No More Wellcare or Coventry PFFS After 12/31/09

[coachd]

They do not have to be underwritten back into med sups. If the company leaves that area with that plan they can get into a med sup.

 

[Frank Stastny]

We all figured on this happening, didn't we?

Well the ones whos plan will not be available next year will at least have a guaranteed issue opportunity and won't have to be underwritten, med supp companies won't like that and I can see the med supp rates taking a big hike adding all of these uninsurable people to their plans.

Spot on!

Yep, we sure did, at least I did. That is the reason I never did get started selling PFFS plans. I didn't like them when they first came out and like them even less now.

I think your assessment of what is going to happen to Med Supps may be very accurate. We have guaranteed issue in Missouri and I wish they would do away with it. It may be good for agents in the short run but agents who are in the business for the long haul end up with a lot of unhappy clients when they get huge rate increases because of it.

I am so pleased to hear that PFFS plans are going away.

In the next couple of years we are going to see a huge increase in Med Supp sales. Now it the time for agents to begin positioning themselves to be there when it happens.

I have gotten a lot of calls recently from agents who want to be trained to prospect for and sell Med Supps.

 

[Hank]

Frank..... I don't know you but I respect you completely for your knowledge and your willingness to help other agents freely. But I don't agree with this statement.

I am so pleased to hear that PFFS plans are going away.

In the next couple of years we are going to see a huge increase in Med Supp sales. Now it the time for agents to begin positioning themselves to be there when it happens.

Here in Upstate/Western, New York State, the senior population will have to chose between eating and buying a Med Sup.

Most of my clients are not poor enough to qualify for Medicaid, but poor enough that they can not afford to buy a Med Sup or a Part D.

Medicare Advantage PFFS was the ONLY thing they could afford to have and still be able to take prescribed meds, pay their heating bill and eat.

What do you suggest a senior making $1,000 a month on SS do to survive ? Just curious ?

 

[GreenSky]

What do you suggest a senior making $1,000 a month on SS do to survive ? Just curious ?

Wait for a government bailout like GM is getting.

The reality is that seniors don't have to buy a med supplement. Unless they are in the hospital or have chemo, they will likely not save enough in services by paying a premium.

I feel bad for people that don't have a lot of money, but are we to pay for their insurance? That's socialism. We already provide 80% of the cost and many doctors and clinics will waive the other 20%.

If the f*cking government hadn't put all the fraternal societies out of business in beginning of the 20th century with their great idea of welfare, we wouldn't have this problem - nor would we have needed Medicare.

Rick

 

[Russ]

Wait for a government bailout like GM is getting.

The reality is that seniors don't have to buy a med supplement. Unless they are in the hospital or have chemo, they will likely not save enough in services by paying a premium.

I feel bad for people that don't have a lot of money, but are we to pay for their insurance? That's socialism. We already provide 80% of the cost and many doctors and clinics will waive the other 20%.

If the f*cking government hadn't put all the fraternal societies out of business in beginning of the 20th century with their great idea of welfare, we wouldn't have this problem - nor would we have needed Medicare.

Rick

I take it you don't write a great deal of med-supps?


Just got this email from Today's Options.....

May 15, 2009


Subject: Individual Private Fee-for-Service (PFFS) 2010 Market


I'm sure you have seen that three of our major competitors (Coventry, WellCare and Health Net) in the individual Private Fee-for-Service (PFFS) market have officially announced they are withdrawing from thismarket as of December 31, 2009 - this year end. Under current CMS rules and regulations, their existing individual PFFS members will be terminated and thus be forced to seek other coverage.

Our Chairman, Richard Barasch, in a recent investor call stated, "For 2010, we expect to bid in all of our current MA markets, including PFFS counties. We go into this bidding season with a favorable trend in our benefit ratios and an improving G&A structure."

From Mr. Barasch's statement, you are assured that we will continue to be in the individual PFFS market and thus continue to support You - a member of our valued field force. We continue to welcome Your Business in the remainder of 2009 as well as in 2010.

We have received numerous phone calls asking whether or not we are withdrawing from the individual PFFS market. Hopefully this clarifies that we are not withdrawing and we are here to support you and your clients.

Very truly yours,

Gary W. Bryant
Executive Vice President &
Chief Operating Officer

 

[thereaper]

I believe I read that all PFFS will become regional PPO's in their prespective areas beginning 2010, but can't find where I read it.

 

[GreenSky]

I take it you don't write a great deal of med-supps?

You would be wrong.

Rick

 

[Cenla Agent]

I believe I read that all PFFS will become regional PPO's in their prespective areas beginning 2010, but can't find where I read it.

Since I've basically gotten out of this market I can't remember where I read it either and I haven't kept up on all of the latest developments. I had read that PFFS will start looking more like a PPO (or at least it was proposed) in the sense that providers will be contracted, etc. But it wasn't exactly going to work like a PPO either.

It may be different in other parts of the country, but in the states I'm familiar with, Humana is the only Regional PPO that I'm aware of.

 

[jdeasy]

I believe I read that all PFFS will become regional PPO's in their prespective areas beginning 2010, but can't find where I read it.

PFFS plans have to have a network of providers in any county with more than one PFFS plan available. This requirement is to met ny the 2011 plan year.

Of course, this is subject to change as always.