Disaster/Emergency SEP

[AugustaMi]

Slightly off topic, but I was just told if someone has OG Medicare with PDP, that they could be put on a 5 star plan. I'm asking bc I do have a person coming back to Michigan from vacation and called me from Fla, asking about getting something when they come back in a few weeks. Hubby has the OG Med with PDP, wife has nothing yet but turning 65, just got B. I know I can do hers, but wondering if this is true...that Hubby can be put on a 5 star.

I am not sure yet if she's right (the lady who told me this), and I haven't tried it yet as this is my first lock-in period I am learning a lot....only 7 months in at this Medicare Adventure.

Thought I'd run it by ya'll. Thanks in advance. If this is the case it would be an option for the OP.

 

[AugustaMi]

It’s funny you say that . Has happened to me. When the clock struck midnight on March 31 st I thought I could relax with regular non dual / lis clients . Nope now with the dst sep call centers will be going wild trying to steal clients . So mapd is basically year a round affair now . The low end mkt is being bombed by call centers . I really believe going forward your not going to have a viable long term business with mostly dual/lis . If you have a book of 100 dual/ lis and walked away 50 would be on the books in 1 year . The nastiness and viciousness in the low end mkt is startling .

As a new person to Medicare, not Health U65, I am shocked at the shady shade happening. This career has always had some bad players, but this is a whole new level. Ended up only doing about mid-30 MAPD enrollments during AEP (I work another busy job in property management so had not much time), of those, 6 were bumped by other agents. I did get 4 back. The other 2 I didn't bother with as they were 3 hour round trip and couldn't get them on the phone. Those two were a twofer. Also managed to get some other products done, but that's not part of this. This jockeying around took a lot of time and I thought, whoa, is this really worth it. I had to go back and get those back, then focus on OEP in general, which was only half of what AEP was.

2 big things stand out, but plenty more was acknowledged. One, a lady with newly diagnosed dementia, was switched 4 times. I originally did hers through her POA (happened to be a neighbor attorney daughter of the lady I wrote). Only kept at helping them bc she was a neighbor. If I didn't personally know the POA, and see their utter confusion I would have walked. BUT OMFG, the headache and yes she was switched 2 times during OEP. I ended March with putting her on the only 5-star in the area. Verdict is out. Would not even doubt if she's switched again, but did manage to get the family to put some precautions in place to keep her off the phone with "strangers", and had the mail re-routed to POA. Could never figure out if there was a way at CMS to stop that kind of thing from happening. Should be a way to get the POA up the food chain to the CMS, to keep that from happening. No one's been able to answer this question for me. Ok, so I know to stay away from this scenario.

The second one that rocked me, was a guy who walked into my office and asked if I could help him, some agent put him on Priority without his knowledge. He only knew when he got the mail and letters. He had a pushy guy call him on the phone and he listened to the pitch, swore he never gave him Med #s or signed a scope. He wrote down the name of the guy he talked to on the phone, he writes everything down (who knows might've even been a fake name). We looked the guy up in licensing, and it showed that guy lost his license back in August. UGH. so I figured the guy took the info and wrote him on Priority under another licensed agent. I mean that's one possiblity. I never did get the actual policy or anything with who actually wrote it. This guy was just a random, so win/win, new client out of nowhere. Yes, it's time-consuming but I dig to see who did what, simply bc I watch my back. Not new to the industry in general, just medicare.

Anyway, that guy loved BCBS, only thing he ever has been on his entire adult life. I did get him back on it, but hopefully, it sticks. It should, he now stops in and thanks me, and gave me a few referrals. Super nice guy. Sad to see what's going on with the elderly folks.

My point is this, if this kind of cray happens in the small bit of business I did, I can only imagine that with larger numbers, it happens more. Or, maybe it's the demo I was doing this first AEP, and my new-ness at the medicare business, idk.

The other point was that yes, during the 1st example, someone did use a shady SEP and got away with it. That's all I could come up with, and what my FMO thought happened.

One good thing, was even in that small bit of biz, I definitely got an education.

 

[LostDollar]

Slightly off topic, but I was just told if someone has OG Medicare with PDP, that they could be put on a 5 star plan. I'm asking bc I do have a person coming back to Michigan from vacation and called me from Fla, asking about getting something when they come back in a few weeks. Hubby has the OG Med with PDP, wife has nothing yet but turning 65, just got B. I know I can do hers, but wondering if this is true...that Hubby can be put on a 5 star.

I am not sure yet if she's right (the lady who told me this), and I haven't tried it yet as this is my first lock-in period I am learning a lot....only 7 months in at this Medicare Adventure.

Thought I'd run it by ya'll. Thanks in advance. If this is the case it would be an option for the OP.

Caveat, not an agent

5-star special enrollment period | Medicare

https://q1medicare.com/faq/FAQ.php?faq=What-is-the-5-star-Special-Enrollment-Period-&faq_id=558

 

[wehotex]

Slightly off topic, but I was just told if someone has OG Medicare with PDP, that they could be put on a 5 star plan. I'm asking bc I do have a person coming back to Michigan from vacation and called me from Fla, asking about getting something when they come back in a few weeks. Hubby has the OG Med with PDP, wife has nothing yet but turning 65, just got B. I know I can do hers, but wondering if this is true...that Hubby can be put on a 5 star.

I am not sure yet if she's right (the lady who told me this), and I haven't tried it yet as this is my first lock-in period I am learning a lot....only 7 months in at this Medicare Adventure.

Thought I'd run it by ya'll. Thanks in advance. If this is the case it would be an option for the OP.

Absolutely TRUE!! Go get ‘em

 

[wehotex]

Would Cigna allow this in most states

Cigna is nearly always the FIRST carrier to announce these DST SEPs as they occur. About 2 years ago, I remember that an agent that I knew was successfully writing up people that were NOT from the designated counties, but STILL went through.

 

[AugustaMi]

Cigna is nearly always the FIRST carrier to announce these DST SEPs as they occur. About 2 years ago, I remember that an agent that I knew was successfully writing up people that were NOT from the designated counties, but STILL went through.

And looking back to right before AEP started, back when I was worried ah about all the compliancy issues that could come up, I laugh at myself. It took me years to get into this market bc it seemed so overregulated, too many things to watch out for and too many certs and AHIP and blah.

From where I sit now, I am like wtf, are there truly any rules and regs? Or is it all just for show?

Yes, as for Cigna, same thing with apparently Wellcare. Another agent I know from out of state, but with same FMO I am with, actually had to get on one carrier, and of course with a vailed threat...they will back off when pushed and withdraw a shady enrollment, so I've heard. Same agent that confronted a carrier, went after an agent submitting shady enrollments, found he had 5 complaints for the same behavior....nothing to date has happened, and he's now on 6 complaints.

That kind of thing I walk from....too busy for that, but man...talk about needing a tough skin. Guess that goes for any real business. Who knows though, after years of doing it, I may have a different perspective. I do though, track who switched who and under what circumstances. For different reasons and having to do with past FMO tactics. Long story...sigh.

 

[DonP]

And looking back to right before AEP started, back when I was worried ah about all the compliancy issues that could come up, I laugh at myself. It took me years to get into this market bc it seemed so overregulated, too many things to watch out for and too many certs and AHIP and blah.

From where I sit now, I am like wtf, are there truly any rules and regs? Or is it all just for show?

Yes, as for Cigna, same thing with apparently Wellcare. Another agent I know from out of state, but with same FMO I am with, actually had to get on one carrier, and of course with a vailed threat...they will back off when pushed and withdraw a shady enrollment, so I've heard. Same agent that confronted a carrier, went after an agent submitting shady enrollments, found he had 5 complaints for the same behavior....nothing to date has happened, and he's now on 6 complaints.

That kind of thing I walk from....too busy for that, but man...talk about needing a tough skin. Guess that goes for any real business. Who knows though, after years of doing it, I may have a different perspective. I do though, track who switched who and under what circumstances. For different reasons and having to do with past FMO tactics. Long story...sigh.

The rules and regulation are a joke . There’s zero zip nada . These old low income one people will be flipped over and over if they answer the phone . It’s there nature of wanting free stuff and a shinier coin .The low end is being hit relentlessly. I wrote an incredible amount of business the last 16 months . And 90% is still here . Only because I saved a ton by being a pit Bull . But it’s really tired me out . I’m 100% now trying to write much more t-65 and non dual business . And I’m looking at trying to get 20% of my business Medigap . I want clients that appreciate my knowledge not ones that switch for a extra tooth brush .

 

[Patrick Flammia]

Slightly off topic, but I was just told if someone has OG Medicare with PDP, that they could be put on a 5 star plan. I'm asking bc I do have a person coming back to Michigan from vacation and called me from Fla, asking about getting something when they come back in a few weeks. Hubby has the OG Med with PDP, wife has nothing yet but turning 65, just got B. I know I can do hers, but wondering if this is true...that Hubby can be put on a 5 star.

I am not sure yet if she's right (the lady who told me this), and I haven't tried it yet as this is my first lock-in period I am learning a lot....only 7 months in at this Medicare Adventure.

Thought I'd run it by ya'll. Thanks in advance. If this is the case it would be an option for the OP.

5 star will get it done for ya, not an option for my guy unfortunately. No 5-star with his doctors!