Dr. Oz says commission churning for MA plan is big issue

Yeah… it's not beneficial for newbies to know that door knocking is a CMS violation. Newbies are better served by conversations about politics, doctor shortages, Americans burning through their savings, wegovy not being cost effective, the price tags of the IRA, and other such conversations.

Y'all are a joke… lol
1) Politics affects health care and insurance/medicare/medicaid policies (and social security which affects the income people have to pay for premiums, health care, meds, procedures, etc.).
2) Doctor shortages affects access, which in turn may or may not affect accepting OM or MA's if they have more than enough patients with insurances that pay at a higher rate
3)Burning through savings may affect medicaid access thus whether or not they are dual eligible and whether or not, if they have health enough problems that OM + supp is a better choice due to premiums +MOOP could well be less
4) Wegovy, with how expensive it is affects how much the "D" portion needs to eat and thus figure out how to pass on (so other drug prices) since those people will hit the $2k early in the year and the D's need to "eat" the rest. Then they need to figure out how to pass those losses along to the rest of the people on D to cover it, then other drugs become unaffordable to some people on D whether or not they are on OM
5) IRA's are related to senior income overall which affects whether or not the lower income ones have the money to access health care, pay higher premiums or higher MOOP's of the MA's, afford their meds which affects their health, which can drive up health care costs as they access it more thus drive up premium costs...

Understanding the environment in which seniors live helps us understand what may affect their choices and what choices may work best for them.

And yes newbies need to know what they can or can not do as well as these other things, Both serve all of us as it may not just be newbies, for example, knocking on doors, and everyone who sells OM supps or MA is affected by what is going on that can affect what we sell or us selling those things.

The name calling and trashing of others that goes on in some of these threads by a subset of the forum membership is not helpful for discussion or for anything else. That should end.
 
Last edited:
1) Politics affects health care and insurance/medicare/medicaid policies (and social security which affects the income people have to pay for premiums, health care, meds, procedures, etc.).

A new agent doesn't gain anything from discussions on politics on an insurance forum.

2) Doctor shortages affects access, which in turn may or may not affect accepting OM or MA's if they have more than enough patients with insurances that pay at a higher rate

Totally irrelevant to an agent. All you're responsible for is checking their doctors and rx, not explaining why a beneficiary may have to wait months before being seen a doctor.
3)Burning through savings may affect medicaid access thus whether or not they are dual eligible and whether or not, if they have health enough problems that OM + supp is a better choice due to premiums +MOOP could well be less

Again.. TOTALLY irrelevant to an insurance agent helping a client with their insurance.
4) Wegovy, with how expensive it is affects how much the "D" portion needs to eat and thus figure out how to pass on (so other drug prices) since those people will hit the $2k early in the year and the D's need to "eat" the rest. Then they need to figure out how to pass those losses along to the rest of the people on D to cover it, then other drugs become unaffordable to some people on D whether or not they are on OM

Again… we are INSURANCE AGENTS… not doctors are pharmacists. This isn't a conversation an insurance agent should be having with a beneficiary. We don't advise on the efficacy or cost effectiveness of drugs. We only confirm their coverage.
5) IRA's are related to senior income overall which affects whether or not the lower income ones have the money to access health care, pay higher premiums or higher MOOP's of the MA's, afford their meds which affects their health, which can drive up health care costs as they access it more thus drive up premium costs...

lol… yeah… you're just arguing to be arguing. You don't even know what I'm talking about.
Understanding the environment in which seniors live helps us understand what may affect their choices and what choices may work best for them.

That's why you hold an appointment with the beneficiary. To understand their situation. Nothing you've mentioned aids in that process.
 
The name calling and trashing of others that goes on in some of these threads by a subset of the forum membership is not helpful for discussion or for anything else. That should end.


You are only bothered when some posters call particular posters names. Your buddies do it all the time and you say nothing. You're a hypocrite. I don't care for your opinion. You can save your time and effort. I think you are a joke that simps for certain posters. I don't take you seriously.
 
A new agent doesn't gain anything from discussions on politics on an insurance forum.



Totally irrelevant to an agent. All you're responsible for is checking their doctors and rx, not explaining why a beneficiary may have to wait months before being seen a doctor.

Again.. TOTALLY irrelevant to an insurance agent helping a client with their insurance.

Again… we are INSURANCE AGENTS… not doctors are pharmacists. This isn't a conversation an insurance agent should be having with a beneficiary. We don't advise on the efficacy or cost effectiveness of drugs. We only confirm their coverage.

lol… yeah… you're just arguing to be arguing. You don't even know what I'm talking about.

That's why you hold an appointment with the beneficiary. To understand their situation. Nothing you've mentioned aids in that process.
These things are not irrelevant to an agent. If you are, for example, trying to find a MA plan with doctors in network and there are far fewer doctors, it may be harder to find a plan that has other things they want if many more systems don't take MA's or OM, only take one MA rather than many, etc. due to low reimbursement and thus want to limit how many people they treat who have lower reimbursement plans.

I am not going to continue to argue with you as arguing seems to be your best skill - you practice it a lot. I taught college business in a previous career and the industry context affects everything in that industry. The insurance options in OM and MA in the health care industry, of which medical insurance is a part of that, is no different. Health Insurance (nor anything else) does not exist in a vacuum and it behoves us to understand the factors that can affect the things we sell and the people we sell it to.
 
Last edited:
Back
Top