prospect came to me with no prescription drug usage and one office call per year Hx. When I quoted her the MedSupp PDP combo she became agitated and declared she would rather go without coverage. She defiantly stated: "I'll let the government take care of me"!

When I showed her an MAPD zero premium plan she was all over it. She was so happy to get prescription drug coverage and didn't have to worry about the 1% penalty.

Did I slam her? Did I give her 3 or more choices? Did I do the right thing?

JD there's plenty of room at the table for your happy butt , but, it appears ya don't like Bud nor Red Stripe! Do ya like Falstaff instead?

My observation wasn't a personal one towards you. I don't even know you, so, I couldn't know if you are one of the agents that don't do due diligence and just slams people into whatever they have.

Surely you know that happens. I suppose in the case where a person can only get a $0 premium on a PDP is by going with the MAPD would be an exception to enroll somone into the MAPD. Of course, that person may very well qualify for an LIS and get a PDP for $0 anyway without being burdened with the restrictions of an MAPD.

I have many clients that love Wellcare's MA plan, but, not their PDP. I have helped them get into whatever PDP plan that has all their meds in the formulary. It doesn't matter whether I represent that company or not. I've helped many get enrolled in Silverscript and I've represented that comapny. I've helped many get on the line with Medicare and let Medicare enroll them in the best PDP for the person. If they were tied to an MAPD, you couldn't do that.

I hate Humana with a passion, but, occasionally, their PDP formulary is the best for the client. I help them get into that stand alone PDP. No way would I ever put someone or help someone get into Humana's MAPD.

As for beer, my favorite is YuengLeng, but, since it's not available here, I generally go with Coors. But, Bud Light is just fine if you are buying.

 

[MedSuppPro]

Of course, that person may very well qualify for an LIS and get a PDP for $0 anyway without being burdened with the restrictions of an MAPD. Her income as a T-65 just retired is not going to get her LIS and she has few restrictions. For 2010 we will look at her options.

... I have helped them get into whatever PDP plan that has all their meds in the formulary. It doesn't matter whether I represent that company or not. I've helped many get enrolled in Silverscript and I've represented that comapny. I've helped many get on the line with Medicare and let Medicare enroll them in the best PDP for the person. If they were tied to an MAPD, you couldn't do that. I'll do exactly the same thing. In fact tonight I'll see a gentleman whom will be walked through the 1-800Medicare process of enrolling in his best PDP for 2009. I've spent over 2 hours on this complex case. I will get the MedSupp portion only.

I hate Humana with a passion, but, occasionally, their PDP formulary is the best for the client. I help them get into that stand alone PDP. No way would I ever put someone or help someone get into Humana's MAPD.

... we are on the same page... I hate Humana with a passion!!! Death to Humana!