June 1, 2010

[insurance0707]

I agree with you Frank, there will be a lot of opportunity in the coming year. Because you didn't sell MAPD plans you didn't get the earful that some other agents did about the copays. While I'm excited about Plan M and N you'll want to really talk to your clients about the copays on Plan M and N. It sounds like office calls will have a $20 copay for Plan N. For most clients that won't be a problem....unless they need physical therapy or chemo. This is where the copays can really add up for a client. If they're having physical therapy 3 times a week for 3 months that Plan N isn't going to look so good. Stroke, hip replacement, knee replacement...these were some of the common things that I ran into. I explained the copays to the clients, who were healthy at the time and didn't think any of this would apply to them, as we all know, your health can change at the drop of a hat. I've written both med supps and MAPD plans during the last few years. Med supps, the only complaint i got was the rate increases. MAPD plans were the copays for those that needed chemo or physical therapy. I'm just trying to give you the heads up on what I ran into. Most of my clients didn't need these services, but for those that did....it can really add up.

 

[timsip]

I am confused. I have read that we can start marketing the two new plans December 1 2009 for a January 1, 2010 affective date, but I also read that the new plans become affective June 1, 2010. What's the scoop? I know of some clients that I have on MAPD that would probably love the new plans, but they would have to change during AEP.

 

[GreenSky]

Tina:

You are correct. Marketing Plan M & N may be allowed as of December, but that won't help anyone in an MA plan. The last date to disenroll from an MAPD would be 3/31 leaving 3 months without a supplement before they could go into the new plans.

Perhaps (and I mean perhaps) you could put them in a current plan and they hope they can still qualify a few months later for the new plan.

Do you think it's a coincidence that there is a gap between the OEP and the effective date of the new plans? Insurance companies want to keep people in MA plans as long as possible.

Rick

 

[timsip]

First off, I think you are replying to me, but I am certainly not Tina!

Secondly, during AEP, Medicare Beneficiaries can get out of MAPD with January 1 affective dates and go to anything they want. During OEP, they can only go from company to company, but must do a like-for-like change; someone that wants out of an MA can't do that during OEP. If someone wanted out of the MA and into a supplement, they can only do that between November 15 and December 31. For everyone making changes during that time, their affective date will be January 1. If they wait until after December 31, they can't choose a Med Supp, they have to choose the same type of plan they currently have.

So my question remains; will we be able to sell plan M & N during AEP for those that want out of MAs or do we have to wait until May for June 1 affectives?

 

[GreenSky]

Sorry Tim - I took my contacts out and couldn't read your name.

You are incorrect about OEP. You can get out of an MAPD by going into a PDP and back to original medicare. It is considered like for like in that instance. It's only that you can't add or delete the drug coverage.

Therefore, you can make one change between Jan 1 and March 31.

Rick

 

[senior-advisor-indiana]

What is an affective date? I'm confused.

 

[GreenSky]

I'm confused.

We know.

Rick

 

[timsip]

Sorry Tim - I took my contacts out and couldn't read your name.

You are incorrect about OEP. You can get out of an MAPD by going into a PDP and back to original medicare. It is considered like for like in that instance. It's only that you can't add or delete the drug coverage.

Therefore, you can make one change between Jan 1 and March 31.

Rick

You are right, I did forget that change over, but you still can't go to a Med Supp, as it has been explained to me during OEP, but you can during AEP.

 

[moonlightandmargaritas]

What is an affective date? I'm confused.

It's a date, that's affective.

 

[timsip]

You are right, I did forget that change over, but you still can't go to a Med Supp, as it has been explained to me during OEP, but you can during AEP.

On Med Supps, the affective date is usually the first of the following month. The exception to that rule is if you request a specific date. For instance, you are meeting today (Aug. 3) with someone that turns 65 October 5. The affective date requested would be October 1.

Of course you probably new all of that, but were just trying to poke fun at something I said.