- 8,707
Re: You've Gotta Be Kidding???
Stormtracker....please post back here the resolution
Stormtracker....please post back here the resolution
You've Gotta Be Kidding ?
- Thread starter stormtracker
- Start date
- Thread starter
- #22
- 919
Re: You've Gotta Be Kidding???
I will because this issue presents some turbulent ground for us agents. I don't like the prospect of being caught in a "catch 22."
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Mississippii: no chargeback as of yet, but Parker & Asses has come up with all kinds of clever means to hijack my escrow account. It was my understanding that chargebacks could only happen with rapid disenrollment, but not at P&A-- they will charge you back for years...
I will because this issue presents some turbulent ground for us agents. I don't like the prospect of being caught in a "catch 22."
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Mississippii: no chargeback as of yet, but Parker & Asses has come up with all kinds of clever means to hijack my escrow account. It was my understanding that chargebacks could only happen with rapid disenrollment, but not at P&A-- they will charge you back for years...
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- 1,704
Re: You've Gotta Be Kidding???
What part of "Your Medicare benefits will be administered by a private company" do you not understand?
That Medicare card just shows who pays the bill if on Original Medicare.
Their medigap card shows who pays the deductibles and copays (20%).
That MA card shows who pays what Medicare would have paid (same benefits) and what co-pays Client has to pay.
You cannot get a MA card without Medicare Part A AND Part B which then converts to Part C.
What part of "Your Medicare benefits will be administered by a private company" do you not understand?
That Medicare card just shows who pays the bill if on Original Medicare.
Their medigap card shows who pays the deductibles and copays (20%).
That MA card shows who pays what Medicare would have paid (same benefits) and what co-pays Client has to pay.
You cannot get a MA card without Medicare Part A AND Part B which then converts to Part C.
- 7,066
Re: You've Gotta Be Kidding???
If you want to start a pissing contest then so be it. You need to learn to read, not just scan posts.
I said, "Regardless of what has been posted here in the past, when someone enrolls in any Part C plan they give up their traditional Medicare."
To tell a senior that when they take a Part C plan they still have Medicare is misleading to them. To them "their Medicare" represents the card with the blue and red stripe across the top.
I talk to seniors almost every day that do not understand that their Medicare Card is no longer of any use to them after enrolling in a Part C plan. It was never explained in detail to them by the agent who sold them the Part C plan and told them that it is "just Medicare and your Medicare Supplement policy only FREE."
That is the "ax" I have to grind is with the unscrupulous, ignorant, quick-buck, greedy agents who have disseminated misleading information simply to make a fast buck.
We know that they are still part of Medicare but most of them don't unless an ethical agent takes the time to explain it to them.
I you don't understand that then maybe you are the one who needs to "get up to speed".
WRONG...WRONG...WRONG...
She is absolutely still enrolled in Medicare. I think you understand this point, but appear to have an ax to grind.
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PEOPLE...PEOPLE...PEOPLE
Enrollment into Part C or Part D, IN NO WAY, disenrolls a beneficiary from Medicare. If this is not your understanding, you need to get up to speed. If you inform people otherwise, you are spreading an untruth, and causing harm.
If you want to start a pissing contest then so be it. You need to learn to read, not just scan posts.
I said, "Regardless of what has been posted here in the past, when someone enrolls in any Part C plan they give up their traditional Medicare."
To tell a senior that when they take a Part C plan they still have Medicare is misleading to them. To them "their Medicare" represents the card with the blue and red stripe across the top.
I talk to seniors almost every day that do not understand that their Medicare Card is no longer of any use to them after enrolling in a Part C plan. It was never explained in detail to them by the agent who sold them the Part C plan and told them that it is "just Medicare and your Medicare Supplement policy only FREE."
That is the "ax" I have to grind is with the unscrupulous, ignorant, quick-buck, greedy agents who have disseminated misleading information simply to make a fast buck.
We know that they are still part of Medicare but most of them don't unless an ethical agent takes the time to explain it to them.
I you don't understand that then maybe you are the one who needs to "get up to speed".
- 1,255
Re: You've Gotta Be Kidding???
I didn't attend the Blagojevich ethics class, but, I did stay at a Holiday Inn.
HollyRoller, welcome to our disfunctional family!
Frank, start a different post on how you never sold, nor certified for Medicare Advantage Part C plans. And dabbled in Part D to make yourself dangerous.
Most people reading this post understand that Stormtracker asked for some HELP! People like stormtracker, Jdeasy, and now HollyRoller deserve your respect for being in the trenches and knowing their business. Experience counts.
Twenty five percent of the seniors are on MA plans and another quarter are on MedSupp's. It is possible to market both plans and chew bubblegum at the same time.
Lock and load!
I didn't attend the Blagojevich ethics class, but, I did stay at a Holiday Inn.
HollyRoller, welcome to our disfunctional family!
Frank, start a different post on how you never sold, nor certified for Medicare Advantage Part C plans. And dabbled in Part D to make yourself dangerous.
Most people reading this post understand that Stormtracker asked for some HELP! People like stormtracker, Jdeasy, and now HollyRoller deserve your respect for being in the trenches and knowing their business. Experience counts.
Twenty five percent of the seniors are on MA plans and another quarter are on MedSupp's. It is possible to market both plans and chew bubblegum at the same time.
Lock and load!
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- 285
Re: You've Gotta Be Kidding???
Thank you for saving me!! 90% of my business is SNP and LIS. Some people don't fit the plans because of Network Issues or Rx, I don't enroll them. The extra benefits we offer SNP's is very good for them. Care Management team that can go help in person!/Dental Helps ya keep what ya got benefits/ Vision(offen I hear "I havent had new glasses in years."/ Hearing.. hell offten time these people I see dont have a PCP(no telling how many I have helped fine a good one)/$560/ Yr. Personal care products.
Let me say this again...ITS NOT RIGHT FOR EVERY ONE!!!
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If you are not in Medicare after choosing to have your benefits coordinated and paid for MCO..... why the heck can she call them and file a complaint. Or get a SEP if a mistake has happened.
Let me tell ya a quick story I think fit in here... I had a problem with a enrollment that was electronically done.. I did it in the home after SOA and Paper Application. I am going to take responsibility that I made a mistake and clicked on a PDP not the PFFS he wanted. I think I'm close on fixing this. I had to help him file a complint on ME! "NBD" It's what it took after over and over tries with enrollment and CMS to fix this problem. Lesson learned? Be very careful on the plan type selection of electronic enrollment. Very hard to correct.
Thank you for saving me!! 90% of my business is SNP and LIS. Some people don't fit the plans because of Network Issues or Rx, I don't enroll them. The extra benefits we offer SNP's is very good for them. Care Management team that can go help in person!/Dental Helps ya keep what ya got benefits/ Vision(offen I hear "I havent had new glasses in years."/ Hearing.. hell offten time these people I see dont have a PCP(no telling how many I have helped fine a good one)/$560/ Yr. Personal care products.
Let me say this again...ITS NOT RIGHT FOR EVERY ONE!!!
- - - - - - - - - - - - - - - - - -
If you are not in Medicare after choosing to have your benefits coordinated and paid for MCO..... why the heck can she call them and file a complaint. Or get a SEP if a mistake has happened.
Let me tell ya a quick story I think fit in here... I had a problem with a enrollment that was electronically done.. I did it in the home after SOA and Paper Application. I am going to take responsibility that I made a mistake and clicked on a PDP not the PFFS he wanted. I think I'm close on fixing this. I had to help him file a complint on ME! "NBD" It's what it took after over and over tries with enrollment and CMS to fix this problem. Lesson learned? Be very careful on the plan type selection of electronic enrollment. Very hard to correct.
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- 19,648
Re: You've Gotta Be Kidding???
Before this gets out of hand, I want to say that I respect Frank more than I can express here. He has been very helpful to me on med sups and though I don't know him personally, I have friends that do and they vouch for Frank's knowledge and integrity.
I even understand where he coming from on the not having Medicare statement. I run into many seniors that think they lost their Medicare when they got an MA plan. I run into many doctor's offices that tell seniors they no longer have Medicare.
It is our duty to explain the plans and the differences and it's our duty to babysit those clients that we enroll in an MA plan until they do understand and, if we can't help them understand, it's our duty to help them dis-enroll. I hate to follow an MA agent that didn't properly explain things. It makes my job harder and it sheds a further distrust on agents with the seniors that already have some distrust to start with.
I no longer sell MA plans. I saw the handwriting on the wall with the legislation last summer. I did honor all my committments thru the '08 AEP. I didn't take a lead from anyone. I only contacted the people that I had promised to see during lock-in and before the silly ass rules came into being in Sept. I still enrolled 100 clients that way. I now refer anyone I run into that would be well served by an MA to a trusted agent friend. I haven't enrolled anyone into an MA plan since Jan.
Even when I was writing MA plans, I always told people that a med sup was the way to go if they could manage the premiums. I got referral after referral for MA plans though because they work so well in this area. If someone is determined to get into an MA, I wanted to be the one to do it. The problems with the carriers and CMS drove me from the market, not the clientelle.
Before this gets out of hand, I want to say that I respect Frank more than I can express here. He has been very helpful to me on med sups and though I don't know him personally, I have friends that do and they vouch for Frank's knowledge and integrity.
I even understand where he coming from on the not having Medicare statement. I run into many seniors that think they lost their Medicare when they got an MA plan. I run into many doctor's offices that tell seniors they no longer have Medicare.
It is our duty to explain the plans and the differences and it's our duty to babysit those clients that we enroll in an MA plan until they do understand and, if we can't help them understand, it's our duty to help them dis-enroll. I hate to follow an MA agent that didn't properly explain things. It makes my job harder and it sheds a further distrust on agents with the seniors that already have some distrust to start with.
I no longer sell MA plans. I saw the handwriting on the wall with the legislation last summer. I did honor all my committments thru the '08 AEP. I didn't take a lead from anyone. I only contacted the people that I had promised to see during lock-in and before the silly ass rules came into being in Sept. I still enrolled 100 clients that way. I now refer anyone I run into that would be well served by an MA to a trusted agent friend. I haven't enrolled anyone into an MA plan since Jan.
Even when I was writing MA plans, I always told people that a med sup was the way to go if they could manage the premiums. I got referral after referral for MA plans though because they work so well in this area. If someone is determined to get into an MA, I wanted to be the one to do it. The problems with the carriers and CMS drove me from the market, not the clientelle.
Re: You've Gotta Be Kidding???
As far as the subject of this thread goes:
Stating the common sense issues seems your best defence in addition to inclusion of the application and any other supporting material.
Common sense issues:
1. How many claims have been filed with CIP for this lady? It would seem rather impossible for her to not know she is on CIP rather than traditional medicare for the amount of time that has elapsed.
2. All the junk CIP mails out to a client. They literally bombard clients with mail. Kinda hard to scream you didn't know you were insured by CIP two years down road with 100# of paper stacked on the table from them.
3. As stated before. She has been on them for three different benefit years. She has received updated benefit books, ID cards, and the amount of premium deducted from her SS check has increased yearly. (I'd bet this is what pissed off her or her family).
4. A combo arguement. Claims and updated cards. Really make a big deal out of the claims. The more providers she's been to the better. That means every year (3) she's had to show a new ID card. I know you can't get your hands on that information due to privacy, but really "TELL" the investigator that if they want to prove the validity of this complaint of "now knowing" then the claims speak for themselves.
I had a manager with one of my larger med supp carriers call me about quality control. He was very matter of fact and stated that they expected agents to serve client professionally and in line with their beliefs. His complaint with me was a client of mine called the company pissed off that he never received his ID cards... 1.5 years since issue. The manager proceeded to question me about my usual delivery method (in person/mail) followup, etc. and stated that my contract with said company is in jeopardy. I let him spew for a while and then asked one question.
"How many claims has this guy filed with #$#$#$ company?"
silence
Manager... ummm.... I didn't check.
Me: Check and get back with me.
He understood what I was getting at. The likelyhood that a senior will not file one single claim in 1.5 years is very remote. I knew this gentleman and was sure with the health conditions I knew about he had to be filing claims.
The manager called back with an apology stating claims had started coming in on this client within 45 days of issue and pretty steady ever since.
Common sense.
As far as the subject of this thread goes:
Stating the common sense issues seems your best defence in addition to inclusion of the application and any other supporting material.
Common sense issues:
1. How many claims have been filed with CIP for this lady? It would seem rather impossible for her to not know she is on CIP rather than traditional medicare for the amount of time that has elapsed.
2. All the junk CIP mails out to a client. They literally bombard clients with mail. Kinda hard to scream you didn't know you were insured by CIP two years down road with 100# of paper stacked on the table from them.
3. As stated before. She has been on them for three different benefit years. She has received updated benefit books, ID cards, and the amount of premium deducted from her SS check has increased yearly. (I'd bet this is what pissed off her or her family).
4. A combo arguement. Claims and updated cards. Really make a big deal out of the claims. The more providers she's been to the better. That means every year (3) she's had to show a new ID card. I know you can't get your hands on that information due to privacy, but really "TELL" the investigator that if they want to prove the validity of this complaint of "now knowing" then the claims speak for themselves.
I had a manager with one of my larger med supp carriers call me about quality control. He was very matter of fact and stated that they expected agents to serve client professionally and in line with their beliefs. His complaint with me was a client of mine called the company pissed off that he never received his ID cards... 1.5 years since issue. The manager proceeded to question me about my usual delivery method (in person/mail) followup, etc. and stated that my contract with said company is in jeopardy. I let him spew for a while and then asked one question.
"How many claims has this guy filed with #$#$#$ company?"
silence
Manager... ummm.... I didn't check.
Me: Check and get back with me.
He understood what I was getting at. The likelyhood that a senior will not file one single claim in 1.5 years is very remote. I knew this gentleman and was sure with the health conditions I knew about he had to be filing claims.
The manager called back with an apology stating claims had started coming in on this client within 45 days of issue and pretty steady ever since.
Common sense.
- Thread starter
- #29
- 919
Re: You've Gotta Be Kidding???
I know what you're saying. Every logical test of common sense would confirm the frivolity of this complaint-- but the carrier is bound to accept the complaint and in fact, egg it on. I used to work for the State of Texas and I saw first hand how these things get blown out of proportion because some derelict along the food chain wouldn't handle a simple call-in for a question. Instead, that knucklehead would tell the customer to file a complaint if they didn't like how it was being handled...
I know what you're saying. Every logical test of common sense would confirm the frivolity of this complaint-- but the carrier is bound to accept the complaint and in fact, egg it on. I used to work for the State of Texas and I saw first hand how these things get blown out of proportion because some derelict along the food chain wouldn't handle a simple call-in for a question. Instead, that knucklehead would tell the customer to file a complaint if they didn't like how it was being handled...
mississippiagent
Expert
- 54
Re: You've Gotta Be Kidding???
so what kind of training dose someone working in medicare call centers have to have before they can talk with our seniors and even mentally challenged about medicare insurance questions?
so what kind of training dose someone working in medicare call centers have to have before they can talk with our seniors and even mentally challenged about medicare insurance questions?
