Don't really do the Senior Market however with clients turning 65 I guess I should be a little up to date on some stuff.
If a client chooses a Medicare Advantage plan and during open enrollements wants to switch back to a MediGap Policy are they able to do that without having to be accepted?
For example a guy has a heart attack while on the Advantage plan, and then finds out he doesn't like the policy because the doctor he has to see is 45 miles away. Can he switch back and get the regular coverage.?
If a client chooses a Medicare Advantage plan and during open enrollements wants to switch back to a MediGap Policy are they able to do that without having to be accepted?
During the first six months after getting Part B of Medicare, Open Enrollment, people can switch policies or companies weekly if they choose without having to answer any health questions.
After six months they will have to answer health questions unless they take a Medicare Supplement policy with AARP. AARP is "group" insurance and the only question they have to answer is if they are on dialysis.
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The senior market is a very neet, clean, easy market to work in.
It is a natural progression for your clients who are turning 65 to take a Med Supp policy. You already have their trust, you are their "insurance agent". Why would they not look to you for guidance and want to continue their health insurance with you?
Don't you think your clients would feel a lot more comfortable with you advising them about Medicare and the options available rather than them having to look for a stranger to help them with something as important as the continuation of their health insurance?
I would be glad to represent you with all of your clients who are approaching Medicare age. Just thought I'd ask, what, the worst that can happen is that you say NO.
If your guy takes an advantage plan at 65 he has 12 months to switch back to original medicare and get a medicare supplement regaurdless of his health. SO actually he is not hosed.
I have sold a few. I do not think they are the worst thing in the world. They are defintetly not the best compared to a supplement but some people can't qualify health wise or they simply cannot afford a med supp. I would never think about putting someone in a MA that had a lot of health problems. Unless they didnt have a med supp. Med supps are definetly the best if they can afford it.
So basically once they get on an Advantage plan they are hosed.......
Why does anyone sell these policies?
Midwest broker is the PFFS expert. Maybe he will join in.
As I understand it they can dump their PFFS plan and go to a Medicare Supplement policy but if it is outside the Open Enrollment period for Med Supps (the first six months after they receive Part B) they will have to answer health questions on the Med Supp app.
I don't recommend PFFS plans nor do I sell them. I don't like them, there are too many potential problems for people who live in rural Missouri.
I have yet to see anything better for people than a Medicare Supplement policy. Unless, they have no money and can't really afford a Med Supp.
If your guy takes an advantage plan at 65 he has 12 months to switch back to original medicare and get a medicare supplement regaurdless of his health. SO actually he is not hosed.
I didn't realize that. Can that person dump their PFFS plan at anytime during that 12 month period and get a Med Supp as Guar. Issue for the full 12 months? What is the process for cancelling the PFFS plan and getting back on Medicare?
If a person goes with any of the Part C Advantage plans they immediately no longer have Medicare. If it is with an HMO then I believe that all they have to do is notify Medicare that they want their Medicare back and the HMO is automatically cancelled. It's been a while since I've done one of those.
Is it the same with dumping a PFFS plan?
Since I really don't sell them I don't know all the ins and outs about them.
United World will accept ANYONE inside the 12 month period of being on a MA plan. If they chose an MA in the OE period then They can go to any med supp inside the 12 month period. All you need to provide is the expiration leter of the MA plan.
United World will accept ANYONE inside the 12 month period of being on a MA plan. If they chose an MA in the OE period then They can go to any med supp inside the 12 month period. All you need to provide is the expiration leter of the MA plan.
This is INCORRECT. I just got off the phone with United World to clarify what I had understood. Before I post the information, I wanted the company to "back me up."
Here's the bottom line:
If the member enrolls for the 1st time in an MA plan and leaves within the first 12 months, he or she may go back to their old Med Supp without proving insurability. If that policy does not exist, then they can go anywhere. Once they are past the 12 months, then they must be underwritten.
If the person moves out of the service area or their MA plan cancels, then they may go to any supplement on a guaranteed issue basis.
United World and every other carrier I know of follows the federal guidelines for guaranteed issue from an MA plan. You might be able to "slip something by the company", but I certainly wouldn't want to risk my client's coverage (not to mention my e&o) on that.
Rick
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Training, Community, Support, and Success Independent Life Insurance Agents Assn rick@iliaa.org
I just got an email yesterday from Senior Market Sales. IT was specifically to say that United WOrld was offering anyone GI regaurdless of their pevious med supp carrier. WIERD!
I believe SMAN and I had an argument about this before. I thought the same thing you did GS.
I know that Sterling Health Plans would allow a client to move from a MA to a Supplement at any time. They call it their choice and modility plan. Say a client is doing well and is on a MA plan, but suddenly comes down with something major. They call Sterling and they will move them to a supp. And when/if they get better they call back in a request to be moved back to a MA plan.
Mutual of Omaha Accepting MA clients Mutual of Omaha/United World will accept your Medicare Advantage Clients GUARANTEE ISSUE.
With the recent moratorium on Private Fee for Service Plans (PFFS) and coverage by the national media, your clients might be calling to see how to get back to Original Medicare and a Medicare Supplement. First of all assure your clients that recent action by CMS does not affect their coverage, only new sales.
With Mutual of Omaha/United World your clients have guaranteed-issue rights when:
* They joined a Medicare Advantage plan when they became eligible for Medicare and want to switch to a Medigap policy and Original Medicare within 12 months. Mutual will take them Guarantee Issue!
* They had a Medigap policy and switched to a Medicare Advantage plan for the first time since eligible for Medicare and they want to switch back within 12 months. Mutual will take them Guarantee Issue regardless of which company they previously had.
It's the 2nd point that Mutual disagreed with. I was told that the person must go back to their prior carrier. I think I'd rather have this information direct from the carrier, rather than an FMO.
I would rather have it direct from the carrier also. SMAN said that he called them direct and they said they could go to any company. SOmeone either mis understood United WOrld or someone was bluffing. I believe you Rick. I am not arguing about what CMS guidelines are because you are correct. SMS thinks different and so does SMAN. I don't see how the application can slip through as GI.
If the shoe fits, I have told some clients aging in... to get a med supp first because of their iffy health. (like recent heart surgery, etc) Then after a while, if they chose a med advantage, at least they could TRY IT OUT for up to 11 months, and then switch back to a med supp if they chose.
This way they were guaranteed insurability for the near future, and could try out the MA plan without being hurt.
(are these emotions smilies replicating, like Pokemon?)
I think you have a guarantee to re-enter Medicare on the same plan by any carrier? Meaning, if you go from Plan F to MA then leave the MA within 12 months, you have GI of a Plan F from any carrier.
Or
If you age in straight to MA then you chose to leave MA within 12 months you have GI just like initial enrollment.
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Keith Kessler
How can everyone be so confused on this subject? It is our job to know the senior market if that is our market. Regaurdless if you like certain plns or not you should know everything about them. To be an expert in the senior market you have to know the ins and outs of MA plans.
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