Medicare Advantage....how often do they change?

[Newby]

https://insurance-forums.com/commun...s-who-use-ssa-rrb-premium-withhold-opt.98021/

(I don't think that referred specifically to SSI, but I assume it is basically the same issue.)

Yes, I meant Social Security billing not SSI.

 

[Newby]

MA plans are about 10% of my book of business and dropping each year. Here are some reasons you may have to move plans:

Service Area Reduction (SAR) - plan pulls out of that county. You do get a SAR SEP that runs after AEP. I think it's Dec 8 thru end of year.

Plans change in the following way:

• Premiums change
• Company removes one of their plans and converts them internally the other plan with a letter to the client.
• Networks change (large dr group opts out)
• Formulary changes - saw one plan drop 800 meds one time.
• New plan comes into the area

My experience with MA is that it's hard to build a large book. Sooner or later, one of the above will happen and you cannot see all your clients in enough time to make changes. The new OEP is Jan - Mar 31; it does give you more time but still difficult. In my area there were too many changes to make it work the time to heavily invest in this market. If you had a strong MA plan in your area, there would be very little service work.

^^^ yes. One year my #2 carrier raised the premium on their zero premium PPO to $45 but introduced a new zero premium HMO plan that enrollment season. The home office was very proactive at contacting all the current members and switching them to the HMO. Thanks guys!

That same year my #1 MAPD carrier which had fantastic plans pulled out of the state entirely.

It was a frustrating year but at least for me MAPDs were just a small portion of what I sold. Some agents got hit hard with this stuff.

 

[vic120]

MA plans are about 10% of my book of business and dropping each year. Here are some reasons you may have to move plans:

Service Area Reduction (SAR) - plan pulls out of that county. You do get a SAR SEP that runs after AEP. I think it's Dec 8 thru end of year.

Plans change in the following way:

• Premiums change
• Company removes one of their plans and converts them internally the other plan with a letter to the client.
• Networks change (large dr group opts out)
• Formulary changes - saw one plan drop 800 meds one time.
• New plan comes into the area

My experience with MA is that it's hard to build a large book. Sooner or later, one of the above will happen and you cannot see all your clients in enough time to make changes. The new OEP is Jan - Mar 31; it does give you more time but still difficult. In my area there were too many changes to make it work the time to heavily invest in this market. If you had a strong MA plan in your area, there would be very little service work.

So much this

I have seen those big changes, I have seen big premium and copay changes as well as dropping extra benefits

I remember one year UHC dropped many providers in FL mud year nightmare

Well care 1 year dropped a suffolk NY plan I had a few of clients on, Opened a new same exact plan except it was noncomisionable and signed up all my clients

I have seen all this and I would say MA is about 15 to 20 % of my buis at most

I dont think I would like it if it were most of my buis

 

[mickeyma]

I read a company email which stated that 25% of MA plans are changed every year. That has not been my experience here in the Los Angeles area.

 

[vic120]

I read a company email which stated that 25% of MA plans are changed every year. That has not been my experience here in the Los Angeles area.

I do remember when I worked for brokerage, We had great anthem $0 premium $0 Primary doc every extra in one year went to premium Between $20 and $80 dep on area lost all extras and primary copay went to $20

That was somewhere between 2009 and 2011

 

[Chazm]

I'm not sure the renewals last forever on MA. I know UnitedHealth, offers only 5 yrs ("in my area'). What about YOUR area?

Uhc and every other company I’m aware of pays lifetime. They made those changes years ago.

 

[Chazm]

I just got an email from Humana that everyone on SSI billing for 2019 plans is not getting billed correctly and will need to mail their payments in. I don't know if that is a regional thing or bigger than that. But sounds like a pretty fun day at the zoo for agents with a lot of that to deal with.

Like someone mentioned, it’s a SS issue and thankfully I’ve never sold an MAPD plan with a premium.
Buuuut I have lots of people on PDP’s with the premium coming out of their SS check.
The letter states they will not be disenrolled for non-payment but should pay their balance. And letters went out to clients so it shouldn’t be an issue. I hope

 

[vic120]

I just got an email from Humana that everyone on SSI billing for 2019 plans is not getting billed correctly and will need to mail their payments in. I don't know if that is a regional thing or bigger than that. But sounds like a pretty fun day at the zoo for agents with a lot of that to deal with.

I had several clients call getting this letter from various companies, In TX and NC so far

 

[Mike Siegal]

MA plans are about 10% of my book of business and dropping each year. Here are some reasons you may have to move plans:

Service Area Reduction (SAR) - plan pulls out of that county. You do get a SAR SEP that runs after AEP. I think it's Dec 8 thru end of year.

Plans change in the following way:

• Premiums change
• Company removes one of their plans and converts them internally the other plan with a letter to the client.
• Networks change (large dr group opts out)
• Formulary changes - saw one plan drop 800 meds one time.
• New plan comes into the area

My experience with MA is that it's hard to build a large book. Sooner or later, one of the above will happen and you cannot see all your clients in enough time to make changes. The new OEP is Jan - Mar 31; it does give you more time but still difficult. In my area there were too many changes to make it work the time to heavily invest in this market. If you had a strong MA plan in your area, there would be very little service work.

'Company converts the plan...'

???

Dayum...that stinks. And they move your customer to an 'INTERNAL PLAN?'

Wat da?

 

[russelltw]

Well, not quite. They removed an old plan and offered a replacement plan, but sent out a letter allowing the client to switch to the new plan (without the agent attached). I only lost 1, but it left a bad taste in my mouth about it.