MAPD With Low Ratings

Apr 14, 2016

  1. thomasm
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    thomasm Guru

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    I don't sell a lot of MAPD, but I'm building a list of people I talk to who are on a crappy MA plan, and was just wondering...

    If a MAPD plan has had a low CMS rating for the last three years, does this qualify them for a SEP to switch? Or do they have to wait for OE?
     
    thomasm, Apr 14, 2016
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  2. TwoCents
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    TwoCents Guru

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    People in that situation should have gotten a letter from CMS advising them of an SEP, but the application can only be completed through 1800MEDICARE. Some carriers have a set up where you can submit the SOA if you go out to discuss plans and you're supposed to still get a commission if they eventually enroll through CMS.
     
    TwoCents, Apr 14, 2016
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  3. Matthew King
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    Matthew King Guru

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    The member may qualify for SEP if the plan has had a consecutive rating below 3 stars for three years straight. However, I would advise you to call 1-800-MEDICARE with the member because CMS must approve that the plan allows the member to be enrolled in SEP. Normally, CMS sends out a notice to agents and clients that a plan allows them to qualify for SEP because of low ratings. They may not approve it but it will at least put a bug in CMS's ear that there is a plan with low ratings.
     
  4. thomasm
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    thomasm Guru

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    Thanks guys!

    I wonder why they haven't already switched. Seems like they had no idea. All I did was check Medicare.gov.

    Question of the Day: Why are some folks so stubborn to change, even if it would better their situation. Most of them come around eventually with a little coaxing. But the ones that don't, sure make you scratch your head and wonder...
     
    thomasm, Apr 15, 2016
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  5. pfg1
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    pfg1 Guru

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    If you can answer that, let us know!

    My mother in law won't change her home phone from a land line home phone service to a cell home phone service. It will save her over $50/mo. The only difference is the call goes through a cell tower rather than a land line, and caller id doesn't show a name & number, only the number (because its cell service). Same house phones, still have voice mail, call waiting, etc. I told her its like walking into the bathroom and flushing a $50 down the toilet each month. She said "she just can't think about it right now".

    Stubborn and set in ways seems to be the norm for older folks. Its their choice. I honestly pray I'm not like that when I get there.
     
    pfg1, Apr 15, 2016
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  6. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    The older they are, the more they resist change. They know that what they have and feel comfortable with it because they're familiar with it. Sometimes it's a trust factor.

    I've felt like banging my head against the wall before. It's frustrating as hell when you can give them the same coverage for half the price and they won't budge.
     
  7. thomasm
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    thomasm Guru

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    In this case that's a good thing, because my dialer now scrubs the cell phones for me! Usually cuts my list in half!
     
    thomasm, Apr 15, 2016
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