First WellCare, then...

MedSuppPro · 10-27-2007, 11:10 AM

What a week! This week has been very volatile. Now I'm looking for another carrier.

MEGA scars me. Just Google...

Coventry will not allow any application distribution prior to November 15th. I can't see everybody between Nov 15th till Dec 31st. Some will have to wait till the like-to-like season. And their stock slipped 6.7%* yesterday?

Maybe UnitedHealth? Though just like Aetna they have limited market strengths in their product lineup. Great names though!

UAFC pops back up on radar, again, though my past experience was one of the worst of all carriers last year.

* Forbes.com 10-26-2007 Quote: "Now Thomas Carroll, the health services analyst at Stifel Nicolaus, said rumors were circulating that Humana may be the subject of a similar investigation. Carroll said that speculation is that the raid at WellCare was related to Medicare and Medicaid fraud..."

So my question for the Forum:

Which MA/MAPD carrier are you going with this season, and am I the only one whom has concerns?

Mr. Bill · 10-27-2007, 12:29 PM

I'm sticking with the AARP brand - UnitedHealth. I don't think any senior wants to hear anything bad about the AARP..... Wienie, huh?

al3 · 10-27-2007, 01:44 PM

While I sent in paperwork for UH - AARP, I've not heard anything back yet so I don't know if they are actually 'serious' in my area (Sacramento, CA).

I'll sell mostly the Blue Cross Freedom One plan. It may not be the 'best' plan, but no matter what you can say about BCC, they have a trusted name among seniors here and they DO pay their claims. Their 'gold' drug plan is pretty good as well. Finally, my wife has been on their Freedom plan for the past year and she has used a lot of medical services (being under-age/disabled) and she has not had one issue with them.

One other thing... which I think is far MORE perception than fact... but which seniors TELL me about... when you go to the doctor/hospital/clinic... or make an appointment on the phone..and they ask what insurance you have or ask to see your card, and you show/tell them "Blue Cross" as opposed to "Medicare" you often get the date YOU want... or you go to the font of the line because the office staff know (or believe) that the practice or provider will get paid sooner, easier, less hassle, etc. BC does pay quickly if EOB receipts are any indication.

There is no way I can quantify this perception but I hear it from others and my wife has experienced it... or at least she BELIEVES she got 'preferential' treatment by having a plastic blue/white BCC card instead of her previous red-blue Medicare card.

I'll hear something like "My friend Mavis has a Blue Cross medicare card and we go to the same doctor and she always gets the appointments on the day SHE wants and I never do." Go figure.

Of course I would NEVER try to "sell" that in a presentation... but you don't have to. It is something a lot of people believe... true or not.

Al

retread · 10-27-2007, 06:29 PM

I had to switch a client from a MA plan back to a Med Sup yesterday.

This started out a couple of months ago with the report that Pyramid's T.O. PFFS was not paying several claims of hers. I called Today's Options provider relations, and they said they would get on it, but they admitted being behind in claims settlements because they underestimated their sales success and had to hire and train more staff.

The client finally called me a couple months later and said she wanted to go back to her Med Sup because her providers were not taking MA plans. When I inquired about switching to another MA carrier, she said NO MA PLANS. Her daughter was present, and told me she had tried to deal with her mother's provider billing reps and was told that they would not accept any MA plans anymore. As a matter of fact, the hospitals and doctor offices were posting this on their doors.

This client's husband had a Coventry MA plan earlier in the year (I enrolled him into a SNP this summer). He is happy now, but tells me there are still some bills Coventry never paid and the providers and Coventry are at odds.

I see the problem growing political volleyball. IMHO, the doctors (AMA) are mad about money going to MA plans while they are getting pay cuts from Medicare. By taking a firm stand against MA plans, they are sending a message.

It is no secret that the Democrats are irritating the Republicans on the SCHIP bills being sought and subsequently vetoed by Bush. This volley between SCHIP and MA funding is also sending a message.

MA plans will not go away, but the constant media contortions will make seniors (who read newspapers more than the younger generation) shy of MA plans. This is another reason to carry Med Sups as well as MA plans.

YMMV

senior-advisor-indiana · 10-27-2007, 10:12 PM

What state is it that you are in, retread?

The New Guy · 10-27-2007, 10:14 PM

Quote:

Originally Posted by senior-advisor-indiana

What state is it that you are in, retread?

I'm going to go out on a limb, and say Kansas.

retread · 10-27-2007, 10:36 PM

Better grab hold of another limb... it was Missouri. I am dual licensed.

senior-advisor-indiana · 10-27-2007, 10:41 PM

Atleast I don't look like an idiot by myslef now

*midwestbroker* · 10-30-2007, 05:03 PM

When it comes to your money, never ask a politician what you should do with it.

policy doctor · 10-31-2007, 12:55 PM

Thought this might be of interest to some.

Poor Health Insurers - Forbes.com

retread · 10-31-2007, 06:58 PM

Quote:

Originally Posted by al3

While I sent in paperwork for UH - AARP, I've not heard anything back yet so I don't know if they are actually 'serious' in my area (Sacramento, CA).
Al

I just inquired for the umpteenth time about my UHC contract today, and was told that, due to overwhelming response from agents, they are several weeks away from completing all the applications. They had to hire extra help to process all the apps! So hang in there!!

senior-advisor-indiana · 10-31-2007, 11:36 PM

Why is it that companies use that excuse when they are slow as hell? HOw could they under estimate the number of agents that wanted it? Gimmie a break!

retread · 11-01-2007, 01:13 PM

Yeah, I hear you. It is also a convenient excuse for the FMO to use.

I try to accept the information given at face value, but I have a memory, and when the same excuse is used again, I question further until I find "the rest of the story" (as Paul Harvey would say). If I can obtain a work-around, I go for it, but in this case, I'm stuck for the moment, so I am just sharing the info I have at this time.

sman · 11-01-2007, 01:55 PM

Quote:

Originally Posted by retread

I just inquired for the umpteenth time about my UHC contract today, and was told that, due to overwhelming response from agents, they are several weeks away from completing all the applications. They had to hire extra help to process all the apps! So hang in there!!

I've called for the umpteenth time as well. My FMO is absolutely no help and unresponsive. A few weeks ago someone from UHC called and said I needed to get my updated E&O in (mine expires every year on 10/15). So while I was on the phone, I faxed it to him. Two days later I get the same call from the same guy. Man was I pissed at this point. So on 10/17/07 I call to see when everything will be available. I was told they didn't have my E&O or a copy of my insurance license. Now I'm really pissed. So I fax it over while I'm on the phone and they confirm it was received.

Fast forward to today, I call to find out about the AARP Med Supp availability and was told they still didn't have my E&O. I asked the lady if they had record of my insurance license. She said they did. I told her that it was impossible for them to not have my E&O since the two were sent together in the same fax. She checked the fax scan system and viola, it was there.

If this is any sign of things to come, we are in trouble. I completed the paperwork on 09/12/07 and faxed it the same day. They still don't have it complete. Good luck to everyone trying to get on this train. Don't assume that just because you haven't heard anything that it's all ok. I'd make some calls.

Cenla Agent · 11-01-2007, 02:22 PM

Quote:

Originally Posted by MedSuppPro

What a week! This week has been very volatile. Now I'm looking for another carrier.

MEGA scars me. Just Google...

Coventry will not allow any application distribution prior to November 15th. I can't see everybody between Nov 15th till Dec 31st. Some will have to wait till the like-to-like season. And their stock slipped 6.7%* yesterday?

Maybe UnitedHealth? Though just like Aetna they have limited market strengths in their product lineup. Great names though!

UAFC pops back up on radar, again, though my past experience was one of the worst of all carriers last year.

* Forbes.com 10-26-2007 Quote: "Now Thomas Carroll, the health services analyst at Stifel Nicolaus, said rumors were circulating that Humana may be the subject of a similar investigation. Carroll said that speculation is that the raid at WellCare was related to Medicare and Medicaid fraud..."

So my question for the Forum:

Which MA/MAPD carrier are you going with this season, and am I the only one whom has concerns?

Anyone have a link on the above quote WRT Humana?

I will probably stick with Humana but my guess is that I won't write as much as I am planning on being much more aggressive in marketing supplements instead. I know there aren't a lot of Humana fans here, but their plans are much better in LA this year, and almost all of the other carriers have cherrympicked and are not marketing in the areas that I am looking to work.