San Jose, CA New to Medicare Advantage questions

12-03-2008, 03:48 AM

Hello,

I have sold LTC and annuities for 10 years. Times have gotten very tough and am only breaking even on my direct mailings for LTC and am considering other insurance markets as I have a family to support.

I am considering Medicare Advantage as I have been hearing a lot of buzz about this market. I have quite a few questions that have not been able to be answered by many FMO's I have talked to:

1. I am in Santa Clara County, CA. What products do I need to have to make money? (I'd like to only carry what I need as time is of the essence, certification, etc.)

2. Any FMO's and/or agents that can tell me clearly what products I need? (So far they all tell me I need to know my local market and tell them which ones I want, if this is the case how do I do that? there are 35 carriers in my area)

3. Is this a market one in which there are good opportunities and I can make money at in this area? (I understand each county is unique)

4. Is medicare supplement something I need too? as a door opener for LTC sales? Or maybe focus only on med supp?

5. Assuming I can get appointed within approx. 4 weeks, is the timing still right to make money starting in the Jan. 1 period? Or is that the time where most of my commisions will be cut in half due to going from one MA to another MA?

6. So far not one FMO could answer the above questions after hours of talking to them, is this something somebody could tell me, either FMO or any med advantage/supp agent out there? (or is this something I can only learn through trial and error?)

Thanks in advance!

Dowejonez · 12-06-2008, 02:27 PM

KInd of in a hurry....but IMHO...most FMO's are worthless when it comes to info on MA and PDP. In fact, when I have a tech question, the only source is another agent and on here. I don't even bother to call them anymore. OK...there is one at SMS who knows his stuff, but it's difficult to catch him during this time of year.

It's going to be pretty hard to get going this late. I usually start lining things up in July or so. If I was you I'd use the gubamint website and do searches with "make believe" Rx lists and see what comes up at the top with PDPs.

I don't have time right now to help you analyze the MAPD choices, but when you look at the results you have to understand that with the MAPD, the premium won't be reflected in the totals. This is actually good for the agent as people buying these on their own will not realize this until they have signed up...if they ever realize it. At least the first three years it has been this way. I haven't had time to do any longhand this year, but I'm sure it's still a valid point.
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To add to my previous post, OK, my resource at IB is pretty good. Again...this time of year a phone call or email reply two days later doesn't help much of the time.

Sure you could write business during the OEP, but it's a little tougher getting in the door. It sounds like you have the client base to call on.

To me the important categories of an MA policy are the OOPM, inhosp. copay and skilled nursing copay. I want to see a dollar amount whenever possible instead of a %. I start with the Rx and then look at the different combinations of health to use with it. Sometimes a case takes me days to figure out when none of the choices are good. Usually have to concede something.

Of course the the whole point of this exercise...PDP/MAPD... is to pry you guys clients away and fix all your mistakes.

Joe Moore · 12-06-2008, 07:52 PM

Originally Posted by SteveDFord

Hello,

I have sold LTC and annuities for 10 years. Times have gotten very tough and am only breaking even on my direct mailings for LTC and am considering other insurance markets as I have a family to support.

I am considering Medicare Advantage as I have been hearing a lot of buzz about this market. I have quite a few questions that have not been able to be answered by many FMO's I have talked to:

1. I am in Santa Clara County, CA. What products do I need to have to make money? (I'd like to only carry what I need as time is of the essence, certification, etc.)
[COLOR=blue]We have a lot of agents specializing in nothing but the senior market, with emphasis on MAPD's, Medicare Supplements and Final Expense; and making great money with only these products. This time if year, the MAPD's get all the attention. [/COLOR]

2. Any FMO's and/or agents that can tell me clearly what products I need? (So far they all tell me I need to know my local market and tell them which ones I want, if this is the case how do I do that? there are 35 carriers in my area)
[COLOR=blue]Your market is probably more LTC and Annuity based than in our local area in Tennessee. Seems the banks and "Financial Planners" in our area do most of this business, simply because of tradition. Most Senior Agents in our area look at this business as secondary. Banks and Financial Planners would usually not be caught dead writing a Final Expense or Senior Health Policy. This is left to the scumbags like us.[/COLOR]

3. Is this a market one in which there are good opportunities and I can make money at in this area? (I understand each county is unique)
[COLOR=blue]I do not think there is an area of the country that good Senior Medical and Final Expense agents are not needed. Some places can be crowded, but the good agent will usually prevail with the right products.[/COLOR]

4. Is medicare supplement something I need too? as a door opener for LTC sales? Or maybe focus only on med supp?
[COLOR=blue]Not all clients are prospects for MA sales. Some folks are married to the Medicare Supplement concept, and refuse to change (usually because their supplement "pays it all"). I would say to be well rounded, you need a good Medicare Supplement to offer. Also, this market leads to an occasional LTC or Annuity sale.[/COLOR]

5. Assuming I can get appointed within approx. 4 weeks, is the timing still right to make money starting in the Jan. 1 period? Or is that the time where most of my commisions will be cut in half due to going from one MA to another MA?
[COLOR=blue]My personal belief is that the OEP should be good compared to what previously we have seen. One company is getting rid of 308,000 of it's dual eligible (Medicare and Medicaid) enrollees: Business News Blog - Daily Business News - Peak Newsroom: Humana to Lose Some Medicare Enrollees[/COLOR]
[COLOR=#0000ff]With the right set-up you could be there to catch them coming out of these and other plans. If they are auto-assigned, the government does nothing to check if all their drugs are covered. I do not know about California, but in Tennessee dual eligibles usually fit well in -0- premium MAPD plans. The key to that is that in TN Medicaid pays all copays for dual eligibles, If CA does the same, you need to find the dual eligibles.[/COLOR]

[COLOR=#0000ff]Also, during the OEP an enrollee in only a Part-D cannot simply change drug plans if their's has changed and is not covering there drugs. They must go to an MAPD, so this opens up a market for MAPD's in the OEP, even if the client only needs to change Part-D.[/COLOR]

6. So far not one FMO could answer the above questions after hours of talking to them, is this something somebody could tell me, either FMO or any med advantage/supp agent out there? (or is this something I can only learn through trial and error?)
[COLOR=blue]We are a small IMO/FMO (around 300 agents, $1 million volume life insurance, and this year should hit 2000 MAPD and Medicare Supplement Enrollments). We usually know what we are talking about because our marketers and I are licensed agents and personally peddle the products we represent. I have never understood how someone could tell you how to do it if they haven't done it themselves. This time of year we are concentrating on personal sales of MAPD products, but still can take time to talk to agents.[/COLOR]

Thanks in advance!

[COLOR=blue]One question you do not address is how to get in front of clients. With your existing book of business, I do not think you would have a problem with an initial contact and the CMS rules. Your present book of business probably has no dual eligibles[/COLOR]

[COLOR=#0000ff]I have looked at zip code 95101 (San Jose) Medicare.gov - MPDPF: Plan Overview[/COLOR]
[COLOR=#0000ff]to see what is available in your county. I only see 16 MAPD Plans. If you are interested, we could supply 5 of these. Our website, www.asurco.com can show some of our available companies. If you can find a good IMO in California to supply your needs, I understand.[/COLOR]

[COLOR=#0000ff]I hope the above answers are helpful, seems you were getting somewhat desperate for some guidance. An agent can make great money in these markets and I believe it can stay good even during these rough times. But you must have the right set-up, the right attitude, clients, good products and good contracts.[/COLOR]

[COLOR=#0000ff]Contact us if you are interested in getting more info. My son, Greg Moore is our office manager. If I am not in, ask for Greg.[/COLOR]

[COLOR=#0000ff]Whatever you decide, good luck![/COLOR]

Dowejonez · 12-11-2008, 01:12 AM

"KInd of in a hurry....but IMHO...most FMO's are worthless when it comes to info on MA and PDP. In fact, when I have a tech question, the only source is another agent and on here."
__________________________________________________ ____

I was perhaps a little harsh in the above statement. Support overall has been great with most. The whole MA/PDP business has been kind of weird and this year is no exception.

My apologies to all of those in my upline. I know they're just doing what they have to do, look out for themselves.

Gunny · 12-13-2008, 05:00 PM

Originally Posted by SteveDFord

Hello,

I have sold LTC and annuities for 10 years. Times have gotten very tough and am only breaking even on my direct mailings for LTC and am considering other insurance markets as I have a family to support.

I am considering Medicare Advantage as I have been hearing a lot of buzz about this market. I have quite a few questions that have not been able to be answered by many FMO's I have talked to:

1. I am in Santa Clara County, CA. What products do I need to have to make money? (I'd like to only carry what I need as time is of the essence, certification, etc.)

2. Any FMO's and/or agents that can tell me clearly what products I need? (So far they all tell me I need to know my local market and tell them which ones I want, if this is the case how do I do that? there are 35 carriers in my area)

3. Is this a market one in which there are good opportunities and I can make money at in this area? (I understand each county is unique)

4. Is medicare supplement something I need too? as a door opener for LTC sales? Or maybe focus only on med supp?

5. Assuming I can get appointed within approx. 4 weeks, is the timing still right to make money starting in the Jan. 1 period? Or is that the time where most of my commisions will be cut in half due to going from one MA to another MA?

6. So far not one FMO could answer the above questions after hours of talking to them, is this something somebody could tell me, either FMO or any med advantage/supp agent out there? (or is this something I can only learn through trial and error?)

Thanks in advance!

I am starting out in Med Sup in the East Bay. I have heard most of the MedAdvatage and MedHMOs are starting to pull out of NorCal. Not sure why yet. I would investigate more before you sell MedAdvantage exclusively.

My 2 cents