Ned Help on MA Client

[VaDwayne]

You guys stroke each other. I have no time for ya.

 

[DS4]

Ok, enough Dwayne bashing. He probably doesn't do MA's.

Question #1, What is the effective date of the med supp for these people. Have both of them been approved??

Question #2, Was the app for the supp done during the AEP or the OEP?

 

[VaDwayne]

I'm surprised that with all your expertise and now feeling that you are qualified to offer training that you would know that there isn't anything anyone on the forum can do to straighten this out. You can get opinions here but that is all they will be.

Those questions are going to have to be answered and decisions are going to have to be made by the companies, Medicare and or CMS. We can tell you what the rules state if you don't know them, but the final word will have to come from them. I suggest that you get on the phone and start calling and talk to the decision makers. Otherwise, if all you give her are more opinions and more bad advice the situation could become further complicated and she may end up with no coverage at all. That's the way a professional agent would handle it.

What makes you think she won't qualify with, diabetic(non-insulin) with high b.p, cholesterol,? Every company I represent will accept a non-insulin dependent diabetic. I cannot recall the last time high blood pressure has entered into the equation and then only with one company I have ever represented. Cholesterol has never presented a problem in getting a policy issued I have submitted.

It sounds like you need to do a lot more research and studying before you really become an expert on Medicare and Medicare Supplement policies. I hope you are not imparting that kind of erroneous information to all of the agents who you are training.

Wrong answer again. CMS,CSA, and WOW, didn't know the answers to my questions. By the way, you stated that EVERY carrier you have will take a non-insulin dependent diabetic AND only 1 ASKED ABOUT HIGH B.P AND DON'T INCLUDE IT IN THE EQUATION. Arent' you a GA with WOO and MOO? They both said NO because of too many High B.P drugs and being a diabetic combined. Is EVERY still the word you want to use. No, you didn't ask about the drugs, you simply saw a way to discredit me and make yourself look good. I would suggest you get out your WOW and MOO applications to see if they ask if the beneficiary is a diabetic AND has circulatory problems(INLUDING HIGH B.P). Know your products, and by the way, training is free. You are welcome..

Keep up the good work

 

[captain94]

Dawyne,
You make yourself look bad...Keep up the good work at that I know you will!

 

[Josh]

There go my plans on hiring Dwayne to train me in Medicare.

Anyone else that has become an expert in the past 3 months want to train me?

Rick

I'm sorry that I've been doing it for 4 years, there is no way I'm qualified.

 

[DS4]

The lady also said that she did the interview on the phone with CSA and the agent called CMS to let them know that she would be switching to a med supp with a stand alone PDP. This happened on January 8th.

Ok. It sounds like the app to CSA is during the AEP??
Step one is to get the supp approval. After approval of the supp, step two is the submission of the Part D. The Part D approval trumps the MAPD, thus, term'ing the MAPD. You do not call CMS. Ever.
Am I missing anything?
Disclaimer: I've been doing this med supp crap for 32 years. I don't recruit agents and I don't train agents.

 

[VaDwayne]

Ok, enough Dwayne bashing. He probably doesn't do MA's.

Question #1, What is the effective date of the med supp for these people. Have both of them been approved??

Question #2, Was the app for the supp done during the AEP or the OEP?

The disenrolment and apllications for Med. supps were done on the same day which was January 8th, 2010. Here's the problem. I sat down with the couple this morning and we called CSA to see why the agent kept telling them that she needed to come back and see them but wouldn't give them an answer on their approvals. She said the computers were down at CSA.

We found out that the ladies med supp had been approved yesterday but the application for the man had never been sent in by the agent although they did the phone interview with the agent there. The effective dates are going to be 2-1-2010. She disenrolled them both from HUMANA effective 1-31-10, acording to CMS, but the man has not been approved by any company for a med supp. The app was done during the OEP not the AEP, which would have been GI as you know, since they were diserolled by Coventry because they dropped their PFFS plan.

I was going to switch the lady to WOW, or MOO, because of price,but she takes too many meds so I told her to stay with CSA for now because of the approval and the 2-1 effective date. I will get her business later.

The man, on the other hand, doesn't have an application in at CSA, he has been disenrolled from Humana MAPD efective 1-31, he has already been enrolled in a stand alone PDP by the agent, so there is a chance that he will only have Parts A,B,D on 2-1-2010. I believe I will get him approved with WOW but I was asking the question just in case, so he won't screw up his coverage. I spoke with WOW and the underwriter said that his meds would not disqualify him. He takes much less than his wife.

He did not go from a med supp to a MA, he went from an MA to another MA during AEP.

P.S I like the Dwayne bashing, some people like people like them, and some people like people like me. It takes all kinds to make the world go round. I'm cool with it. I just try to remind myself
if Chevy wants to make itself look better, it condemns Honda, and if Ford wants to build a better image, they compare themselves to Toyota. They are simply trying to make themselves look better and the easiest way is to condemn others. Whatever!!!

 

[DS4]

As I mentioned in my previous post, during the OEP, the supp needs to get approved first. THEN, you submitt the PDP, which in turn trumps the MAPD.
I would say the other agent has liability.

 

[VaDwayne]

As I mentioned in my previous post, during the OEP, the supp needs to get approved first. THEN, you submitt the PDP, which in turn trumps the MAPD.
I would say the other agent has liability.

I appreciate the help and advice. I was a little hesitant to get involved but these folks are family to one of my aunts, and they called me and were super confused. The agent only left a replacement notice, no plan details, or the Choosing a Med supp guide, or any details about their coverage. They had no idea they had a plan F until i had the lady call the agent. They have absolutely no information on their PDP except what i got off of the Medicare.gov website.

 

[sman]

Did Ned ever answer the question or offer help?