Evercare MAPD Plan for duel eligibles

[retread]

Just an update since I posted last May on this subject:

Ovations (subsidiary of UHG) offered a seminar here in KC last fall, which I attended. The main offering was the AARP co-branding of products for 2008. Agents are allowed to contract through an FMO, which I did.

AARP co-brands UHC's Med Supp, UHC/SecureHorizons Medicare Complete and Medicare Direct plans, and a PDP (as well as an under-65 indemnity plan).

NOT co-branded is UHC's SecureHorizons' MA and MAPD plans or Evercare's SNPs.

Evercare has a Dual Eligible SNP (DP) and a Chronic Illness SNP (MP) in my area. Other areas have additional/other offerings. The DP is fully co-ordinated with Medicaid. The MP covers 8 chronic illnesses this year, which the prospect must have at least one.

Commission is set by contract through your FMO: mine is $400.

SNPs can be sold year round. I call on assisted living facilities, as well as use telemarketing.

I also sell Care Improvement Plus, but it is Missouri only (for me). Additionally, I carry Coventry's SNP, which is new this year, but limited to just several counties in KS and MO (for me). Evercare covers both Kansas and Missouri (for me). There are some advantages of one over the other in different situations. Having 3 SNPs lets me offer the best one for that individual. All are managed-care plans. Yes, I agree we are going to see more of these each succeeding year. This was part of the plan in the 2003 MMA.

I also sell Med Sups, MA/MAPDs, and other health insurance and PDPs through about 9 different carriers. The smorgasborg I offer allows me to find the best fit for the prospect. This is the goal of an independent agent.

 

[Winter_123]

Evercare has a Dual Eligible SNP (DP) and a Chronic Illness SNP (MP) in my area. Other areas have additional/other offerings. The DP is fully co-ordinated with Medicaid. The MP covers 8 chronic illnesses this year, which the prospect must have at least one.

SNPs can be sold year round. I call on assisted living facilities, as well as use telemarketing.

Can you give us a sense of how you work with assisted living facilities. In my state Evercare also has an institutional SNP in addition to the chronic care SNP but I gather that you are talking about just the chronic care one. How do you work with the assisted living facilities logistically. You set up a meeting and you have family members as well to help with those who are moderately impaired? How do you work it when their primary care physician is not in the network. Is that a showstopper or you are able to get them in or what?

Thanks.

Winter

 

[retread]

I work through the person responsible for event scheduling. You have to know the facility's residents. By that I mean that they vary widely in mental awareness.

Some are full of savvy seniors, others are barely conscious. If the facility has mentally impaired residents, I ask that we schedule a seminar and invite the adult children of the residents (they are the ones making health care decisions for their parents), and while presenting Medicare plans, speak to some issues of LTCi. Usually the adult children are much more interested in LTCi for themselves, since they are witnessing what is happening to their parents. Also, they want to know how they can cut costs for their parent's health care, so they listen to the SNP offer.

 

[Winter_123]

I work through the person responsible for event scheduling. You have to know the facility's residents. By that I mean that they vary widely in mental awareness.

Some are full of savvy seniors, others are barely conscious. If the facility has mentally impaired residents, I ask that we schedule a seminar and invite the adult children of the residents (they are the ones making health care decisions for their parents), and while presenting Medicare plans, speak to some issues of LTCi. Usually the adult children are much more interested in LTCi for themselves, since they are witnessing what is happening to their parents. Also, they want to know how they can cut costs for their parent's health care, so they listen to the SNP offer.

Thanks. So how is it going in general with the assisted living market? Is this highly labor intensive for a onesy -twosy sale or is it better than that. You try to come back once every six months or so or how do you work that? Also, what has your experience been in getting a doc into the network. Is that a long cycle or can Evercare just call them up and give them the info and make it happen if they are interested.

Thanks again.

Winter

 

[fostever]

Why would anyone sell these lousy benefits? For instance, Inpatient Hospital days 1-16 $250 co-pay per day NO ANNUAL MAX. ARE you out of your mind? Medicare deductible $1024 days 1-60. O.K. maybe this would help someone who is inpatient for 4 days or less or in a coma over 60 days but that's it. Isn't the whole idea of an MA plan to cut down on OOP costs? They have to stay in network and have a possible huge bill for a 2 week stay. My plan is $175 for 3 days and $1500 oop Max/year. We have a former agent who is selling this and just telling them he needs to update their file for 2008. He also tells them our plan was bought out by Evercare and he needs to sign them with the new company. He's a rogue agent that gives everyone in this market a bad name.