Marketing Multiple MA Plans Compliantly

[WCMason]

As we know from our AHIP certification courses, comparing the specifics of two or more MA plans to a consumer is not permitted. So, for those who are certified with more than one carrier, how do you compliantly make sure you're putting them in the most appropriate (almost said best) plan for their needs?

 

[agentjhc]

Good question...................

 

[kennethbroyles]

I use Medicare.gov ..... shhhhh

 

[sman]

As we know from our AHIP certification courses, comparing the specifics of two or more MA plans to a consumer is not permitted. So, for those who are certified with more than one carrier, how do you compliantly make sure you're putting them in the most appropriate (almost said best) plan for their needs?

I always get all pertinent info (doctors, meds, hospital) over the phone and go from there. There are usually 2 or 3 viable plans in a given area. Then I confirm which of those plans include their doctors and hospital preference. I also run the comparison for the meds.

Once I've done all of this I can usually narrow it down to one plan and that's the one I present.

 

[agentjhc]

I always get all pertinent info (doctors, meds, hospital) over the phone and go from there. There are usually 2 or 3 viable plans in a given area. Then I confirm which of those plans include their doctors and hospital preference. I also run the comparison for the meds.

Once I've done all of this I can usually narrow it down to one plan and that's the one I present.

Makes sense.........Thanks

 

[BobbyMcGee]

Every area is different, of course, but I like to start a conversation after the "warm up" to determine what they are looking for in a plan and exactly what they know about Medicare/ Med Supps/Mapd's. Some know a lot, some nothing. After I explain the differences, and they decide to go the MA route, I ask how important it is to have their Dr./Drs./ Hospital in the plan. Bingo. Half the plans on the sidelines.
Silver Sneakers is a big deal to some. Some dental benefits (usually crap) big to others. Then there's star ratings. Do they qualify for a chronic SNP? DSNP? Is 0 90 day generics mail order a big deal?

Then, in Fla., we have the "give back" programs. Up to 100% of your Part B returned for some higher co-pays and co-insurance, altho they are all 0 PCP at present . People can't believe it. So, I don't see it as "comparing" plans. One plan has this and the other one doesn't. Travel a big deal? What's important to the client? Get 'em the right fit.

 

[WCMason]

Every area is different, of course, but I like to start a conversation after the "warm up" to determine what they are looking for in a plan and exactly what they know about Medicare/ Med Supps/Mapd's. Some know a lot, some nothing. After I explain the differences, and they decide to go the MA route, I ask how important it is to have their Dr./Drs./ Hospital in the plan. Bingo. Half the plans on the sidelines.
Silver Sneakers is a big deal to some. Some dental benefits (usually crap) big to others. Then there's star ratings. Do they qualify for a chronic SNP? DSNP? Is 0 90 day generics mail order a big deal?

Then, in Fla., we have the "give back" programs. Up to 100% of your Part B returned for some higher co-pays and co-insurance, altho they are all 0 PCP at present . People can't believe it. So, I don't see it as "comparing" plans. One plan has this and the other one doesn't. Travel a big deal? What's important to the client? Get 'em the right fit.

What inspired my question was a concern that "one plan has this and the other doesn't" might cross that comparison line. Not intended as a criticism; I just get more nervous each year about compliance as the renewal stakes grow higher.

 

[senior-advisor-indiana]

I always get all pertinent info (doctors, meds, hospital) over the phone and go from there. There are usually 2 or 3 viable plans in a given area. Then I confirm which of those plans include their doctors and hospital preference. I also run the comparison for the meds.

Once I've done all of this I can usually narrow it down to one plan and that's the one I present.

How do you compliantly get the rx list?

 

[WCMason]

How do you compliantly get the rx list?

I tell the caller that I'll send them an SOA, explain it. I tell them they are not required to give any health information; emphasize that. However, if they would like help comparing drug plans, they may include list of meds with returned SOA. If they do, I bring the Plan Finders. If they don't, I don't, but at the appointment show them how to do the Plan Finder on their own. And I would stop doing even that the day I find out that isn't compliant. The goal is to compliantly be as helpful as possible.

 

[senior-advisor-indiana]

I tell the caller that I'll send them an SOA, explain it. I tell them they are not required to give any health information; emphasize that. However, if they would like help comparing drug plans, they may include list of meds with returned SOA. If they do, I bring the Plan Finders. If they don't, I don't, but at the appointment show them how to do the Plan Finder on their own. And I would stop doing even that the day I find out that isn't compliant. The goal is to compliantly be as helpful as possible.

It's almost impossible to be fully compliant and get them into the best plan for them. Most freely offer their rx list though. I think as long as you have the best interest if the client in mind you will be fine.