Too Many "Experts"

[Joe Moore]

We had an interesting ridiculous situation greeting us at the office yesterday morning. A lady my son Greg had written a MA only plan ($13/month) (policy not issued yet) was at our office wanting to cancel. She could not afford to pay the $13 per month, had just been kicked off Tenn-Care (leaving nobody to pay co-pays).

But, she wanted out because her "Good Christian Man" Pharmacist had told her anything with the word "Advantage" in it and tied to Medicare was nothing but a big "Rip-Off".

We tried to reason with her to no avail. Eventually we had her sign a statement saying her Pharmacist had advised her to drop her health insurance coverage, and 2 licensed insurance agents were telling her it could lead to disastrous financial consequences. She chose to believe the Pharmacist, only because he was a "Good Christian Man", he would not lie to her, and she realized he knew nothing about and was not licensed for or certified to give advice on health insurance.

I tried to compare the situation to me advising her on what medicines to take. She was deaf to any ideas.

I called the State Pharmacy Board to try to see what would happen, and the man agreed the pharmacist had probably overstepped his bounds. We are filing a complaint, and will keep the board posted on what happens.

Anyone ever have a similar situation? If so, how was it handled and what was the outcome?

Never a dull moment in the Senior Market!

 

[Josh]

Anyone ever have a similar situation? If so, how was it handled and what was the outcome?

Absolutely. Most of the time I find the best you can do is to explain everything as best you can, try to help them understand what's going on so they're making the decision, and if that doesn't work then just leave and shake your head. I'll usually explain to them the "catch" to what the "expert" is telling them to do, and then tell them they can always give me a call. On more than one occasion I've received those calls and they're easy to work with after that, but it really takes them losing faith in the "expert" before you can move on.

 

[VaDwayne]

We had an interesting ridiculous situation greeting us at the office yesterday morning. A lady my son Greg had written a MA only plan ($13/month) (policy not issued yet) was at our office wanting to cancel. She could not afford to pay the $13 per month, had just been kicked off Tenn-Care (leaving nobody to pay co-pays).

But, she wanted out because her "Good Christian Man" Pharmacist had told her anything with the word "Advantage" in it and tied to Medicare was nothing but a big "Rip-Off".

I guess if he was a good Muslim, or Hindu,or even a good athiest, his advice would have been more acceptable. Interesting......... Did you tell her that MA's wil be gone soon? I bet not..... Hmmm...

We tried to reason with her to no avail. Eventually we had her sign a statement saying her Pharmacist had advised her to drop her health insurance coverage, and 2 licensed insurance agents were telling her it could lead to disastrous financial consequences. She chose to believe the Pharmacist, only because he was a "Good Christian Man", he would not lie to her, and she realized he knew nothing about and was not licensed for or certified to give advice on health insurance.

He doesn't need a license, so there is nothing you can do. If he started giving rates, that would be something completely different.

I tried to compare the situation to me advising her on what medicines to take. She was deaf to any ideas.

You wouldn't need a license to do this either.. Prescribing it is someting entirely different. Do you advise your mother on her medicines? See what I mean..


I called the State Pharmacy Board to try to see what would happen, and the man agreed the pharmacist had probably overstepped his bounds. We are filing a complaint, and will keep the board posted on what happens.

You are wasting you time. I have clients mention the pharmacist all of the time, especially on but not limited to, PDP's. Seniors need someone they can trust, and it doesn't sound like your son was it (not that he's not honest, probably an age thing, how old is he?). Since you are older, I bet she would have trusted you.

Anyone ever have a similar situation? If so, how was it handled and what was the outcome?

You will never get her back and you are wasting time trying. Use that time to get somebody else.

Never a dull moment in the Senior Market!

It's only going to get worse...

 

[gdoty]

Absolutely. Most of the time I find the best you can do is to explain everything as best you can, try to help them understand what's going on so they're making the decision, and if that doesn't work then just leave and shake your head. I'll usually explain to them the "catch" to what the "expert" is telling them to do, and then tell them they can always give me a call. On more than one occasion I've received those calls and they're easy to work with after that, but it really takes them losing faith in the "expert" before you can move on.

Hard to fix stupid!

 

[Guest]

The home health agencies are the worst for us around here. They bash MA plans to their clients non stop and tell their clients that they can't come to their house anymore if they sign up on an Advantage plan (which is completely untrue).

It is usually a good indicator of a home health agency that is making unneccessary visits to patients just to bill medicare. They know that an MA company is going to be a little more strict on unneccessary visits.

I've never filed a complaint, but I should. Who would you complain to about a private home health agency?

 

[medx]

Had similar happen

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[lflashman]

Happens all the time, with just about every product. There isn't any recourse that I've found, but, I haven't tried too hard to find one.

 

[sokybrian]

After many years in real estate and also onsite sales, I can attest to the fact that there is ALWAYS and Uncle Charlie out there with no clue putting in his/her 2 cents. I'll bet it happens in your life as well. It's a good lesson for your son about the old rule of "like, trust, and help". If you get past those three hurdles, they won't listen to anyone else. I'm sure he is a great salesman, honest, and good insurnace man. Move on man, she's the one with the problem.

SokyBrian - BGKY

 

[Norwayguy]

So no more Tenn Care and she can't afford the MA co-pays....So how will she afford the medicare cost...So now she only has original Medicare....Think she will like the first $155 or part b costs?

I am not a fan of MA plans mainly due to the insane marketing rules but I agree they can be appropriate for some people...And this person sounds like a good fit, income just above medicaid. I would not worry too much about this client my bet is she ends up with a medical condition her assets go south and back to Tenn Care she goes. I wouldn't work too hard for someone that can't afford $13 a month for her insurance coverage I've found them to be the type to spend a lot of time on due to their income levels but not get a lot back in return...

VaDwayne, I bet his problem is a lot of people call themselves good christian people only to lower peoples hesitation factors....I know personally when someone tells me they are a good christian I cover my wallet...If your a good christian you don't need to be telling people that....however In this case what does the Pharmacist have to gain? My bet is he has had a lot of people on MAPD plans with inferior formularies which is why he developed his belief that anything with advantage in it was bad because that is all he would deal with...

Joe sorry for your son, tell him to move on when this client realizes she wants back on MA she will be outside her enrollment period and will have to wait. Tell him he can't fix stupid and to move on she might come back or she might not.

 

[lflashman]

When I first got into this business, my mentor told me that there are two types of people that we can't help, those that are dead broke, and those that are stupid. If she can't afford the $13/mo then she's dead broke. If she can and chooses not to because of bad advise she got from a person she wrongly believes in then she's stupid. Either way.......