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His deal is that he thinks it better to post here 1,000 times instead of finding a local agent to harass.
I can't image having this anal of a client.
Rick
Cigna Is Back After 18 Month Sanction
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His deal is that he thinks it better to post here 1,000 times instead of finding a local agent to harass.
I can't image having this anal of a client.
Rick
I had him on Ignore for months, took him off for about 1 week, he's back on again-it's not my job to police the forum and the mods and owner don't seem interested so he can post whatever stupidity flows through his head, I don't care
I'll bite. It could be a number of reasons. One could be as you said, they are already on a plan that is cheapest for them for the following year that I didn't write. Another reason could be because the least expensive plan is with a carrier that either doesn't contract with independent brokers or the broker chooses not to contract with a particular carrier.
And to answer the question about SHIP and agents losing commission. If a person goes to SHIP and takes their advice, then they likely will enroll directly with the carrier or through the Medicare website which cuts the agent out of the loop. The Medicare beneficiary doesn't save any money going that route. And quite frankly, it might be hit or miss on the advice they get. A good agent will be proactive in making sure his client is always getting the lowest cost plan. And some scenarios, may help that person avoid a headache.
For example, I just ran a comparison for a man. The difference in total out of pocket cost for the two least expensive plans is $20 between August and the end of December. The lowest cost plan would have paid me. The second lowest cost plan will not. I recommended the second lowest cost plan. Why? Because one of his medications has a Prior Authorization and another has a Step Therapy on the lowest cost plan. Not so on the second lowest cost plan. I simply explained what those two requirements are and asked him if he felt if paying an extra $20 over 5 months was worth avoiding that hassle. He said yes.
I have no way of knowing whether someone at SHIP or a pharmacy will look beyond the lowest cost plan and provide that level of service. But I know I do.
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Thank you. I did not think about the contracting issue and also would not have known about one of the variants you mentioned.
I am really having trouble with whether or not the commissions on PDP's are an issue-or the extent to which they are.
When I first started reading and posting on the forum, it seems like a relatively large proportion of the posts in the senior forum spoke about PDP as a PIA. Lots of time, little money, or no money. It seemed like there were some agents that did not do PDP at all because of a combination of risk and time in relation to reward. Given that my ship representative wanted me to make an appointment in august for plan evaluations whenever they started in the fall, I also had the sense that there are already a large base of folks who just go (in KS anyway) over to the extension office each fall.
A recent thread for an agent focused on just PDP (not PDP and MA). The contents of that thread, as well as the bitterness in tnagent's outburst, suggest the direct opposite.
I don't know how to correctly assess that situation.
I remember considering prior authorization issues, I'll have to take a look at what step therapy is.
I appreciate you risking your forum reputation in speaking to me.
I am really having trouble with whether or not the commissions on PDP's are an issue-or the extent to which they are.
When I first started reading and posting on the forum, it seems like a relatively large proportion of the posts in the senior forum spoke about PDP as a PIA. Lots of time, little money, or no money. It seemed like there were some agents that did not do PDP at all because of a combination of risk and time in relation to reward. Given that my ship representative wanted me to make an appointment in august for plan evaluations whenever they started in the fall, I also had the sense that there are already a large base of folks who just go (in KS anyway) over to the extension office each fall.
A recent thread for an agent focused on just PDP (not PDP and MA). The contents of that thread, as well as the bitterness in tnagent's outburst, suggest the direct opposite.
I don't know how to correctly assess that situation.
I remember considering prior authorization issues, I'll have to take a look at what step therapy is.
I appreciate you risking your forum reputation in speaking to me.
PDP is a PITA due to the minimal pay. But my Med Supp clients are going to be talking to someone about it so it might as well be me. Otherwise I run the risk of losing the client to another agent.
Not sure what the SHIP rep could tell you in August about the following year's plans. The plans aren't available for review until October 1st.
Step Therapy is simply a requirement that an insured beneficiary has to try other medications prior to the carrier covering the one in question. Many times a person has already tried those medications in the past so the can usually get this requirement waived, but it requires their doctor to get involved in the process. Some doctors loathe the PA and ST process. They feel it's time consuming and I don't disagree.
As for my forum reputation, I'm not too concerned about that since the forum and its members don't put food on my table. That's not to say I don't value some of the input from other forum members. I've been in this business a long time and I still occasionally learn something here.
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New to medicare in 2016.
After my questions about what she thought about my 2016 situation, she wanted me to, in August, go ahead and schedule my appt time for drug plan review in Oct-Nov because of the heavy demand they had for that service. She wasn't telling me anything about 2017 plans in Aug 2016.
I wasn't sure about some penalty situations and did my PDP myself prior to getting an agent and MedSupp. I may be able to give my agent a 2018 PDP change-I'll have to see how the med situation looks. With overseas medication purchase as an option, I've basically been looking at what I do as a "drug plan place holder" to avoid CMS penalties. I need to work through some of that myself because it is not fair to dump all that on an agent now that I understand how the system works.
After my questions about what she thought about my 2016 situation, she wanted me to, in August, go ahead and schedule my appt time for drug plan review in Oct-Nov because of the heavy demand they had for that service. She wasn't telling me anything about 2017 plans in Aug 2016.
I wasn't sure about some penalty situations and did my PDP myself prior to getting an agent and MedSupp. I may be able to give my agent a 2018 PDP change-I'll have to see how the med situation looks. With overseas medication purchase as an option, I've basically been looking at what I do as a "drug plan place holder" to avoid CMS penalties. I need to work through some of that myself because it is not fair to dump all that on an agent now that I understand how the system works.
Ok, new to Medicare makes sense for an August meeting. I interpreted that reply as them bringing you in to train you for this coming AEP.
If you have an agent for your Med Supp you can ask him/her if he/she runs prescription plan comparisons and let the agent decide. Personally, if I have a client who understands the comparison system on Medicare.gov, I have no issues with them running their own comparisons and completing their own enrollment. That's one less comparison I have to run.
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Yes, my agent is well experienced and knowledgeable about Medicare and has staff to help with PDP lookups in the fall.
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In August, not too much to tell. At that date, a few of the plans will reveal premium rates. You can't run Plan Finders until usually Oct 2nd or 3rd.
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I have totally ignored MA plans because they don't affect me personally.
I am now led to ask two questions about those types of plans.
One is about commissions. If an insurance agent says to me something like "you want to be a SHIP volunteer and you will steal my business", would that potentially apply to MA plans just like PDP plans? ie, can the consumers directly enroll in an MA type plan on the CMS website?
The other is about drug coverage. I'd always sorta thought MA and MAPD meant the same thing-but I think I'm seeing now that is not the case.
Before I can track with the details I have to get better understandings of the fee-for-service, PPO and HMO concepts. At that point my question then becomes, is it common, "in the wild"-in the hands of "real medicare participants" to find MA plans which are not PPO or HMO plans, so that the plan holder might have a combination of Medicare Advantage + PDP rather than an MAPD?
Thanks.
I am now led to ask two questions about those types of plans.
One is about commissions. If an insurance agent says to me something like "you want to be a SHIP volunteer and you will steal my business", would that potentially apply to MA plans just like PDP plans? ie, can the consumers directly enroll in an MA type plan on the CMS website?
The other is about drug coverage. I'd always sorta thought MA and MAPD meant the same thing-but I think I'm seeing now that is not the case.
Before I can track with the details I have to get better understandings of the fee-for-service, PPO and HMO concepts. At that point my question then becomes, is it common, "in the wild"-in the hands of "real medicare participants" to find MA plans which are not PPO or HMO plans, so that the plan holder might have a combination of Medicare Advantage + PDP rather than an MAPD?
Thanks.
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