I have had several clients tell me this year that Humana has called them to discuss their drug plans, and tell them they were on the wrong one, and Humana would recommend a new one. When i would re run their plan, the one that Humana recommended was clearly not the right choice.
Disgusted with Humana this Year for AEP
- Thread starter selfgen
- Start date
DeadSlash
Expert
- 42
I trained a couple of Humana's call centers for PDP this year. The call center locations were just vendors, but they are Humana's largest PDP call centers. It's a pretty big vendor, I spent a week and a half at Humana's office in Tampa this summer getting prepped for the rollout etc. I am not aware of any outbound program from Humana this year for PDP plans. I guess it is possible that there is another vendor taking these inbound calls, but I'd be surprised if I wasn't ware of them. There would have been a script to handle the calls, or where to transfer them.
Are you 100% sure the calls are from Humana?
I asked the same thing "are you sure its humana?" every single customer says the same thing "yes, the knew what plan I already had, and said they were with humana..."
and the funny thing is its only happening with my customers that have a humana PDP
I. M. Green
New Member
- 16
This must be your first time around the block with Humana. The fact that you guys are complaining about paper enrollmnet kits and applications makes me laugh. Lol, the enrollment kits a little thin this year, too funny.
You won't be so worried about the kits anymore once you learn about some of the other things they do:
Like most carriers, they ARE above the law. CMS looks the other way while they conduct all kinds of illegal marketing activities, including year round shady outbound calls campaigns from within their own call centers, (I beleive there are 4 of them around) employing captive telesales agents. These places are run by the most dishonest, shady, Amoral group of people you will ever come across.
Just to clarify the previous discussion, Humana calls ALL of your customers year round. They will call to sell them OSB or Dental and Vision Coverage among other products, regularly. If you enroll someone onto a PDP Only, say bundled with a MedSupp from another carrier, guess what....they will call and try to switch that member over to an MAPD promising to save money on premium and provide additional benefits, cancelling the member's supplement.
Since they are already giving CMS the finger and spitting in your face, why stop there......
For example, One of my existing Humana Members in FL got an they are sending out mailers to ALL of their existing RPPO members promising them a $10 Amazon Gift Card to call and enroll onto their LPPO. They even have to sack to print '$10 gift card just for calling and enrolling today', or attending a seminar.
Have my own members that are going to seminars that want the gift cards.
Last I checked, CMS Marketing Rules state that we can not offer any cash or anything that is easily converted in to cash, specifically says NO GIFT CARDS!
SMH
You won't be so worried about the kits anymore once you learn about some of the other things they do:
Like most carriers, they ARE above the law. CMS looks the other way while they conduct all kinds of illegal marketing activities, including year round shady outbound calls campaigns from within their own call centers, (I beleive there are 4 of them around) employing captive telesales agents. These places are run by the most dishonest, shady, Amoral group of people you will ever come across.
Just to clarify the previous discussion, Humana calls ALL of your customers year round. They will call to sell them OSB or Dental and Vision Coverage among other products, regularly. If you enroll someone onto a PDP Only, say bundled with a MedSupp from another carrier, guess what....they will call and try to switch that member over to an MAPD promising to save money on premium and provide additional benefits, cancelling the member's supplement.
Since they are already giving CMS the finger and spitting in your face, why stop there......
For example, One of my existing Humana Members in FL got an they are sending out mailers to ALL of their existing RPPO members promising them a $10 Amazon Gift Card to call and enroll onto their LPPO. They even have to sack to print '$10 gift card just for calling and enrolling today', or attending a seminar.
Have my own members that are going to seminars that want the gift cards.
Last I checked, CMS Marketing Rules state that we can not offer any cash or anything that is easily converted in to cash, specifically says NO GIFT CARDS!
SMH
- 1,453
I have heard stories of PDP members who called in about a question, and were tranfered to telesales that pitched an hmo/ppo. It was discussed on the forum last year during AEP, and a few agents said thats why they wont use humana pdp when they could use another carrier like silverscript.
As for the $10 giftcards, I really would like to know how that is within the rules. Last year I remember seeing Aetna offer $10 giftcards if a person shows up to a seminar. If its within the CMS rules, thats fine with me, I'd just like to know how I can use the Giftcard offer in my own marketing efforts.
I. M. Green
New Member
- 16
I tried reading into that subject, Medicare Marketing rules STRICTLY PROHIBIT using gift cards, cash, or anything easilt converted into cash. Since Medicare is a federally funded it is potentially a violation of the anti-kickback statue, same law the Feds use to throw the book at Dr.s and agents. Love it how same rules never apply to the carriers.
Freedom/Optimum this year also is also running hourly TV Commercials offering $10 gift cards advertising Part B Give back and DE Plans.
Retail is super slow this year and customers I have retained for years are hoing to these seminars and getting high pressure sales tactics to enroll.
I asked my GA how we can compete against that, still waiting on a response....
Freedom/Optimum this year also is also running hourly TV Commercials offering $10 gift cards advertising Part B Give back and DE Plans.
Retail is super slow this year and customers I have retained for years are hoing to these seminars and getting high pressure sales tactics to enroll.
I asked my GA how we can compete against that, still waiting on a response....
- 1,704
Amen to the giftcards...I sure would like to know how they skirt that regulation.
I usually mail one for client referrals if their referral buys.
I'm having a slow AEP so far....few SARS and existing clients staying put with their plans.
The meds seem to be key.....if their T-2 goes to T-3 plus deductible they will shift.
I usually mail one for client referrals if their referral buys.
I'm having a slow AEP so far....few SARS and existing clients staying put with their plans.
The meds seem to be key.....if their T-2 goes to T-3 plus deductible they will shift.
- 783
You are more then welcome to use the gift cards, I've done it and I get great response. You MUST give a gift card to anyone that you meet with, go to the grocery store and buy 10 buck gift cards.
The new LPPO is better than the current ppo. If they call and switch on their own you remain the AOR and if you don't trust it you should be switching them on your own.
As far as the Amazon gift cards go, I was compliant handing out $10 gas cards to my seminars 3 years ago.
Problem is, the new LPPO lists diagnostic tests and procedures as $0 to $200 OR 20%, with not an explanation as to what qualifies for each option. Outpatient X-rays as $10 to $45 OR 20%....no explanation on that either.
The R5826-074 lists diagnostic tests and procedures as $0 to $290 copay. No mention of possibly paying 20%. X-rays $0 to $290 copay. No mention of possibly paying 20% on that either.
Humana should do a better job of listing what qualifies for each option on the new LPPO plan.
I have a couple that has Humana that did convert over the phone. Otherwise I've taken care of the rest, so far. People don't like answering the phone.
