No more Medicare Advantage leads

[patch36]

What fatal hit to PFFS? Did I miss something?

I don't see MA PPO & HMO plans going away nor their subsidies cut substantially. They are slightly over subsidized and I can see some adjustments, but Medicare itself has cut reimbursement rates and the trend is going to be to shave a little off of everything.

Hospitals negotiate rates with the MA's and don't accept just medicare assignment like Drs. do, and that is creating problems with networks in some areas.

 

[GreenSky]

So are we looking at only PPO and HMO MA plan for 2009? That is what it looks like to me.

This WILL NOT affect PFFS plans themselves for 2009. Funding is already set in stone.

The cold calling and other rules that make it impossible to let seniors know of their choices will apply however.

Rick

 

[InsuranceJosh]

What fatal hit to PFFS? Did I miss something?

I don't see MA PPO & HMO plans going away nor their subsidies cut substantially. They are slightly over subsidized and I can see some adjustments, but Medicare itself has cut reimbursement rates and the trend is going to be to shave a little off of everything.

Hospitals negotiate rates with the MA's and don't accept just medicare assignment like Drs. do, and that is creating problems with networks in some areas.

I heard that PFFS plan would not have the deeming anymore and would have docs on a provider list instead... like a PPO or HMO.

 

[fostever]

You can thank all the greedy bad apples in this market, now all of us suffer. It was bound to happen considering the feedback I've gotten from seniors.

 

[GreenSky]

I heard that PFFS plan would not have the deeming anymore and would have docs on a provider list instead... like a PPO or HMO.

Correct, starting in 2010. However, if there are less than 2 network plans in a given area (county?) then PFFS can continue with the deeming garbage.

What do you call a PFFS with a network?

A PPO.

Rick

 

[floridabroker]

Correct, starting in 2010. However, if there are less than 2 network plans in a given area (county?) then PFFS can continue with the deeming garbage.

What do you call a PFFS with a network?

A PPO.

Rick

 

[Crabcake Johnny]

You can thank all the greedy bad apples in this market, now all of us suffer. It was bound to happen considering the feedback I've gotten from seniors.

I went to Bravo last year to find out about MA plans. First, they gave everyone the answers to the CMS test - 1st clue.

Second, their manager told everyone that the basic pitch was "these are benefits in addition to your Medicaid and nothing changes."

He harped on "not confusing the seniors."

Yes...we don't want to confuse seniors with the truth. So if you want to blame someone, blame outfits like this with a room packed with 40 agents teaching people to lie.

 

[InsuranceJosh]

I went to Bravo last year to find out about MA plans. First, they gave everyone the answers to the CMS test - 1st clue.

Second, their manager told everyone that the basic pitch was "these are benefits in addition to your Medicaid and nothing changes."

He harped on "not confusing the seniors."

Yes...we don't want to confuse seniors with the truth. So if you want to blame someone, blame outfits like this with a room packed with 40 agents teaching people to lie.

Yea, I had a guy that wanted me to get appointed with him and he sent me the MA test and answers.

Needless to say that I never worked with him or talked to him again.

 

[MedSuppPro]

they gave everyone the answers to the CMS test -

Same thing happened at UnitedHealthCare training. The company instructor allowed agents to share answers during their test. And wasn't the ear plug -- stupid glasses -- AARP desensitization training another example of a need for one standardized Federal test. We don't even get CE credits for the hours upon hours of certification.

 

[fostever]

I went to Bravo last year to find out about MA plans. First, they gave everyone the answers to the CMS test - 1st clue.

Second, their manager told everyone that the basic pitch was "these are benefits in addition to your Medicaid and nothing changes."

He harped on "not confusing the seniors."

Yes...we don't want to confuse seniors with the truth. So if you want to blame someone, blame outfits like this with a room packed with 40 agents teaching people to lie.

Totally agree there are alot of those types out there. The outfit I'm with is small and has a very good compliance lady who cracks the whip on those issues. I can say they are very diligent about doing the right thing but had turned blind eyes on some top agents because of sales at times. They finally weeded out some unscrupulous agents only to see them move clients away. My wife heads up the department that deals everyday with compliance and customer retention issues on the customer service side, so I get an inside view almost daily.