Medicare Advantage 48 Hour Rule

[djs]

My point is, you are supposed to do the MA presentation in full. That part is actually almost clear. Also what is clear is that they want the prospect to be able to focus on what you are presenting. It's not a stretch to say that intertwining medsupps and MA's in the same presentation will lead to confusion.

By doing them as 2 separate things, even if MA then medsupp, you help prevent one of the things that I agree with the rules on, try to keep it straightforward and simple. You'll still end up with people on an MA that state that you said that they could go to any doctor that takes medicare, but that will always happen, just hopefully with a lesser frequency.

Yes, it is semantics, but it's also 'reasonable', regardless of what you are selling. It's hard to look at a Honda Civic and a Toyota Corolla at the same time and not walk away and end up a bit confused about the feature set. If you look at them at different times, it's much easier, and this is for something you already have a good understanding about. Try something you don't know up front, like medicare.

Dan

 

[PinSeeker]

So if I am understanding the information in this thread correctly, and I am in a Med Sup appointment and the beneficiary asks me to show her ABC's MA Plan...I have to get a SOA signed and come back in 48 hours.

In looking at the link SAL15 so kindly provided, I do not see that scenario discussed. What I see references the cross-selling of different plans while in an MA appt. I see no reference to the situation where I am actually "in house" presenting a Med Sup. The other references I can find are related directly toward creating MA appts. through "unsolicited contact or to "outbound" marketing calls.

The statements are so vague and as I said...there is no reference to being ask by the Medicare recipient face to face...even though I am there for other reasons.

 

[RFNAPLES]

Yes, it is semantics, but it's also 'reasonable', regardless of what you are selling. It's hard to look at a Honda Civic and a Toyota Corolla at the same time and not walk away and end up a bit confused about the feature set. If you look at them at different times, it's much easier, and this is for something you already have a good understanding about. Try something you don't know up front, like medicare.

Dan

The only reason it is hard to look at a Honda and a Toyota at the same time is that they are usually at different dealerships. But it would sure be nice to make comparisons side by side.

I prefer to do a needs and wants analysis before offering any options. Then if for some reason my suggestions are not accepted or the client wants to see alternatives I will make comparisons for them.

I find many of the CMS marketing regulations harmful to the best interests of our clients. If you represent more than one company do you really need to bore the clients with complete presentations from each company if they want to know just a bit more? Is it really any more difficult to compare and contrast the various types of Part C plans than to compare and contrast Medicare Supplements plans? How would a 48 hour waiting period simplify the situation? Why do other in-home sales have cooling off periods after the sale while CMS requires them before?

If a child asks you where they came from; must you tell them the entire story of insemination, gestation and birth or merely tell them which hospital they were born in?

 

[djs]

I NEVER said the 48 hour rule made sense to me. Thats why I said its semantics, but there are little glimpses of sanity contained within the overall craziness. It's the optimist in me that finds those glimpses.

Dan

 

[Franz Kafka]

To this date, I haven't had a definite and clear answer on this question from anyone (i.e. they all contradict each other to some degree). I'm 100% confident that no one including CMS does.

 

[sshafran]

I've asked sales support at carriers this exact question. If I'm on a Med Supp appointment, and the beneficiary states that they have no means to pay anything for their supplement - regardless of value, then what are my options as the agent?

The answer I get from sales support is that if they ask for other options, then I can present the other options (MA/MAPD) after the SOA is signed. UHC said, "In an ideal world they would sign it 48 hours prior, but that may not always be feasible."

I asked 2 carriers, and neither told me to turn around and go home. Not that Sales Support is always right

 

[ksigmtsu]

As long as you don't bring up ma and you have only discussed health products and you get the SOA right then you can do the presentation but you are not supposed to compare them directly for the client, only answer their questions.

It's meant to favor the carriers, not us.

 

[djs]

I'm not sure what is not clear. If you start on a medsupp appointment, the rules are VERY clear. The 48 hour rule applies. I'll repeat the rule:

For research, please refer to the bible:
https://www.cms.gov/ManagedCareMarke...ads/R91MCM.pdf

You will find that the 48 hour rule does apply (I'm assuming Sal15 is implying otherwise) - page 79:

Sales of MA and PDP products are subject to our scope of appointment guidance, even if conducted during a sales appointment for a Medigap policy. This includes the requirement for a beneficiary-completed agreement form prior to the appointment and a 48-hour waiting period.
​

If anyone can read that anyway other than what it clearly says, I'll gladly accept it. Now, I'll grant you, if you had a soa signed so you could discuss a PDP while on the medsupp appointment, then you can have a new soa signed and go to the MA discussion without the (additional) wait period.

Dan

 

[ksigmtsu]

I'm not sure what is not clear. If you start on a medsupp appointment, the rules are VERY clear. The 48 hour rule applies. I'll repeat the rule:



If anyone can read that anyway other than what it clearly says, I'll gladly accept it. Now, I'll grant you, if you had a soa signed so you could discuss a PDP while on the medsupp appointment, then you can have a new soa signed and go to the MA discussion without the (additional) wait period.

Dan

If I think I might be talking about ma at a med supp appointment I send the SOA. Postage and envelopes costs about a dollar. Be prepared.

 

[Sal15]

When I go on a Med Supp appointment I always get a SOA. IMO, Part D is a very important part of my prospective clients health care and should be talked about while on a Med Supp appointment.

I imagine plenty of sales have been left on the table due to agents ignorance of how to handle the 48-hour rule.