I Feel Like I Am in "Low Income Subsidy Hell"

Mar 6, 2016

  1. wehotex
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    I would say that about 60% of my MA business is LIS or Medicaid-entitled. I've put many, if not most of those people on the "help" myself. Yet, I am stunned (and sometimes downright butt hurt) when I find that they switch over to other MA plans with another agent. I'm not referring to recent Enrollees, but LONGTIME members who I have dutifully serviced for some time (years) IF they call me with their issues. I've lost the majority of them during the AEP when other agents come out of the woodwork. I can't get around to all of them and miss some during that busy time. I've considered some of the longtime ones to be "safe" and always "thought" that they would call me FIRST, but not so. I've had them leave D-SNP plans with ALL $0 to "regular MA plans" with COPAYS that utilize the SAME network! It seems really stupid on the member's part. I keep the overwhelming majority, but am shocked at some of the ones that I lose. I also get some of them back eventually. Is there a better way to retain these folks or is it just the nature of the market that I work?
     
    wehotex, Mar 6, 2016
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  2. jacobtn
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    Unfortunately that's the way the LIS folks roll. Happens to all of us.
     
    jacobtn, Mar 6, 2016
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  3. policy doctor
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    I don't like this market either...this group does switch because of their low income.
    You never know which benefit becomes important to them at a given time....could be the 0 or $5 copay to PCP or 0 drug cost for 3 month mail order.

    I'm also getting more complaints from the PPO/premium plans. Mainly either dr won't take plan or drugs cost or unhappy with dental.

    I think once you reach a " critical mass" your ratio of disgruntled clients increases.
     
  4. TDS551
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    I once helped a blind woman who lost her Qmb. She was hours away and I even hand delievered her qmb app to the medicaid office. 3 months later another agent rolls in and switches her out of the D-snp. I then started mailing out QMB forms becausr here in Mo. they wouldnt accept them until the month before an effective daye, and I'd say 1 out of ten actualy followed through. Unfortunately theres a reason why alot of these people are destitute.

    its a shame, because when you get someone all that extra help you actually feel good about what we do.
     
    TDS551, Mar 6, 2016
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  5. TDFnCali
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    Go after T65 with a lil higher income (above 25k for instance), that will get your duals to a lower %.... 60% is too high. I'd guess mines is about 25%.
     
  6. sshafran
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    I don't think there is a better way to deal with them... You'll continue to retain the vast majority of them, but a few will fall off.

    I used to wonder what I did wrong when someone switched without calling me first. I thought it had something to do with my ability to sell and/or service.

    But it doesn't, really. If CMS laws were not in place, you could easily call x-client and get them back. Almost guaranteed. But, since it's a CMS no-no, they are really tying your hands, so it's not a reflection on your ability to retain!

    I guess you could reach out via letter - and maybe we should... but I'm not sure if it's worth spending a lot of time on....
     
  7. Chazm
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    This is what I have done in my area. I now market $30k and above. Medicaid appts have dropped substantially
     
    Chazm, Mar 7, 2016
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  8. MedicareAgent
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    I too go through this, do not take it personally. If you were in their shoes, you would switch to better your situation too. You are doing the right thing for them at the time and thats all you can do.

    I have even gone so far as to call my snps every month or so to "check on them" to retain them and its just not worth it to be honest with you. We end up being social workers instead of agents.
     
  9. LilT
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    Unfortunately it is the nature of the human phsychie. We worry about what we did not do good enough. the client has the same issue in a different way. Did they choose right, is something better, Part of it is that most of these folks are more lonely and will talk to anyone that shows them a new shiny thing that they can have. Plus they feel like their needs change more often and they need something different. Just keep a handle on the ones you can control and add some $30 and up folks. :GEEK:
     
    LilT, Mar 7, 2016
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  10. wehotex
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    I often joke that I AM a social worker. Thank you all for your comments!! It's odd that so many of the switchers are actually "worse off" with their new plan than what they had before. They just don't know it. Gawd bless em.
     
    wehotex, Mar 7, 2016
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