Humana Medicare Advantage Question

[bluediamond]

Carriers are getting WAY too aggressive in snaking business away. Would be nice if CMS came down on them hard.

That will happen.

When pigs fly . . .

You're so right had a husband and wife call me last week and LIS they had someone from a call center representing UHC in November told them he was also representing Medicare got their Medicare numbers and enrolled them for December 1. Dr's appt last Tuesday and their doctor was not in network. I enrolled them back to Blue for Jan 1.

 

[fun2drum]

When calling Humana's customer service about anything, tell your clients to ignore the phone menu and press zero at the first prompt. Sometimes you have to press zero more than once, but it will eventually get them to a live person faster. BTW, yes it's a rule that agents can't cancel a Humana enrollment app that they've submitted. It has to be done by the member directly with customer service.

 

[sshafran]

The other OBVIOUS thing to have done rather than sit all day on the phone with Humana, would have been to enroll them in another Prescription Drug plan. If you do that, they are automatically disenrolled from the MAPD plan. It's the final plan you enroll in that sticks during AEP.
...
Experienced Medicare Advantage agents and brokers know a lot of stuff because we are held to a higher standard. We have to take a lot of certifications and tests for weeks!! That's why we make the big bucks.

Does it take experience to skim over the fact that the MAPD enrollment happened on 12/7?

Still advising that the OBVIOUS thing to do would have been to enroll them in a PDP?

 

[lifeismylife76]

AEP is from October 15 to December 7. You can enroll on December 7. It’s the last day to enroll.

This couple may have met with the agent before and decided to save some money and give MAPD a try at the last minute. It happens.

Does it take experience to skim over the fact that the MAPD enrollment happened on 12/7?

Still advising that the OBVIOUS thing to do would have been to enroll them in a PDP?

 

[somarco]

Couple of years ago I had a few clients call BEFORE 12.7 and ask if they screwed up. Got them enrolled in a PDP and everything went back to how it was before.

But also had one lady call me on 12/8 to tell me she enrolled her terminal husband in the same MAPD she had with $0 premium.

Discovered a few more in Jan when I got the termination notice from the carrier.

 

[myinsurebiz]

The other OBVIOUS thing to have done rather than sit all day on the phone with Humana, would have been to enroll them in another Prescription Drug plan. If you do that, they are automatically disenrolled from the MAPD plan. It's the final plan you enroll in that sticks during AEP.

Furthermore, there is a Special Disenrollment Period for new MAPD enrollees to switch back to original medicare.
And a special period for an enrollee who switches to MAPD from a Supp of 12 months where the Carrier is REQUIRED to take them back. It's a trial period.
And "OEP" is a thing in 2019 as well.

There really was no risk to this couple. There was however, a risk to your commission. Just sayin!!

Experienced Medicare Advantage agents and brokers know a lot of stuff because we are held to a higher standard. We have to take a lot of certifications and tests for weeks!! That's why we make the big bucks.

What in the world takes "weeks" for tests / certifications?

AHIP done in less than an hour.

Carrier Certs a few minutes each.

 

[T Sparks]

I would have let the Humana plan stay in place, BUT, on or just after 01/01/19
I would have explained to the client that if they indeed feel like they were misled to go ahead and file a complaint with CMS, If they were not misled then, help them enroll into a PDP. Personally I would have never ever written a Med Advantage on a 87 and 86 yr old with a Med Supp in place, also knowing that the couple has mobility issues and heart issues. Questions for the agent who would...
- What would you do if these folks and or their family members contacted you about the need for Skilled Nursing Care?
- What would you do, if they needed expensive DME. Durable Medical Equipment?
This is just a start, there are other issue with this case...But from MANY MANY years of personal experience in the retiree market,
Use common sense , and put the prospective clients needs first,
Do a good job and the referrals will flow. Also, if the agent did mislead
these people let them answer to CMS and Humana he or she will not last long.

 

[lifeismylife76]

What in the world takes "weeks" for tests / certifications?

AHIP done in less than an hour.

Carrier Certs a few minutes each.

WOW!!! You consider yourself a TOTAL BADASS!!! YOU ARE!!! Total Badass.

You complete all certifications, AHIP, and everything else you have to do to prepare for AEP in about 3 hours!!! Good for you.

This was my second AEP and I have hosted since March of 2017 more than 200 "events" and enrolled more than 400 Medicare Eligible Enrollees in various types of Medicare Products, primarily Medicare Advantage!!

I've been selling insurance full-time since 2012. I was a Paralegal for 14 years before that and a waitress for 12 years before that!! I also have two other small businesses...so I can safely say that I have met with or had one on one meetings with or some type of business interaction with more than 20,000 people. Way more than that if you consider all my jobs since I first started waitressing at age 13.

The ONLY REASON I am responding to this is because I have SEEN a THING or two, so I KNOW a thing or two.

Myself, AHIP takes time, all the carriers I represent....their certifications take time as I represent NO FEWER than 5 Medicare Advantage and 5 PDP Plans.

And because I have been a high producing Broker, I get a lot of opportunity for marketing dollars directly from the CARRIER. I AM A CLOSER.

HELLO, I am the B&@$$!!!!!! It all takes WEEKS OF PLANNING followed by WEEKS OF SHOWING UP AND DOING THE JOB.

It takes time because I have to arrange all the meetings, create compliant flyers, call the venues, spend my own money for rental fees, on and on.

SORRY - I don't believe you sell Medicare Advantage and are the BADASS YOU THINK YOU ARE.

I hate the way Agents and Brokers treat each other. If you knew what you were talking about in the first place, you would have backed me up...instead....you want to tear me down.

Good for you, BADASS.

 

[lifeismylife76]

I also must add that I was using “constructive criticism” in my initial response to the Orignal Poster/ Starter of this conversation. I was simply trying to share knowledge. You however, come off like a jerk.

 

[lifeismylife76]

What in the world takes "weeks" for tests / certifications?

AHIP done in less than an hour.

Carrier Certs a few minutes each.

Sorry, @myinsurebiz I am stil NOT IN AGREEMENT. Pay yourself those hundreds per month when you are NOT hospitalized, or past the 20th day for a rehab. Wow.... YOLO. You Only Live Once!!! #YOLO