MA dual eligibility - being pitched

I spoke with them this afternoon and it looks like I'll be putting away the gold Jewelry and Tommy Bahama and substituting with some nice Fubu gear :yes:

Apparently an agent has to get certified as a Medicare agent for legal reasons. Looks like a good deal though for everyone involved. My only concern with the program is that they are only targeting Baltimore and Philly, although I was told they are working on VA as we speak.

$25 per exclusive lead
$300 for single
$600 for family

I did not discuss chargebacks, although after reading this post, some thoughts come to mind.
 
I spoke with them this afternoon and it looks like I'll be putting away the gold Jewelry and Tommy Bahama and substituting with some nice Fubu gear :yes:

Apparently an agent has to get certified as a Medicare agent for legal reasons. Looks like a good deal though for everyone involved. My only concern with the program is that they are only targeting Baltimore and Philly, although I was told they are working on VA as we speak.

$25 per exclusive lead
$300 for single
$600 for family

I did not discuss chargebacks, although after reading this post, some thoughts come to mind.

A minor correction. The $25 is for a set and confirmed appointment - not just a lead.
 
Wellcare has a program like that here in Kansas City.

Designed for duel eligs who got dental, vision and hearing at no cost to them.

I would have been all over it but they only went into 2 counties, both which were whored out by the time I caught wind of the program.

There is no real catch here. If you can get in when it is first introduced, then you should be able to make some serious $. I know that if you do a seminar with food at a high rise, they will come out of the wood work.
 
I also don't see any real catch outside of the normal BS we all put up with. Bottom line for me is 3 appointments a day doesn't distract from my health insurance biz - I'm operational with a laptop and cell phone. I still meet with health clients but not 8 hours a day worth! 12 appointments a week - if I closed half would be six appointments. Assume half of them are husband and wife - that's 9 enrollments for $2,700. Not a bad part-time venture.
 
Healthagent, is the product an HMO, PPO, and or something other like a PFFS?

Are there more product lines for the duals with this carrier, I.E.: an hmo and pffs, and or something other? I know Wellcare, for instance, has a PFFS. On the other hand, Unitedhealth has an HMO and PPO.

Depending on the type of program, it can really help or hurt people and it's all on a judgement call, made by you 'the expert' - 'certified agent,' which elicits from your experience with insurance and working with really really sick people who are smothered with chronic diseases.

There are a lot of ingredients in the mix when working with duals and it either will be very easy or extremely difficult and a major pain for you - the agent. Sometimes, it's better to walk from things like this but again, there are many variables in the mix to look at with the product line and more so too, how your state operates with duals, and what, if any, home health care agencies are working this market too.

Last, think of home health care. Are there a ton of docs and nurses already out there indundating these people with their so called 'home health care' services? That's going to be quite a challenge too be it whether your product line has decent contracts with facilities like this and or not. Many of the duals faulter and fail to realize what quality care is; they like relationships with people, as many of the duals lack this. So a foreign doctor coming when 'I'm in your area and I'm coming by to see you to take your blood pressure' oh but wait... "I'm not treating your diabetes and or other ailments accordingly... ha ha ha" kind of a deal, but they baby these folks and make them think they're getting 'quality care, while billing up the wazoo every month for their so called 'services,' though they're not treating these conditions or seeing them every month as they should. And of course not all of these home health care docs do this but many many do. Some have gone so far and have even lied to duals telling them if they switch programs, they will lose their Medicare and Medicaid benefits!!!

You also have to consider the social/case workers because they can have a profound influence on their people. And the pharmacies.... DON'T EVEN get me started here. I am going to assume the part D is commingled with this? Yes?

Please let us know the types of programs available through Bravo (like if it's an hmo, ppo, and or pffs) and if I can say more, I gladly will. Also, please include if the product / programs have the Part D built in it.


Last, I cannot recall who said this, but yes, duals can change every month. Be careful and proceed with caution regarding chargebacks. Sometimes the state or case worker can switch them too, either with or without their consent, fyi. And it could have been a good fit for the dual, but the lack of education on the case worker's part can greatly mess things up for you and your client/s.
And this comes from my experience working in my state. The case may be different in your state; so do your homework there too. Good luck and let us know the about the types of programs available with this carrier. Tx.
 
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[FONT=verdana,Helvetica,Geneva,Swiss,SunSans-Regular,New Century Schlbk]Want to Switch Back from Your Advantage Program to Medicare? [/FONT][FONT=verdana,Helvetica,Geneva,Swiss,SunSans-Regular,New Century Schlbk]Basically, you're screwed, and must suffer until the end of the year. Remember: The insurance and drug companies wrote this bill. According to the Medicare Rights Center (MRC), however, an internal memo circulated recently within the Centers for Medicare and Medicaid Services allows disenrollment if you were signed up without your consent. Grounds for disenrollment also include statements by an agent that imply the plan is a Medicare supplement or Medigap policy, statements suggesting that the plan is accepted by all Medicare providers, or statements saying that you can switch back to Medicare any time you want. [/FONT]
[FONT=verdana,Helvetica,Geneva,Swiss,SunSans-Regular,New Century Schlbk]Call 1-800-Medicare. Tell them you qualify for a special enrollment period because you were misled into an unwanted plan. If you are dual-eligible, you can switch back within a month just by calling Medicare. Know, too, that a state has no obligations to pay for cost sharing for dual-eligibles enrolled in an Advantage plan. Questions? Call MRC at (800) 333-4114.[/FONT]
 
Healthagent, is the product an HMO, PPO, and or something other like a PFFS?

Are there more product lines for the duals with this carrier, I.E.: an hmo and pffs, and or something other? I know Wellcare, for instance, has a PFFS. On the other hand, Unitedhealth has an HMO and PPO.

Depending on the type of program, it can really help or hurt people and it's all on a judgement call, made by you 'the expert' - 'certified agent,' which elicits from your experience with insurance and working with really really sick people who are smothered with chronic diseases.

There are a lot of ingredients in the mix when working with duals and it either will be very easy or extremely difficult and a major pain for you - the agent. Sometimes, it's better to walk from things like this but again, there are many variables in the mix to look at with the product line and more so too, how your state operates with duals, and what, if any, home health care agencies are working this market too.

Last, think of home health care. Are there a ton of docs and nurses already out there indundating these people with their so called 'home health care' services? That's going to be quite a challenge too be it whether your product line has decent contracts with facilities like this and or not. Many of the duals faulter and fail to realize what quality care is; they like relationships with people, as many of the duals lack this. So a foreign doctor coming when 'I'm in your area and I'm coming by to see you to take your blood pressure' oh but wait... "I'm not treating your diabetes and or other ailments accordingly... ha ha ha" kind of a deal, but they baby these folks and make them think they're getting 'quality care, while billing up the wazoo every month for their so called 'services,' though they're not treating these conditions or seeing them every month as they should. And of course not all of these home health care docs do this but many many do. Some have gone so far and have even lied to duals telling them if they switch programs, they will lose their Medicare and Medicaid benefits!!!

You also have to consider the social/case workers because they can have a profound influence on their people. And the pharmacies.... DON'T EVEN get me started here. I am going to assume the part D is commingled with this? Yes?

Please let us know the types of programs available through Bravo (like if it's an hmo, ppo, and or pffs) and if I can say more, I gladly will. Also, please include if the product / programs have the Part D built in it.


Last, I cannot recall who said this, but yes, duals can change every month. Be careful and proceed with caution regarding chargebacks. Sometimes the state or case worker can switch them too, either with or without their consent, fyi. And it could have been a good fit for the dual, but the lack of education on the case worker's part can greatly mess things up for you and your client/s.
And this comes from my experience working in my state. The case may be different in your state; so do your homework there too. Good luck and let us know the about the types of programs available with this carrier. Tx.

Fantastic post. Safe to say that I'm not selling **** until I have done insane research after my meeting this Tuesday. I'd be selling a HMO MA plan and from what I'm being told, as long as their doctors and caregivers are in network there's no harm done. I find is difficult to believe that anyone would approve any plan that would take the place of Medicaid and put the client in a worse position. Where the hell is the DOI? Where the hell is the government? If there's never a case where a MA plan would be an improvement over what they already have why even issue them in the first place?

I will take this extremely seriously. I know I'll be dealing with people with chronic illnesses that can NOT have any adverse change in care. If I come to find that the outfit I'm getting hooked up with is "scamming" seniors or teaching anything unethical they're biggest problem with me will be my complaint to the DOI and CMS. Anyone who puts a senior in a worse situation to get a commission should not only lose their license, but also have criminal charges filed.
 
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