- 11,280
I think you are wrong JD. People could afford supps before the pffs were here. Most seniors will go broke paying for a supp if they have too. They need the security.
Medi C & D Insurers Plummet
- Thread starter MedSuppPro
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- 15,319
It's amazing how much smarter you seem to be when you agree with me!
JD is correct in that there are many seniors who cannot afford a supplement. But the sometimes false promise of quality medical access by enrolling in a PFFS is worrisome.
Rick
- 19,619
They weren't buying them. I did over 200 MA's last year and I've done more than a 100 this year. I can count on one hand the replacements for med sups. Now about 50 of the one's I've done this year are for duals. They certainly were not med sup customers then nor will they be in the future.
I just got off the phone with a lady that sent in a FE lead. She is 50 years old and I didn't even mention medicare. We went over several FE plans and even some term quotes and she wants to go with a whole life. She then said, "if I had some help with my Medicare bills, I could buy more life insurance". Turns out she is on SS disability for a bad back and has been for years. I asked her a bout a med sup and she said she has wanted one for years and just can't apy for one. Since she is an LIS person, she is a dual and I can help her with an MA now. This is not a person that was ever going to buy a med sup.
Someone above asked what will happen to current SNP clients. New SNP's are not going to be approved but the old ones can continue, but like all MA plans they may change from year to year.
I am also in the KC area and as Midwest said, Coventry and Humana are the two main MA players. I will not sell the HMO's, so I sell the PPO's or Med Sups. NO PFFS in the Metro area but in the rural counties it is the only inexpensive option for many. I have had no issues with Drs or Hospitals accepting the PFFS plans recently. Intially they were confused and contrary, but that is long past.
Good MA PPO plans are the best option for many people. There are exceptions and you have to ask all the qualifying questions regarding travel (network issues), provider network issues, and medical issues. Coventry for instance has a $2000 out of pocket maximum. An senior with a limited income may have to pay over $2k every year for a Med Sup, but only $2k during the worst medical year of their life with a MA.
Its not so cut and dried, and to only sell Med Sups is not necessarily doing the best for your customer. I sell both and make recommendations after asking a lot of questions. I have no cancellations because I do what is best for the customer, and I stay in touch to make sure everything is going well.
Also, Medicare took free food out of the equation for next year. No more seminars with free lunches. Meetings only, no meals.
I am also in the KC area and as Midwest said, Coventry and Humana are the two main MA players. I will not sell the HMO's, so I sell the PPO's or Med Sups. NO PFFS in the Metro area but in the rural counties it is the only inexpensive option for many. I have had no issues with Drs or Hospitals accepting the PFFS plans recently. Intially they were confused and contrary, but that is long past.
Good MA PPO plans are the best option for many people. There are exceptions and you have to ask all the qualifying questions regarding travel (network issues), provider network issues, and medical issues. Coventry for instance has a $2000 out of pocket maximum. An senior with a limited income may have to pay over $2k every year for a Med Sup, but only $2k during the worst medical year of their life with a MA.
Its not so cut and dried, and to only sell Med Sups is not necessarily doing the best for your customer. I sell both and make recommendations after asking a lot of questions. I have no cancellations because I do what is best for the customer, and I stay in touch to make sure everything is going well.
Also, Medicare took free food out of the equation for next year. No more seminars with free lunches. Meetings only, no meals.
- 7,066
Hopefully in the toilet where the PFFS plans belong. (HMO & PPO I can tolerate, sorta kinda.) Probably not for 2009 but we can still hope for 2010 and beyond.
Once again, I'm "holding back".
- 19,619
It's not a false promise in my service area. In western Ky, southern In and west Tn., my PFFS clients get the same quality care as anyone else. I have yet to have run across a problem with accptance by any Doctor, hospital or medical facility. I don't work the Louisville, Ky area, I have heard of problems there. And, I've heard of problems in other parts of the country. I've had 2 clients call me and tell me that their Dr. would take the plan. In both cases I called the doctor's office and it was just a misunderstanding over terminology and I was able to correct the problem in both cases.
Maybe i've just been lucky, but, I don't think so. I don't do cold calling, I don't do door knocking and I don't schedule appointments on the hour. I always schedule, at least, 2 hours in the home and more than half of my MA's are two appointment deals because I don't pressure sell at all. If they need to "think about it", I give them time to do just that. It's very rare for someone to replace my work. Not just the medicare business, the life business, too.
I know there are many agents out there peddling the MA's that have given us all a bad name, especially in the business. I also know of many agents that are just as diligent as I am.
- 19,619
Well, please don't hold back. What problem do you have with the PFFS? I'm not trying to cause a problem, I seriously would like to know.
I feel that way about the HMO and PPO part of the business and I won't sell them. Of course, that is not really an option in my area anyway.
I would like to know what the main argument is against PFFS.
- 15,319
Since I have limited myself to California for the past couple of years, perhaps you can remind me.
Which PFFS plans are either dual or chronic SNPs.?
Rick
- 19,619
I don't know of a PFFS for SNP, but, for Duals, Wellcare PFFS is a big one here Their "DUET" was a great plan for medi/medi folks. It still is, they just changed the name to "Melody". I put some dual on Wellcare's Sonata if they have a spend down. You can use Coventry's PFFS for LIS duals that don't have medicaid.
I'm sure there are many others that I'm not aware of. There may even be some for SNP's. I just can't name one.
- 15,319
It was actually a trick question. As far as I know, there are no PFFS plans that are SNP's - and that includes the Duet/Melody plan.
They marketed Duet as if it was a, but that marketing was deceptive. I'm not knocking the plan because it does have some added value in some states, but from the perspective of the doctor, it does absolutely nothing. They receive no more payment than if the patient was simply on Medicare and Medicaid. If I was a physician, would I want to assume that the insurance company would pay or bill Medicare and KNOW I'd get paid?
While I don't have any issue with the fact that you obviously are helping people, I do have an issue when you suggest that WellCare offers a PFFS dual SNP.
Rick
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