How many of your clients MAPD plans are being dropped?

[sshafran]

Sounds like you guys in Florida are business as usual. I only have 33 MAPD plans with Humana and 14 of those need replacing. I am surprised @DonP your numbers aren't higher in being axed. I feel you though on having to shop the others.

The 14 - are they losing coverage or are they just becoming junk plans?

 

[Midlevel]

17 with UH.

 

[InsuranceGuy29]

For people losing coverage due to service area reduction - I know of 30 so far; 28 Aetna, 2 UHC. I haven't gone thru Humana's list yet but I don't think there will be a lot of SARs with them for me - but boy are they raising the Max OOPs on most of my book - some double.

Those 30 will be getting calls from me for sure.

I haven't 100% decided how aggressive to be with the higher MOOPs yet. In the past I usually have a "Passive AEP" mentality - i.e. I send them (a) a letter and (b) an e-mail and offer a review and put it in their court - I don't call them.

I know the 30 losing coverage - I'm calling and being very proactive.

The other 100+ where their Max OOP is going higher... not sure how to handle them - I'll probably do some extra reaching out but I really think those can be kept "passive" during AEP (since many will call in) then maybe get more aggressive during OEP.

With the higher MOOP's just remind them that only 1.8% of people ever even hit that (when it was lower) because the copays are so low. Even with people that are really sick, they gotta try pretty hard to hit that, given the way the program is structured.

 

[kak6407]

The 14 - are they losing coverage or are they just becoming junk plans?

How do I tell? I have just looked at their plan number and I don't see it available in their county next year so I am assuming they are losing it??

 

[DonP]

How do I tell? I have just looked at their plan number and I don't see it available in their county next year so I am assuming they are losing it??

Your state reps should have printouts of state showing sars with Humana. Aetna reps in my area worthless

 

[sshafran]

How do I tell? I have just looked at their plan number and I don't see it available in their county next year so I am assuming they are losing it??

That's probably a good indication that they're losing the plan.

Sometimes - the plan number changes. Our Regional NC MPAD RPPO is changing plan numbers but it'll still be available - it's hidden at the bottom of the Humana first look. I had e-mailed my rep and asked her since I didn't see it
R1390-002 > R0110-005


I wasn't sure if you were planning on calling people who also had increasing MOOPs (i.e. plan is still available but MOOP goes from $3,600 to $6,750).

Obviously if they're losing the plan outright, we need to be more aggressive.

 

[kak6407]

I wasn't sure if you were planning on calling people who also had increasing MOOPs (i.e. plan is still available but MOOP goes from $3,600 to $6,750).

Not planning on calling them. It will be as you said more passive. if they reach out to me then we'll go from there. I will be reaching out to the ones where the plan number isn't listed.

I'll do some digging on the plan number changes to see

 

[kak6407]

I'll do some digging on the plan number changes to see

Looks like 4 of them are "Legacy" so I guess they are still in place just not being marketed/sold. Probably would be good to go ahead and move them.

 

[Russ]

Hoping Q1 Medicare has 2025 info soon. You can easily check what plans are being moved or eliminated. You would think Humana would already tell us.

 

[sshafran]

Not planning on calling them. It will be as you said more passive. if they reach out to me then we'll go from there. I will be reaching out to the ones where the plan number isn't listed.

I think that's solid.

Good balance between helping but not caring more than they do.