Why I want NO Advance for MA Business.

[Mac1958]

Agreed, as-earned would probably flush out some of those who need to be flushed. No segment of our population is lied to and cheated more than our seniors, and a few bad agents make the rest of us look bad chasing these bucks.

I guess that's why I don't have a problem with CMS. In my dealings with them, their priority is protecting seniors, and I've got no problem with that.

Should be interesting to see if CMS standardizes plans, especially as we move away from PFFS and towards managed care. You'll see very few Medicare PFFS plans, if any, after 2011.

...

 

[allhealthandlife]

What percentage of seniors knew what Medicare Advantage really was in 2006 maybe 10 % how many now really know what Medicare Advantage is now maybe 20 % ( and MA now has over 25 % market share of the 40 million Medicare beneficiaries )

My point if CMS really wanted seniors to know and understand that there Medicare was being privatized they would have used clear labeling instead the euphemism " Medicare Advantage "

In my opinion CMS set the standard for confusing seniors.

 

[midwestbroker]

The problem boils down to PFFS plans.

Captive agents and brokers have been selling HMO and PPO plans in some markets for years. Kansas City Metro has had some sort of Medicare HMO in place since the early 90's.

Many of us in the senior market prior to that thought that they lock in would never happen. It was proposed back in the late 90's for MA plans and AARP said nope. Most of the carriers have just gotten creative and are selling all year (SNP plans).

As earn the commissions. I do not care. I do not see the bad agents who have been selling on borrowed time going anywhere.

 

[Mac1958]

Well, CMS requires MA companies to make the following things crystal clear to MA prospects:

1. MA plans are not Medicare Supplements
2. MA plans are part of the Medicare system, and enrollees are still in the Medicare program
3. MA plans and Medicare Supplements are sold by private insurance companies

They back this up by:

1. Utilizing "secret shoppers" at both seminars and in-home appointments to confirm that the requirements are being followed
2. Pulling the ability to sell MA products, pulling licenses altogether, or both, to those agents who purposely break the rules.
3. Penalizing MA companies for the behaviors of agents that are directly or indirectly representing them.
4. Requiring that every word on every slide in every MA presentation, that every word in every print/radio/television advertisement pass their specific approval.
5. Requiring that every agent representing every MA company completely and clearly addresses every slide or page of the CMS-approved MA presentation.

I can't imagine there's much more they can do.

It's been my experience that the real culprits behind the confusing of seniors are usually dishonest agents after a quick and easy buck. I see it regularly. CMS is trying to protect the "last trusting generation."

...

 

[myinsurebiz]

It's not the advances that are the problem - it's CMS.

As bright as they are - they still let agent B come in behind agent A and roll them into whatever plan is the flavor of the month.

Change the damn system. Tell all the carriers to go to hell and just improve the Medicare System. The government is paying anyway - just manage the thing themselves.

Who needs the carriers? Take the commissions, the premiums and our taxes and put them into funding the program. Hook up with PHCS and rock and roll!

I hope the next President and Congress fix this crap.

What a sad state our seniors are in . . .

Thank goodness my healthcare costs will be self funded because I certainly won't be counting on the USA . . .

Tom

 

[GreenSky]

It's not the advances that are the problem - it's CMS.

As bright as they are - they still let agent B come in behind agent A and roll them into whatever plan is the flavor of the month.

Change the damn system. Tell all the carriers to go to hell and just improve the Medicare System. The government is paying anyway - just manage the thing themselves.

Who needs the carriers? Take the commissions, the premiums and our taxes and put them into funding the program. Hook up with PHCS and rock and roll!

I hope the next President and Congress fix this crap.

What a sad state our seniors are in . . .

Thank goodness my healthcare costs will be self funded because I certainly won't be counting on the USA . . .

Tom

Tom:

I'd argue with what you posted but it's obvious you have no idea what you're talking about.

Rick

 

[myinsurebiz]

Rick -

My point was - the government is paying anyway - commissions to the carriers, etc - why not just manage the healthcare themselves - it's not rocket science.

Wasteful spending is all it is.

CMS pays carrier A for Susie to be on the WellCare plan, in comes an agent for carrier B and switches Susie to the HealthNet plan. CMS just paid WellCare their "commission" - now they have to charge that back and pay HealthNet the commission - and round and round we go . . .

The last agent to get it in - wins!

What a waste.

Obama, John, C. Rice - whoever - I hope somebody does something to fix it . . .

But noooooooo - big brother can't manage spending $500 for toilet seats - neverless healthcare.

What a joke.

They need one GIANT ppo plan - give tax breaks to the providers that cooperate and fix the mess.

Say what you want Richard - but a monkey could do it . . .

Tom

 

[GreenSky]

Rick -

My point was - the government is paying anyway - commissions to the carriers, etc - why not just manage the healthcare themselves - it's not rocket science.

Wasteful spending is all it is.

CMS pays carrier A for Susie to be on the WellCare plan, in comes an agent for carrier B and switches Susie to the HealthNet plan. CMS just paid WellCare their "commission" - now they have to charge that back and pay HealthNet the commission - and round and round we go . . .

The last agent to get it in - wins!

The plans are capitated on a MONTLY basis. What "commission" are you talking about?

Seriously, you clearly do not have an understanding about how these plans are paid so your comments really make no sense. CMS doesn't pay the agent a commission, the health plan does.

So once again I suggest that you gain some knowledge before you make a comment.

Rick

 

[MedSuppPro]

Change the damn system. Tell all the carriers to go to hell and just improve the Medicare System. The government is paying anyway - just manage the thing themselves.

Tom

Problem is that Medicare contracts all their services out. Take 1-800-Medicare; it's a multi level contracted out patchwork of call centers. And we are paying for their 8 minute average hold time. Plus multiple service problems.

So, when you call 1-800-Medicare your not talking to Medicare.

Within the next couple of days we will see the new new CMS regs! I'm afraid they will overstep reality. We will all have more rules, disclaimers, and more confused seniors.

CMS will change their 1-800 disenrollment policy to be a more user friendly system of proactively asking for marketing infractions and retroactively disenrolling. In fact, they will encourage retroactive disenrollments. So, Joe get your checkbook out for more debit balance payments.

 

[mking]

I see your point and it may be a good one............However I am going to wait and see what the commissions will be...the new rules put a real damper on selling these plans....How much time and money do I want to spend on this program????We did good for the last two years, but the party may be over..............Lets face it behind all this CMS and the Demcrats do not want use selling MA plans....really!
I hate to say it , but I may through in the towel..........A few bad agents ruin it for the rest of us good one.........We helped a lot of seniors in the last two year....LIS, Medicare Savings plans , etc..........NO body has ever looked at the postive things that agents have do with this program...Is CMS going to meet face to face with every senior in American and explain the details....I do not think so...