Medi C & D Insurers Plummet

[Frank Stastny]

Once again, I need to disagree with you. It was 1992.

Rick

The plans were put together and approved in 1991 and became effective and companies had to start selling them in 1992!

 

[floridabroker]

You may think that is "ballsey" but where is it written that a doctor has to do anything or should be forced to or dictated to about who they should treat and what insurance they should accept.

How about if I tell you that you have to represent x company even though you neither like that company or would choose to represent them. Does that make you an "egomaniac"? Do you really need a reason and have to justify to someone else what you do and how you run your business? I don't and I would raise hell if someone told me I had to.

I would say the same thing you are accusing doctors of saying, "kiss my ass", it is my business and I will run it as I see fit. Who are either you or me to tell a doctor, dentist, insurance agent etc how to run their business?

What about the doctors who won't even see Medicare patients? What do you think of them? Should they be forced to see seniors on Medicare? I think not.

You have said you are

Frank,

The POINT is they don't care! So lets call it like it is. Lets educate the people that the docs are doing what is best for THEM!

i had a couple who were on the AARP supp. They contacted me to join secure horizons because they couldn't afford the supplement. I told them I wanted to contact the doctor before they did anything. When I expalined to the billing person that they were hoping to stay with Dr. X, she said "oh well too bad".

THAT is what I have a problem with!!!!

You are right it is a free country.

Except you and I go to jail for forcing people to do what we want them to do.

Doctors however have people so scared they are going to lose their doctor that they will pay $200 a month to do so 3 times a year.

Sorry you don't see how sick that is. i do!

 

[Frank Stastny]

Frank,

The POINT is they don't care! So lets call it like it is. Lets educate the people that the docs are doing what is best for THEM!

i had a couple who were on the AARP supp. They contacted me to join secure horizons because they couldn't afford the supplement. I told them I wanted to contact the doctor before they did anything. When I expalined to the billing person that they were hoping to stay with Dr. X, she said "oh well too bad".

THAT is what I have a problem with!!!!

You are right it is a free country.

Except you and I go to jail for forcing people to do what we want them to do.

Doctors however have people so scared they are going to lose their doctor that they will pay $200 a month to do so 3 times a year.

Sorry you don't see how sick that is. i do!

How many posts have you read here where agents say things like "I wouldn't sell for that company, they only pay 10% commission" or similar statements like that. The company may have a good plan but to most agents that really doesn't matter does it? You may not be one of them but they are everywhere.

What if a prospect wants to take a policy from a certain company only and you don't sell for that company? Are you going to get licensed with them just to sell one policy even though you have decided in the past that you don't want to represent them?

Where do you see that doctors are "forcing people" to do what they want? And, when you say "you and I go to jail" please leave me out of that. Maybe you have tried to "force people to do what you want them to do" but that is not how I operate nor do I have to do that to sell insurance. (I stopped carrying a sawed-off shotgun with me on appointments several years ago.)

In other words, I don't understand your statement that people are being "forced" to do anything. If you mean that they are afraid then that is really their problem isn't it, not the doctors, yours or mine. You may be afraid of your doctor but I sure am not of mine. Neither are the vast majority of my senior clients either. Maybe you just deal with a wimpier client than I do, or not.

If you own a home you must have fire insurance. How many times has your house burned to the ground? Do you still pay the premium every year?

Some people want excellent medical coverage in the event they need it. Every agent who sells HMO's, PFFS plans uses that same argument. They all claim that all seniors are "poor" and can't afford a supplement. Maybe those are your clients but they are not mine.

I don't sell PFFS plans and even if I could I would not sell HMO's. My clients are happy with their Med Supps and do not want to change, especially with I throughly explain to them exactly what they are getting into if they do take a PFFS plan.

There is nothing "sick" about running your business they way you see fit regardless if insurance agents disagree with it.

 

[jdeasy]

The way it was presented to me was that it was designed for dual eligibles. While no one ever used the term "SNP", it was implied that it was a plan for Medi-Medi. The reality is that it never was and from what I understand (correct me if I'm wrong) that is why CMS stopped the sale of Duet.

I was told by the regional sales rep that WellCare paid 100% of the Medicare allowable. Turns out they pay 80% just like Medicare. When I found this out, I decided there was no advantage to California residents to go into the plan.

As far as concern for the doctor, if the doctor does not want to accept the plan, that is a concern. This has been the issue with PFFS all along, not just WellCare's plans.

In California, Medi-Medi people have terrific benefits including vision and dental. I know this is not the case in all states. I know that the dual SNP plans are a good value in Ohio but they are HMO plans.

In California, there is little reason for a full dual to be on any kind of managed care plan. The negative of not knowing if your doctor will take the plan makes putting a dual on a PFFS a little "iffy."

Rick

I don't know if CMS prompted the name change from Duet ot Melody or not. The Duet is still available with the name of Melody. It is not currently available in Ky and In and I don't when/if it will be again. It still available in Ohio I know for sure. It's actually still available in Ky and In, just not for agents to sell. dual could call up Wellcare and enroll in the Melody right now.

If they told you it paid 100%, they misinformed you. It pays what Medicare a and B paid plus some of the wellness benefits. The state's medicaid picked up the rest or whatever they paid without the person being on Duet. In Ky, the medicaid pays it all. The Duet was for dental, eyeglasses, hearing and the monthly amount for the otc stuff. In Indiana, it seems that most of the medicaid are on a monthly spend down. The Duet is not usually a good fir gfor them. The Sonata, especially in A counties is a good fit. You have to do your homework with the folks to get the proper fit.

We do not have a doctor acceptance problem. If I were in an area where that was a problem, I would feel exactly as you do about it.

 

[Frank Stastny]

I would like to see what posts look like and what people's opinions are regarding HMO's and PFFS plans if the amount of commission was regulated to say $15.00 per month instead of the $400, $500, $600 dollars they are now receiving when they write one.

I venture to say that agents would not nearly be so "in love" with them and defending them the way they do.

They would then be wanting to "help people" get into a Med Supp.

My guess is the same agents who are going to disagree with that would be the first ones to jump back on the Med Supp band wagon.

 

[jdeasy]

I would like to see what posts look like and what people's opinions are regarding HMO's and PFFS plans if the amount of commission was regulated to say $15.00 per month instead of the $400, $500, $600 dollars they are now receiving when they write one.

I venture to say that agents would not nearly be so "in love" with them and defending them the way they do.

They would then be wanting to "help people" get into a Med Supp.

My guess is the same agents who are going to disagree with that would be the first ones to jump back on the Med Supp band wagon.

Not this agent, I didn't sell med sups before the MA plans were available and I won't if the MA plans go away. I carry one med sup company in my tool box and it's the lowest priced med sup in the State of Ky. I only carry it in the unlikely even I run into someone that believes a med sup is the proper route for them. I have yet to run into that person.

Now, I'm sure a large part of that is because I personally fell that med sups are a rip off and I would not put my mother on a med sup. I'm sure your clients are totally opposed to PFFS plans because you steer them to your way of thinking about them.

But, I don't know your area. You are probably justified in your approach because of isses with the PFFS plans there. I understand, from another agent, that your area has very well priced med sups.

I do what's in the best interest of my clients regardless of the commission. You can believe that or not. i haven't been in the insurance industry as a lifer, but, one of the first things a great mentor taught me was to never do anything for the commission. He said that, if you do it that way, the commissions will take care of themselves. And, they do. For example, I had a lady during AEP that had contacted the company about getting relief on her high priced supplement. I met with her and she was paying $94/mo for an F plan. The best MA inat county was Pyramid's Today's Options Premier for $49/mo. She was all over it and wanted to enroll to save that $45/mo. I would not enroll her. It took me over an hour to convince her that it was not a good change for her and for her not call another agent that would enroll her. Fortunately, I know her son as he had done some dozier work for a few years ago. I called her son and told him to not let his mother switch her plan and told him why. She still has that med sup today. I din't make a dime form that appointment, but, that family has referred, at least, 10 other customers to me since that day.

That's how I was taught to do business and that's how I do business. Believe it or not.

 

[GreenSky]

Question for jdeasy:

If PFFS plans cost $20 less than a med supp, which would you sell.

In other words, if you take price out of the equation, which plan has better benefits and access to physicians?

If I offered to pay for either an MA or a Med Supp for your mother, which would you have me pay for?

Rick

 

[jdeasy]

Question for jdeasy:

If PFFS plans cost $20 less than a med supp, which would you sell.

In other words, if you take price out of the equation, which plan has better benefits and access to physicians?

If I offered to pay for either an MA or a Med Supp for your mother, which would you have me pay for?

Rick

Certainly, I would have you pay for a med sup. Of course, if you take price out of the euasion, med sups are better. I tell my clients or prospective clients the same thing, if you can find a way to pay for a med sup, it's the way to go.

In realty, a med sup costs on average, $150 mo. in my service area. The most expensive MA PFFS is $49/mo. We do not have an acceptance problem in my area. What would sell here?

I would issue a challenge to you, or anyone. I have done over 300 MA PFFS plans since Jan. 1, 2007. If you, or anyone, could put anyone of my MA clients on a med sup, I will double your commission. No, I will triple it.

I'm not trying to tell you how to do business in your area, but, I know mine. I will be fine with whatever the new rules are. I don't do do gimmicks and won't. I have never held a seminar. Hell, I've never even attended one. I don't buy meals, I just work. I don't have an agency, I don't have agents under me where I get overrides. In a perfect world, everyone could get on a med sup plan F and not pay anything other than their low monthly premium for that med sup. We don't live in a perfect world. I do whatever i can to help people get by.

 

[theinuranceguy]

90% or my clients are dual eligibles and people with a LIS...

Even if med supps were free... these clients still want dental, eye glass coverage, and hearing...

Not to mention free rides to the dr, and $30 a month to spend in their care catalogue...

Med supp is the best insurance... some people just arent looking for it... others simpy dont need it.

 

[floridabroker]

How many posts have you read here where agents say things like "I wouldn't sell for that company, they only pay 10% commission" or similar statements like that. The company may have a good plan but to most agents that really doesn't matter does it? You may not be one of them but they are everywhere.

What if a prospect wants to take a policy from a certain company only and you don't sell for that company? Are you going to get licensed with them just to sell one policy even though you have decided in the past that you don't want to represent them?

Where do you see that doctors are "forcing people" to do what they want? And, when you say "you and I go to jail" please leave me out of that. Maybe you have tried to "force people to do what you want them to do" but that is not how I operate nor do I have to do that to sell insurance. (I stopped carrying a sawed-off shotgun with me on appointments several years ago.)

In other words, I don't understand your statement that people are being "forced" to do anything. If you mean that they are afraid then that is really their problem isn't it, not the doctors, yours or mine. You may be afraid of your doctor but I sure am not of mine. Neither are the vast majority of my senior clients either. Maybe you just deal with a wimpier client than I do, or not.

If you own a home you must have fire insurance. How many times has your house burned to the ground? Do you still pay the premium every year?

Some people want excellent medical coverage in the event they need it. Every agent who sells HMO's, PFFS plans uses that same argument. They all claim that all seniors are "poor" and can't afford a supplement. Maybe those are your clients but they are not mine.

I don't sell PFFS plans and even if I could I would not sell HMO's. My clients are happy with their Med Supps and do not want to change, especially with I throughly explain to them exactly what they are getting into if they do take a PFFS plan.

There is nothing "sick" about running your business they way you see fit regardless if insurance agents disagree with it.

Frank,

I MEANT if you and I forced people to do something WE would go to jail. C'mon I write a post of what I say is poor ethics and then say I strong arm people????

And YES Frank we see people strong armed and people pushed and forced. We have people that come to seminars and say the same thing.

I'm glad your area is different and I am sorry you seem to have this idea that I am making this up but we offer supps so what do I gain except that you are reading this as I have become fed up.

Doctors have power. People are afraid to leave their Doctors and I can't be the only one who has people that act like their doctors are gods. So yes when they tell their patients they need to get a supp and pay more money for the "privilege" to see them, YES I have a problem with that because the senior is in a vulnerable position.

Again Frank 100% is 100%. I don't care if it is for 1 patient. 1 will turn into more so lets not get dramatic. They will make their money. Girls being lazy in the office....that's what the complaint our clients give us.

It takes about 1 hour of paperwork for an office to get credentialed. If the doc and his practice is just in it for the money. Great! Just let the people know.