Why are there so many rules to Medicare Advantage??

Dec 19, 2018

  1. InsuranceGuy29
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    InsuranceGuy29 New Member

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    I understand the company line of wanting to "protect" seniors, but I just feel like all 1,000,000,003 rules just aren't necessary. It almost feels like CMS and the insurance companies are putting all these provisions in to be able to say "gotcha!!," one day, and not pay the agents.

    Also, not being able to get paid for any previous business, if you fail the AHIP test, is kind of ridiculous. But, I'm a newer agent. What do I know? lol. Just wondered if the vets have any opinions or thoughts on the matter. It all just seems ridiculous.

    You basically can't even have a conversation with someone on Medicare without feeling like you're violating one of the rules.
     
  2. lukifer
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    lukifer Expert

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    Leave it to the government to further complicate a complicated process they created.

    In Washington, I believe it is called "Tuesday".
     
    lukifer, Dec 19, 2018
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  3. somarco
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    somarco GA Medicare Expert

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    I'm from the government and I am here to help you. - Ronald Reagan

    While it is true that DC makes things more complicated and expensive than it needs to be. It is also true the MA marketing rules, apply to agents but not carriers or CMS. And much that comes out of DC is created, overseen, administered and regulated by the Redundancy Department of Redundancy.

    But you need to understand this.

    When MA plans first hit the scene it was a wild west show. Almost anything goes.

    Agents created this mess that caused the govt to step in and over-regulate a product and market. When that happened almost everyone lost. The agents who abused the system are now back to selling snake oil and the good agents that are left are still making a living.
     
    Last edited: Dec 20, 2018
    somarco, Dec 19, 2018
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  4. DayTimer
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    DayTimer Guru

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    We could use a man like Ronald Reagan again
     
    DayTimer, Dec 19, 2018
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  5. Newby
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    Newby Guru

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    It was political. Advantage Plans were considered to be Preseident George W. Bush plans in the beginning and greatly upset the Democratic Party. It was a way to bankrupt real Medicare and funnel the money to “for profit” insurance companies. It had no rules the first few years and agents did run wild.

    Agencies recruited new agents to door knock entire cities and get them to sign up for their free benefits. Once the plans locked in it was nothing but complaints from duped seniors. The networks were shit. They had no idea they had given up their “real Medicare”. There were a lot of problems.

    By the time president Obama got elected the Dems had regulated it to death and cut the commissions in half. On one of President Obama first recorded interviews on the Sunday morning news channels he vowed to eliminate all Medicare Advantage plans which threatened Medicare and did nothing to help seniors. But he didn’t understand that the low income Democratic base liked Medicare Advantage. They had dental and other benefits and zero premiums. It wasn’t going anywhere or they were going to upset the masses.

    So now the politicians know it’s not to be tampers with too much. They have to deal with it. So they regulate it to death so it’s not really an open market success beating out government healthcare (original Medicare). Some of the regulation has been good. Some is way ineffective and over the top. But it’s better now than it was in the early days in many ways. Not as feature rich though.

    I think I got that right from my perspective of how it all played out. Could be wrong.
     
    Newby, Dec 19, 2018
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  6. somarco
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    somarco GA Medicare Expert

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    Or Herbert Hoover . . . .

     
    somarco, Dec 19, 2018
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  7. fun2drum
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    fun2drum Expert

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    I loathe new regulations on top of regulations, but I don't want it to be too easy for new money-hungry agents to come into the business or for bad agents to stay in the business. It seems to me that for some reason MA's attract the most unscrupulous agents who'll do or say anything to make a sale. The regulations we have to deal with are a PITA for sure, but I believe they protect the integrity of our industry and those of us who take it seriously.
     
    fun2drum, Dec 20, 2018
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  8. Newby
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    Newby Guru

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    Yes. But the over regulating has the opposite effect. It runs good agents off. The ones that try to follow rules and be compliant. And bad agents thrive because they aren’t going to follow rules any way.

    It’s just like the Do Not Call List. It penalizes good agents. But makes it much easier for the bad agents (and the scammers) that are going to call anyone and everyone.

    Rules don’t apply to people that don’t follow rules. The whole gun law argument is correct that if they ever banned guns you would have a whole country of good law abiding people with no guns to protect themselves and criminals (law breakers) with all the guns.

    Law makers and politicians live in a bubble. They seldom understand how their rules are going to play out in the real world.
     
    Newby, Dec 20, 2018
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  9. fun2drum
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    fun2drum Expert

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    Granted, there's a balance that should be maintained. Believe it or not I actually don't support over-regulation of any industry. Some of the laws are indeed political and ridiculous but I still think having laws is overall a good thing. It's the standard that separates the good from the bad. Good agents would still be good agents and bad agents would still be bad agents with no laws. The bad agents would thrive anyway but with no options for recourse and they would operate with impunity. We've got to have regulations - it's just a necessary evil, and the MA products have certainly demonstrated that need in the past. Besides, I've often lamented new regulations as they've been announced, but I've never been able to say that a regulation kept me from making any sales. The problem is that sometimes lawmakers add laws for political reasons or just for the sake of adding them, like they're not doing their job if they're not coming up with new laws. Common sense leaves the building when that happens.
     
    fun2drum, Dec 20, 2018
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  10. rousemark
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    rousemark Still Here!

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    I was fortunate enough to live in an era when med supp and FE apps consisted of one page...You had to get one signature (two if bank draft)..There was a replacement form to be completed if replacement was taking place.. There were no HIPPA Forms, No Outline of Coverage Forms or any of the myriad of other forms that we deal with now.. And, guess what? I cannot tell any difference in the amount of agent abuse from back then until today. All, the extra "disclosure" and paperwork hasn't helped one bit.. :no:
     
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