Need Some Advice on MA Re-enrollment

[jdeasy]

I had a couple Bankers agents replace a couple of my life policies using scare tactics. No big deal. problem solved and I saved them.

But while there yesterday to get them back on bank draft they informed me that the Bankers agents also replaced her Humana MAPD with a better one.

I told her those plans changed all the time so they probably did OK for her. She pulls out her new Humana card to show me. It's a stand alone PDP.

She was on the PPO. I asked her what she did about her medical. She pulls out a Bankers HD F and then a Convalescent Care card that she said was her LTCi. $79/mo for both and she didn't have co-pays now since she had plan F and she was covered at the nursing home too.


And she thought it was all still thru Humana.

Once I explained to her what she had done she is livid. Naturally. She wants her Humana MAPD back.

She does not get extra help. There are no 5 star plans in her county. We call Humana and they say they can't do anything but we should call Medicare and make a complaint. We do that.

First the lady at Medicare says she believe she can get her back on the MAPD because she was mislead. Then she puts us on hold and comes back and says no. Even though the lady was mislead she did sign up for what she had and a complaint won't change that. She suggested we call Humana back and talk to a supervisor and see if they will re-enroll her.

We couldn't get a supervisor on the phone since they had all left early due to weather.

Is there another avenue to pursue? Did I just get the wrong person at Medicare?

Any ideas would be much appreciated.

 

[goillini52]

I had a couple Bankers agents replace a couple of my life policies using scare tactics. No big deal. problem solved and I saved them.

But while there yesterday to get them back on bank draft they informed me that the Bankers agents also replaced her Humana MAPD with a better one.

I told her those plans changed all the time so they probably did OK for her. She pulls out her new Humana card to show me. It's a stand alone PDP.

She was on the PPO. I asked her what she did about her medical. She pulls out a Bankers HD F and then a Convalescent Care card that she said was her LTCi. $79/mo for both and she didn't have co-pays now since she had plan F and she was covered at the nursing home too.

And she thought it was all still thru Humana.

Once I explained to her what she had done she is livid. Naturally. She wants her Humana MAPD back.

She does not get extra help. There are no 5 star plans in her county. We call Humana and they say they can't do anything but we should call Medicare and make a complaint. We do that.

First the lady at Medicare says she believe she can get her back on the MAPD because she was mislead. Then she puts us on hold and comes back and says no. Even though the lady was mislead she did sign up for what she had and a complaint won't change that. She suggested we call Humana back and talk to a supervisor and see if they will re-enroll her.

We couldn't get a supervisor on the phone since they had all left early due to weather.

Is there another avenue to pursue? Did I just get the wrong person at Medicare?

Any ideas would be much appreciated.

I don't know about the ins and outs of the MAPD's since it's been 7-8 years since I messed with that crap, but if she's paying $79 a month for a HDF and an overpriced Convalescent Care plan, how would a Plan N compare in price? I'd think she'd be better off.

 

[jdeasy]

I don't know about the ins and outs of the MAPD's since it's been 7-8 years since I messed with that crap, but if she's paying $79 a month for a HDF and an overpriced Convalescent Care plan, how would a Plan N compare in price? I'd think she'd be better off.

The best N I had was $97/mo. But she cancelled the HD F and the CC plan once she realized what she had done. She says she can't afford the N.

It come down to that being her only option? And right now it is.

I don't do MA plans either. But it was my understanding that a complaint about being mislead would give them an SEP.

 

[goillini52]

The best N I had was $97/mo. But she cancelled the HD F and the CC plan once she realized what she had done. She says she can't afford the N.

It come down to that being her only option? And right now it is.

I don't do MA plans either. But it was my understanding that a complaint about being mislead would give them an SEP.

Well, hand it off to your friend and let him try for that SEP. At this point she's got nothing to lose.

Don't you just love those Bankers Life agents?

 

[jdeasy]

Well, hand it off to your friend and let him try for that SEP. At this point she's got nothing to lose.

Don't you just love those Bankers Life agents?

I did call my friend that I refer the MA plans too. He said they wouldn't let him do it. Either Humana would decide on their own or Medicare might make them.

I've been a war with this particular Bankers office for a while now. many DOI complaints filed against them but they just keep on shrugging them off.

 

[goillini52]

I did call my friend that I refer the MA plans too. He said they wouldn't let him do it. Either Humana would decide on their own or Medicare might make them.

I've been a war with this particular Bankers office for a while now. many DOI complaints filed against them but they just keep on shrugging them off.

Could he try doing the SEP with another company besides Humana?

It amazes me how many states they've been in trouble in, yet like you say, they keep getting away with it. Makes you wonder.

 

[bluediamond]

I have two cases of another agent, not bankers, replace my MAPD plans on Dec 7th through fraud, the clients called Medicare to file a complaint and they gave them a SEP and I wrote them in the past couple of days and the company I placed them with has back dated them to Jan 1. So yes, she should call and speak to a supervisor and yell fraud, she will have to give the Banker's agent name.

 

[jdeasy]

I have two cases of another agent, not bankers, replace my MAPD plans on Dec 7th through fraud, the clients called Medicare to file a complaint and they gave them a SEP and I wrote them in the past couple of days and the company I placed them with has back dated them to Jan 1. So yes, she should call and speak to a supervisor and yell fraud, she will have to give the Banker's agent name.

Will do. She did tell Medicare that she thought it was fraud and she gave them the agent's name.

But we will try again.

 

[G.Gordon]

Call 800 Medicare again, get a new person, ask for a supervisor there. It is a situation I have had reversed this time of year. You will not be AOR because they basically re-enroll her. If you say that having her on the new plans will cause her limitations in healthcare access or undo financial stress they can even process is retro to 1/1. I've done it, she was lied to, they are there to protect them and offer resolution. Use the right terminology and be passionate about it, they will make it happen.

Also help the lady file a DOI complaint, crap like this deserves a ding in someone's record.

 

[jdeasy]

Call 800 Medicare again, get a new person, ask for a supervisor there. It is a situation I have had reversed this time of year. You will not be AOR because they basically re-enroll her. If you say that having her on the new plans will cause her limitations in healthcare access or undo financial stress they can even process is retro to 1/1. I've done it, she was lied to, they are there to protect them and offer resolution. Use the right terminology and be passionate about it, they will make it happen.

Also help the lady file a DOI complaint, crap like this deserves a ding in someone's record.

I have no interest in being the AOR. I don't sell MA plans anyway. So I couldn't be the AOR even if I wanted.

I talked to her today after the answers in this thread. I'm going by there Monday and we will call Medicare again. Thanks!