PART C

10-20-2006, 03:47 PM

I am looking for a policy to fit with Medicare Part C for a 75 year old gentleman of fair health and lives in the midwest. Any suggestions?

*midwestbroker* · 10-20-2006, 04:25 PM

Depends on where you live in the Midwest as to what plans are available.

You can go to Medicare.gov and compare different plans in your area.

10-20-2006, 04:37 PM

Oh Yes! Delta, Iowa I am posing here because it was recommended that I do on another site.

*midwestbroker* · 10-20-2006, 04:48 PM

http://www.medicare.gov/MPPF/Include...rchOptions.asp

That link will get you a landscape of plans. Just guess if you do not know the informaion they ask about health and letters.

Humana has a $0 premium Private Fee for Service plan in Keokuk County

If you are in Mahaska county, you have regional PPO's from Wellmark Blue Cross starting at $33 per month.

If you have any question just post away!

10-20-2006, 07:38 PM

Thanks. Did not think anyone knew where Delta was, very small.

*midwestbroker* · 10-20-2006, 11:38 PM

Sorry to say that I do not know where it is...I just googled the name and it gave me the zip. Sounds like a 1 stop light town.

*STIBROKER@AUSTIN.RR.COM* · 10-21-2006, 07:48 AM

*midwestbroker* · 10-21-2006, 10:03 AM

Is that the same IP address from Blackie?

*STIBROKER@AUSTIN.RR.COM* · 10-21-2006, 10:13 AM

No...he is.............

*midwestbroker* · 10-21-2006, 10:31 AM

Sigh of relief!

*STIBROKER@AUSTIN.RR.COM* · 10-22-2006, 08:39 AM

Originally Posted by midwestbroker

sigh of relief!

Sorry.....my bad....yes they are all the same person.....

insurebob · 10-22-2006, 11:58 PM

I participated in a training class Saturday, regarding Medicare Advantage Plans. It was an all-day session, and not every detail has sunk in yet. From what I understand CMS is running the show, and there are only certain ways you can obtain an appointment, and only certain things you can say in the meeting with the beneficiary.

The three plans I got certified with were:

Universal Health Care
Pyramid
(the third one slipped my mind)

Universal sponsored the meeting. A company by the name of Parker and Associates are the ones providing the leads. It was their person who trained us Saturday.

What I like about this is, after March 31st, the client is mine, to sell LTC or Annuities to, once the MA Selling slots are done (Nov. 15 - Dec 31 and Jan. 1 - March 31).

They spent most of the day convincing us why it's not too good to be true (which I expected). Part of the time they actually told us when it would not be good to move beneficiaries to the MA Plans. Those were mostly people who were in ALF's and SNF's or on group plans.

From what I understand, we are not allowed to cold call, either by phone or mail. We can, however, respond to the lead cards, and there are CMS approved Seminar Flyers we can distribute.

I'd like to hear any feedback from anyone who has more knowledge, and can enlighten me.

James · 10-23-2006, 07:16 AM

I don't know of any thing against cold calling. As far as those you shouldn't sign up, I wouldn't sign someone up that it isn't a good fit for, such as if they would pay more with the MA plan then they would with a Supplement. Simply ask them how many times they were in the Hospital last year and how many times they expect to be in the Hospital in the upcoming year. If they generally had or expect 3 seperate stays in the hospital at 4-5 days you shouldn't sign them up, generally only goes down hill from there depending of course! Unless you have a HMO MA plan that hasn't no hospital copay.

What I do to display the cost difference is using a yellow pad write down 1-12 straight down representing the months of the year, then you write the cost of the Supplement they have or expect to have by month, if they pay 100 dollars amonth I write 120 straight down through 1-12. Then on the other side of the paper write down the cost of the premium and if that is zero put down 0, then as them how many times they have gone to the Dr for a visit, if its three times then multiply the copay by 3 and write that down with or next to the Zero's or whatever, then you ask them other questions about Copay items, such as specialist or whatever and then add that column up and hopefully its less then 100 dollars. Now the Supplement should be about 1200 or so depending upon age, I've seen them as high as 48 hundred for a husband and wife at age 80 in perfect health!

Then you say, "well here with the Supplement you pay in advance, do you get anything back if you don't use it?" obviously they say no. So then I point to the cost of the MA Plan and say "with this plan you don't pay unless you use it! Does that make sense to you? In other words you are in charge!"

10-23-2006, 08:01 AM

Originally Posted by James

I don't know of any thing against cold calling. As far as those you shouldn't sign up, I wouldn't sign someone up that it isn't a good fit for, such as if they would pay more with the MA plan then they would with a Supplement. Simply ask them how many times they were in the Hospital last year and how many times they expect to be in the Hospital in the upcoming year. If they generally had or expect 3 seperate stays in the hospital at 4-5 days you shouldn't sign them up, generally only goes down hill from there depending of course! Unless you have a HMO MA plan that hasn't no hospital copay.

Also, ask them what the policy max is on Medicare supplements--many are 50k lifetime max.

As far as telemarketing goes, this bill was introduced but I do not know if it passed:

109th CONGRESS

1st Session

S. 1798

To amend titles XI and XVIII of the Social Security Act to prohibit outbound call telemarketing to individuals eligible to receive benefits under title XVIII of such Act.

IN THE SENATE OF THE UNITED STATES

September 29, 2005

Mr. CORZINE (for himself, Mr. JOHNSON, Mr. LAUTENBERG, and Ms. STABENOW) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend titles XI and XVIII of the Social Security Act to prohibit outbound call telemarketing to individuals eligible to receive benefits under title XVIII of such Act.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Medicare Do Not Call Act'.

SEC. 2. TELEMARKETING PROHIBITED.

(a) PRESCRIPTION DRUG PLANS- Section 1860D-4(a) of the Social Security Act (42 U.S.C. 1395w-l04(a)) is amended by adding at the end the following new paragraph:

`(5) PROHIBITION ON TELEMARKETING.

`(A) IN GENERAL- A PDP sponsor offering a prescription drug plan shall be prohibited from conducting outbound call telemarketing (as defined in subparagraph (B)) for the purpose of soliciting enrollment into such a plan under this part.

`(B) OUTBOUND CALL TELEMARKETING DEFINED-

`(i) IN GENERAL- Except as provided in clause (ii), for purposes of this paragraph, the term `outbound call telemarketing' means a telephone call initiated by a telemarketer--

`(I) to induce the purchase of goods or services; or

`(II) to solicit a charitable contribution.

`(ii) CATALOG MAILINGS NOT INCLUDED IN DEFINITION OF OUTBOUND CALL TELEMARKETING- Such term does not include--

`(I) the mailing of a catalog; or

`(II) the receipt or return of a telephone call initiated by a customer in response to such mailing.'.

(b) Medicare Advantage Organizations- Section 1851(h) of the Social Security Act (42 U.S.C. 1395w-21(h)) is amended by adding at the end the following new paragraph:

`(6) PROHIBITION ON TELEMARKETING- A Medicare Advantage organization offering a Medicare Advantage plan shall be prohibited from conducting outbound call telemarketing (as defined in section 1860D-4(a)(5)(B)) for the purpose of soliciting enrollment into such a plan under this part.'.

(c) Criminal Penalties for Fraudulent Telemarketing- Section 1128B of the Social Security Act (42 U.S.C. 1320a-7b) is amended by adding at the end the following new subsection:

`(g) Whoever knowingly and willfully engages in deceptive or abusive telemarketing acts or practices (as defined in part 310.3 and part 310.4, respectively, of title 16, Code of Federal Regulations), or makes any false , statement or representation of a material fact while conducting outbound call telemarketing (as defined in section 1860D-4(a)(5)(B)) with respect to a prescription drug plan offered by a PDP sponsor under part D of title XVIII, a Medicare Advantage plan offered by a Medicare Advantage organization under part C of such title, or who falsely alleges to be conducting outbound call telemarketing (as so defined) with respect to either such a plan, shall be guilty of a felony and upon conviction thereof shall be fined not more than $25,000 or imprisoned for not more than five years, or both.'.

(d) Effective Date- The amendments made by this section shall take effect on the date of enactment of this Act.
[/b]

Superchief · 10-23-2006, 08:48 AM

Key words are "for the purpose of soliciting enrollment". Cold calling is fine so long as there are no attempts to enroll said client over the phone.

Get the appointment and enroll them in person.

10-23-2006, 09:02 AM

Originally Posted by Superchief

Key words are "for the purpose of soliciting enrollment". Cold calling is fine so long as there are no attempts to enroll said client over the phone.

Get the appointment and enroll them in person.

Not true...you can not even set the appointment over the phone because that is soliciting enrollment. Read ANY carriers marketing rules concerning this and you will see they are very strict concerning telemarketing.

James · 10-23-2006, 12:44 PM

I doubt if you Democratic Bill passed, don't know many that have in since '94. Yet if you feel as though you're uncomfortable then simply don't mention MA Plans directly.

Superchief · 10-23-2006, 01:35 PM

This is straight from my Advantra training.

Outbound Telemarketing Activities

Brokers/agents have the following obligations and responsibilities
When conducting telemarketing:

�� Must adhere to the Federal Trade Commission requirements for
sellers and telemarketers and applicable state laws.
�� Must comply with National and State Do-Not-Call Registries.
�� Must honor Do not call again requests.
�� Must abide by Federal and State calling hours.
�� Enrollment by outbound telemarketers is not permitted.
�� Outbound calling may only be used to solicit requests for
preenrollment information, describe benefits and set up meetings or
home visits.

*midwestbroker* · 10-23-2006, 10:36 PM

We have been advised not to cold call.

CMS says that we can only contact our prospective clients once every 90 days.

When looking at supplements vs MA plans, I use a spreadsheet that I input all the premiums and estimated dr / hospital visits and it calculates the totals. That way we can play with the numbers. If you want a copy of it let me know. It has been calculated for Humana plans here in Kansas City, but you could modify it to suit your needs.

James · 10-24-2006, 02:24 AM

Originally Posted by midwestbroker

We have been advised not to cold call.

CMS says that we can only contact our prospective clients once every 90 days.

When looking at supplements vs MA plans, I use a spreadsheet that I input all the premiums and estimated dr / hospital visits and it calculates the totals. That way we can play with the numbers. If you want a copy of it let me know. It has been calculated for Humana plans here in Kansas City, but you could modify it to suit your needs.

I was capture with Sterling for a while and they lived off the cold calling. The leads they provided were basically like all other leads, they suck.

Guy I sell just about everything on a yellow pad, its the best dang thing ever invented! I'm not going to carry a laptop around, if I do it stays in the car unless I'm going to need it to run something like a illustration. I couldn't imagine it would do anything but hinder a sale of a Supplement or a MA Plan.