No more Medicare Advantage leads

Nothing on the horizon looks good for MA's. The next AEP is probably the same old same old except for the marketing rule changes- but beyond that everything is up in the air. MA's are already losing ground under the current administration because of Democratic control in Congress. Imagine what it will be like with Obama. He is completely on record as being against them and he is likely to be elected along with a Democratically controlled Senate and Congress. If so, they are toast.

As discussed, it is not likely that Obama and Congress will eliminate them because it looks too much like not supporting seniors but once they cut the subsidy and gravy train for carriers they will lose any type of competitive edge and just turn into dogs for both agents and clients.

Obviously there is some chance, not much, that McCain could be elected but you have change the whole balance in Congress too. You have both the AMA and AARP gunning to kill MA's and making quite a bit of progress as you would expect with that unholy alliance. (yes, I know AARP is also hawking MA's over on the other side of the house. They will do anything for a buck and clients pretty well know it these days).



Winter
 
Please explain which MA plans you are talking about. If you mean to say PFFS are gone, then say it. HMO plans have been here since 1985 and are cost effective. Medicare used to save 5% for every person enrolled in one of them.

Rick
 
Please explain which MA plans you are talking about. If you mean to say PFFS are gone, then say it. HMO plans have been here since 1985 and are cost effective. Medicare used to save 5% for every person enrolled in one of them.

Rick


PFFS is toast for sure longterm. All MA's are at risk because the data does not show any savings, the 5% figure notwithstanding. The Congressional Budget Office reported to Congress that "on average" the medicare advantage plans were paid 12% more than the same services would have cost under the traditional medicare fee for service arrangement. It stated, further, that the percent was even higher for PFFS plans (so they were not referring to just PFFS plans.

I dont know what the data concludes but Obama and Congress are going to be the ones to convince and they have far more than just the PFFS plans in their gunsights. If the data shows savings instead, then fine. That should be something for Congress to consider. The Congressional Budget Office conclusions will carry weight though.

Winter
 
So, what is the game plan to market MA plans this fall?
That's a very good question. I won't feel good about selling PFFS as they are probably only a one year deal. But then again, if they do go down the drain or the benefit really are changed, a med supp can be written on a GI basis.

In California, there is only one PPO and I really don't like it. So I will likely stay close to home and sell HMOs like the "old days." I'll continue to solicit and sell Med Supps.

Rick
 
If I was a senior... and very Ill... and had an MA...

Id enroll is a PFFS this year...

When 2010 comes around... Im in a Supp Baby!

Todays Options where you at?
 
That's a very good question. I won't feel good about selling PFFS as they are probably only a one year deal. But then again, if they do go down the drain or the benefit really are changed, a med supp can be written on a GI basis.

In California, there is only one PPO and I really don't like it. So I will likely stay close to home and sell HMOs like the "old days." I'll continue to solicit and sell Med Supps.

Rick


What is hard to predict at this point is how much collateral damage there will be when the PFFS plans begin to go south. We all know that many of the problems with MA's are specific to PFFS but the thinking of seniors and the general public is not that finely callibrated and they just respond to what the general drift is. A senior may be considering an MA but then hears that they could go out of business in a year or two, or she hears from a friend who has a PFFS zero premium plan that just popped up to sixty dollars a month just a year after all the spin about it being zero premium. Sure, you can wade in and huff and puff and explain that your plan is an HMO or a PPO or whatever, but it is always tough or tougher to make any kind of sale when the rumor mill is working against you.

My point is that I think that the demise of PFFS will cast a spell over the PPO and HMO plans as well. Yes, seniors will do a lot to save money, but they also value being on an even keel and knowing exactly what they have and dont have when you walk away. Telling them that things change every year and thats why you have an AEP wears thin after a while.

My strategy is going to be to lean more toward med supps but to get certified for MA's just to be involved enough to stay tuned. I like the idea that some seniors are saving dollars with MA's. I dont like the fact that most seniors who have an MA have no flaming idea what they really have and do not have after the agent walks away, regardless of how well he or she did in explaining it (assuming anyone explained it at all. They might have just signed up and sent the app back or did a telephone enrollement). There are complexities with med supps but a client has a Plan F or J for example, and is thinking that whatever they have, they are probably pretty well covered, then they are right even if they are in a fog about the details.

Still sorting it out. Personally, I think high deductible F could be a good choice for some seniors but there are few incentives for agents to sell it. Note that I said for "some" not all.

Winter
 
Ok, you already cannot cold-call for MA, but you can call to give information, etc about MA plans as a way to get around CMS. I imagine that nothing will change.
 
Here is what I see happening...

Major MA carriers in metro areas will either have a captive sales force on hand (like Humana) or they will keep just a few agents on hand throughout the year (1-3 agents) and during the enrollment seasons they will have brokers become semi-captive for the season.

Rural markets will have some contracted agents out there but the oversight will not be there. So, the metro areas will boom and the rural areas will not.

Just my $.02
 
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