Almost every state someone who's ever had a pdp you will not get full true up of $601 . I'm on many national Facebook groups and almost every agent says the same . There might be a few carriers or states were it still happens .
True ups end of year?
- Thread starter AgentGeneral
- Start date
Almost every state someone who's ever had a pdp you will not get full true up of $601 . I'm on many national Facebook groups and almost every agent says the same . There might be a few carriers or states were it still happens .
Not every company pays that way,
Not sure what having a PDP has to do with going on an MAPD. If someone has had an MAPD then you just get the half commission. I write mainly Aetna and they always pay full commission on someone who has not been on an MA plan before regardless of effective date. I write alot of Cost Plans which can be done year around and they also pay full commission whenever eff date is coming off a Med Sup and PDP.
Im speaking for United and Humana . United 100%. It's obviously the same with the poster asking .
As I said in yrs past i used to get full true ups no matter if they had a pdp card .Some states and carriers obviously still pay full tru ups if they only had a pdp card .
- Thread starter
- #26
AgentGeneral
Guru
- 423
Arguing again I see
I have seen it both ways in Michigan. I have not always gotten Tru up on people with PDP, particularly the ones also on Medicaid.
I do not write UHC. It's not in my main county, so can't speak on it. And not good in the surrounding counties. So I don't bother contracting so far. I used to and still have a good number U65 on it, but zero MAPD.
I still see Tru ups on some that should not be and no tru up on others I believe should be paid on. Its messy and the only answer I get it "Its up to CMS, carrier has no control" they pay us how it's paid to them. I've tried figuring this out...BCBS seems to pay full, Humana hit or miss. I'm thinking it has to do with the "accreted" process which I still don't fully understand and that's actually what I was told early on when I started noticing this in 2022. Price of doing any business with anything the government has their hands in -- buck is always passed to next guy.
I am not counting on it being like last year. Already I'm still owed T65s back to 9/1
Last year, yes Don, Humana was fast like Jimmy Johns, paid on Jan 6th. BCBSM wasn't far behind, Jan 16th I think. I know most aren't doing BCBSM but we have a bunch of agents here who are, as esp this coming year they blew out with some nice looking plans This past year, we have BCBSM giving food/otc card for those not even on Medicaid, just SSBCI is necessary and easily obtained. Who knows how this coming Jan will pan out. Judging on the hold up just for T65s, I'm just thankful I'm pumping GTL.
Weird though still no T65 from 9/1 on since last week I did get paid over ride by FMO on almost all I've done already through AEP--guess theyre just being generous
. I'm thinking any day now on T65s, but not holding my breath.
I have seen it both ways in Michigan. I have not always gotten Tru up on people with PDP, particularly the ones also on Medicaid.
I do not write UHC. It's not in my main county, so can't speak on it. And not good in the surrounding counties. So I don't bother contracting so far. I used to and still have a good number U65 on it, but zero MAPD.
I still see Tru ups on some that should not be and no tru up on others I believe should be paid on. Its messy and the only answer I get it "Its up to CMS, carrier has no control" they pay us how it's paid to them. I've tried figuring this out...BCBS seems to pay full, Humana hit or miss. I'm thinking it has to do with the "accreted" process which I still don't fully understand and that's actually what I was told early on when I started noticing this in 2022. Price of doing any business with anything the government has their hands in -- buck is always passed to next guy.
I am not counting on it being like last year. Already I'm still owed T65s back to 9/1
Last year, yes Don, Humana was fast like Jimmy Johns, paid on Jan 6th. BCBSM wasn't far behind, Jan 16th I think. I know most aren't doing BCBSM but we have a bunch of agents here who are, as esp this coming year they blew out with some nice looking plans This past year, we have BCBSM giving food/otc card for those not even on Medicaid, just SSBCI is necessary and easily obtained. Who knows how this coming Jan will pan out. Judging on the hold up just for T65s, I'm just thankful I'm pumping GTL.
Weird though still no T65 from 9/1 on since last week I did get paid over ride by FMO on almost all I've done already through AEP--guess theyre just being generous
. I'm thinking any day now on T65s, but not holding my breath.Anita McAllister
New Member
- 11
I called UHC a few days ago. They said CMS was "backed up" on the TrueUps. I just received one today I was expecting for two months...still waiting for one more.
I hope that's helpful!
I hope that's helpful!
- Thread starter
- #29
AgentGeneral
Guru
- 423
I did get an email a month ago or so. not going to go back and find it that did say what Don is saying.
It was a Humana email pertaining to commissions. Can't remember the exact wording and don't have time to dig it out.
It was a Humana email pertaining to commissions. Can't remember the exact wording and don't have time to dig it out.
I've gotten a good many prorated tru ups on mapd people who had plans with other CO's before I write them . Ive also seen chargebacks 8 months later on plans . I just keep writing and don't try to figure stuff out .Having the pdp card is really only an issue with people on Medicaid that get their Medicare card in March - Nov and it's prorated in most states . 95% of people that switch from a med sup/ pdp to mapd do it during aep . With a 1/1 effective date it's a full $610 trueup.
Similar threads
