Medicare Advantage- Cannot Discourage Based on Health Needs?

AboutThatLife

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How does this work? You can explain to clients until you are blue in the face the cost-sharing and copays of a plan but if the client just sees the low premium; you have to enroll them even if it would be deleterious to their ability to afford care?
 
Also, you cannot discourage them based on geographic location in the service area. Well...what if the client has no access to a way to get back and forth between the network facilities?

Are there provisions for this?
 
There is no law that says you HAVE to write them up. It is your choice as well. If you feel that strongly that they would be screwing themselves, then don't write it.

However, if you do write it, make them sign a piece of paper that you have drawn up stating that you have advised them that you do not think this is the best plan for them.
 
There is no law that says you HAVE to write them up. It is your choice as well. If you feel that strongly that they would be screwing themselves, then don't write it.

However, if you do write it, make them sign a piece of paper that you have drawn up stating that you have advised them that you do not think this is the best plan for them.

I'm sorry I should have mentioned this instruction is specifically in the AHIP course regarding what marketing reps can or cannot say. I dont know if I can post the relevant slide here, but maybe AHIP is using an extreme interpretation of the marketing guidelines.

The official guidelines only state that a sponsor cannot discriminate based on health status or location in the geographic area. That's completely different than discouraging someone from doing something that is obviously not in their best interest.
 
Just do what’s right. I walked into a guys house today who wanted to switch to allwell and he was on uhc. Allwell barely has any doctors, has higher copays but reduced his part b premium by $70/month.
I could of signed him up and made money but he would be worse off in my opinion. I told him this and he was happy that I didn’t think about $$. It’ll come back to you if you just do what’s right. There’s nothing illegal with me telling him this.
 
If you are not comfortable with the direction that the customer is taking, walk away. You will get many more phone calls from someone disappointed with their coverage than you will get from someone you didn't write.
 
Tell them you could sign them up, and while you would appreciate the commission provided by the enrollment, you wouldn’t sign up your mother if she were in their same position. That really sets with people to know you are treating them the same way you want your mom treated. Then tell them that they are more than welcome to give your information to anyone else they know of who is wanting or needing to look at their Medicare options. I get just as many referrals from not selling.
 
make them sign a piece of paper that you have drawn up stating that you have advised them that you do not think this is the best plan for them.

My guess is that as about effective as the parking lot signs that say "We are not responsible for damage to your car or loss of valuables"

When I encounter someone getting way off track I fire them on the spot and suggest they deal direct with home office for the product they want.

Most of the time they change their tune and follow my recommendation. But sometimes they just go away and become someone else's problem.

Works for me.
 
My guess is that as about effective as the parking lot signs that say "We are not responsible for damage to your car or loss of valuables"

When I encounter someone getting way off track I fire them on the spot and suggest they deal direct with home office for the product they want.

Most of the time they change their tune and follow my recommendation. But sometimes they just go away and become someone else's problem.

Works for me.

It would serve to work well if they or the family ever came back and said, "Why didn't you tell me/my mom that....". Agents have been sued for not telling someone something before. I'm just saying....cover your butt.
 
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