I Won't Write that App !!

[Yagents]

I've started walking away from some business this year due to the "attractiveness" of HMO pricing in some counties.

I've had several clients with major health issues on PPO's now. Prices spiked quite a bit. We go shopping, only HMO's are cheaper. Start checking doctors, some on, some not in the network.

I look at their health history, and basically tell them they can go buy that HMO, but I won't be part of it. I'm not going to contribute to a client's deteriorating health care, or the need to change doctors, or the requirement for PCP referral, or lack of hospitals.

Same with families with kids who want a cheap HMO without Children's hospital in network. Disaster in the making.

And I'm so tired of hearing: "I don't expect any major health issues next year", and don't need to pay for a PPO plan.

Send me the wealthy and the UN-healthy.........they value PPO's. The rich can afford the best, and the sick know they need a PPO.

 

[Ann H]

I agree with that!!!!!!!!!!!!!!!

 

[AllenChicago]

YAgent's post describes perfectly the pitfalls of HMOs, and why we as agents should take the time to comprehend the implications of HMO restrictions.

I "rescued" two families last week from HMO-hell. While their primary doctors were in the HMO network, the referrals to specialists for ongoing treatments forced them to drive 40 and 70 miles, respectively.

Our colored company has gone so far as to force applicants to read and sign a section at the end of the online health insurance application attesting that they understand the restrictions of the HMO plan they've chosen. In addition, they receive a phone call informing them of the restrictions.

 

[HealthGuy]

Ok, but what about UHC, who has a big big network but you have to sell the plan with a PCP who has to give referrrals in network for anything and everything? Will you sell that?

 

[FLM2]

I've started walking away from some business this year due to the "attractiveness" of HMO pricing in some counties.

I've had several clients with major health issues on PPO's now. Prices spiked quite a bit. We go shopping, only HMO's are cheaper. Start checking doctors, some on, some not in the network.

I look at their health history, and basically tell them they can go buy that HMO, but I won't be part of it. I'm not going to contribute to a client's deteriorating health care, or the need to change doctors, or the requirement for PCP referral, or lack of hospitals.

Same with families with kids who want a cheap HMO without Children's hospital in network. Disaster in the making.

And I'm so tired of hearing: "I don't expect any major health issues next year", and don't need to pay for a PPO plan.

Send me the wealthy and the UN-healthy.........they value PPO's. The rich can afford the best, and the sick know they need a PPO.

While I don't completely disagree with you it has reached the point where, for the majority, the cost of a PPO plan is outside of their means.

I can't completely ignore 75% of the people who call me asking for help and can only afford an HMO plan. Most of them don't have regular healthcare needs-they are healthy and see a doctor for an annual exam and maybe a few sick visits each year. I am in the same position (although on Medicare) and have a Medicare Advantage HMO-I am considering switching to a Med Supp Plan N next year but mostly as a hedge against future, unknown needs. The premium is also very affordable for me.

My business relies on referrals so if I start turning away all of the ones who are OK with an HMO then my business will eventually fall off the table. All I can do is explain to each of my clients about the limitations of the two HMOs in my area (Aetna and UHC) and let them make the choice.

Let's face it-the PPO model of healthcare is going away (for all but the wealthy) in the very near future and is being replaced by the HMO model. While I have big problems with regional HMO plans without good hospital coverage I don't see how enrolling a client in a strong HMO network can be a life threatening event and, with an annual Open Enrollment, those who don't like the HMO process and experience can switch the following year.

 

[somarco]

I patently refuse to write an hmo plan. Had it come up a few days ago on a referral. "If you want the hmo buy direct from the carrier. "

 

[FLM2]

I decided tonight to walk away from business with clients who have wasted my time for the past month and now decided to go ahead with a plan that has minimal compensation for me.

I did it with two laggers tonight for Off Exchange policies-I sent them my personal link for their plan choice and told them to submit them on their own.

I have better things to do than waste any more time with people so intent in wasting mine.

 

[JE INSURANCE]

Seems pretty odd to lose business by not selling the HMO...plenty of clients are happy with the low premiums even if there are limited drs.....

 

[taterpeeler]

Seems pretty odd to lose business by not selling the HMO...plenty of clients are happy with the low premiums even if there are limited drs.....

Ding ding ding....winner winner chicken diner

 

[Yagents]

Ding ding ding....winner winner chicken diner

You only require a pulse to write someone.

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Seems pretty odd to lose business by not selling the HMO...plenty of clients are happy with the low premiums even if there are limited drs.....

Sure, I'll write a younger, healthier, uninsured, with no kids on an HMO all day long. I'm speaking about sicker/older folks, or families with kids and no children's hospital in network. If You put them on an HMO, and you can expect a phone call when things go sour.