Medicare Advantage Regulations

[DS4]

BTW, going to Reno this weekend.

I sure hope when I grow up I don't have a gambling habit like yours. I would never waste my money on such foolishness.
I would rather waste my money at the local Asian massage parlor.

 

[sdmillar]

man i thought those were just suggestions.....didnt realize I was supposed to follow those rules?!?!?!

Another one that I thought was complete BS when going through the training materials was:

Agents are NOT allowed to request referrals from those they present MA plans to. You are allowed to hand the client a business card and IF the client wants to give that card to a person to have them call the agent, that IS allowed.

Can someone tell me WHY CMS is afraid of agents asking for referrals? From what I read, even if the client (or beneficiary as they are referred to at CMS) volunteers the names and numbers of people that they know need my help, I can not take those referrals and call them as they are considered cold calls. What planet are these people on that write these rules?

 

[Newby]

Holy Cow, I just finished my certification for the privilege to be able to enroll people in Medicare Advantage. My head is still spinning with the overwhelming number of acronyms that are used in this business. I trust that I will be able to retain enough to be effective.

The marketing regulations that are a bit concerning are:
An Agent cannot conduct marketing through unsolicited conduct including:
Door to door soliciting
Leaving door hangers
Cold calling on the phone

Another one that puzzled me in the ethics guidelines:
An agent shall not engage in any discriminatory activity such as, attempts to recruit Medicare beneficiaries from higher income areas without comparable efforts to enroll beneficiaries from lower income areas....

I will say that they never did stipulate what I could drive or what I could wear when I go out and meet with these people, but maybe that is still yet to come.

I am not sure I am going to be able to get over this feeling of being smothered by Big Brother with this Medicare Advantage business. Trouble is, we have a 5 star MAPD here in our backyard that has dominate market share, I am afraid that without having it in my bag I would be leaving a lot of business behind.

Good news is I took the course and passed the exam in just a few hours. Bad news is I almost feel like I have handed over my soul to the devil. Is this how people that work at the DMV feel?

Gotta go take a shower...

The obvious question is; why don't you sell them the 5 star rated plan? That's the whole advantage of being independent. You sell them what they want.

 

[JimmyUt]

I remember this past AEP, during one company's face to face training, a girl just couldn't quite get past the idea that she thought it was legal to door knock. The trainer just kept saying, "no, it is not legal". She was so confused but failed to realize that this class and all the studying she was doing was only referring to MA plans.

I told her later it had NOTHING to do with Med Supps. You can door knock, cold call and all that other good stuff.
Then she said what if they don't want a med supp?
- - - - - - - - - - - - - - - - - -

Be careful even with the door knocking for other products. I was following up on a FE lead and left a note when the lady was not home. Someone complained on her behalf that I was marketing Medicare advantage door to door and now I am having issues with the state and United Healthcare over it.

 

[SportsNut]

Be careful even with the door knocking for other products. I was following up on a FE lead and left a note when the lady was not home. Someone complained on her behalf that I was marketing Medicare advantage door to door and now I am having issues with the state and United Healthcare over it.

Unless you left something on the door that mentioned MA plans, why wouldn't you just be sending to CMS and UHC a copy of what was left on the door (similar brochure or note), and that should be the end of it. Assuming you were prospecting for FE or other product, they shouldn't have any reason for further concern over this.

Exactly what kind of issues are you having with CMS and UHC...?

 

[russelltw]

Seriously, if you have a 5 star plan in your backyard and are not appointed with them, you may be losing business pretty quick.

R

 

[Dave020]

We have one in CA, Kaiser. Agents are not allowed to sell it. Bummer.

 

[SportsNut]

We have one in CA, Kaiser. Agents are not allowed to sell it. Bummer.

Isn't that always the way... when they have a crap-plan, then they need agents to sell it. When it is golden plan with a halo, then you can't have it. We should remember these companies that employ such strategy... but then they all do it. So what is the use.

 

[DS4]

We have one in CA, Kaiser. Agents are not allowed to sell it. Bummer.

You can sell it...you just don't get paid

 

[sdmillar]

Seriously, if you have a 5 star plan in your backyard and are not appointed with them, you may be losing business pretty quick.

R

Exactly the reason I sat down yesterday to get certified to be able to sell it. I do not like the government telling me how to run my business, especially when their regulations in many cases make no sense. How do they think an agent is going to prospect to enroll beneficiaries in Medicare Advantage?