Insurance Agent Forum

[MOHEALTH]

This (these) questions go out to the veterans in the senior market:

My market segment for a while now has always been individual health and small group. This year I am looking to add Senior products to my portfolio. I pride myself on ALWAYS doing the right thing for my clients and looking out for their best interest.

As I read through the posts on this forum there seems to be some conflicting information. Some have stated that MAs are bad plans for consumers vs Med Supps.

My question(s) are as follows:

What makes MAs a bad option?

What are actually the best products for my clients?

Where can you receive QUAILTY training in this field that isnt geared towards a carrier or FMO's interest? Unbiased training.

Do the rules of CMS make this market segment to complicated to make it worth entering?


Now, as much as I love to hear people's opinions, I prefer to hear facts. I dont have time to read a bunch of BS and people arguing about who knows more than the next guy/girl. So please keep your responses on the topic.

Thanks,

A New Guy Trying to Get Clear Answers

[jdeasy]

Originally Posted by MOHEALTH

This (these) questions go out to the veterans in the senior market:

My market segment for a while now has always been individual health and small group. This year I am looking to add Senior products to my portfolio. I pride myself on ALWAYS doing the right thing for my clients and looking out for their best interest.

As I read through the posts on this forum there seems to be some conflicting information. Some have stated that MAs are bad plans for consumers vs Med Supps.

My question(s) are as follows:

What makes MAs a bad option?

What are actually the best products for my clients?

Where can you receive QUAILTY training in this field that isnt geared towards a carrier or FMO's interest? Unbiased training.

Do the rules of CMS make this market segment to complicated to make it worth entering?


Now, as much as I love to hear people's opinions, I prefer to hear facts. I dont have time to read a bunch of BS and people arguing about who knows more than the next guy/girl. So please keep your responses on the topic.

Thanks,

A New Guy Trying to Get Clear Answers

You cannot get "clear answers" for the MA part of things. Even if you did get a clear answer today, it could very well change tomorrow.

What you will get at this site is some very educated opinions. I just found this site this year and I sure wish that I had been here long ago. I have learned so much from the people here. I would be money ahead if I had been before I ever heard of Parker and Asses, just for one example.

As far as the senior business. I love working that field. I do mostly FE now and MA business. I still do a certain amount of term life from referrals or when the need arises for a client. I have dabbled in med sups before, but, am nowmoving into doing more of them.

I think that a med sup is the best health coverage for a senior. If they can afford the premium, there is just nothing better.

Many cannot afford the premium or, if they didn't buy one when they had a GI period, cannot qualify healthwise. That's when MA plans are a great choice. In my area, we don't have vialbe PPO or HMO plans. I wish we did, but, they are just not here. PFFS plans dominate this market and they are good options as we don't have an aceptance problem I did 300 PFFS plans last year and have done 200 this year. The next call I get where the PFFS plan was not accepted will be my first.

I also pride myself on looking out for my clients best interest and keeping up with what plans are available in their counties and how the plan has changed for each year and what new plans may have become a player on their county. I had many clients last year that I encouraged to stay in the plan they had. I had many that I moved to better plans for them. I take pride in doing that. I've had a total of 9 disenrollments over the last 2 years and 3 of them want to re-enroll. I must be doing something right. Now, CMS says that my continuing to do what I've been doing is churning and should be stopped. They are saying that I can't contact my clients to tell them about better options. Well, they say I can as long as I send a CMS pre approved letter to them and they contact me from that mailing. As an independent agent, I can't spend thousands of dollars on a mailer and get it CMS approved in order to speak to my own clients. That is just so ridiculous that it defies belief.

Here's an encounter I had yesterday. A lady calls me because she was given my number by a current client. This lady is 76 years old and wants a med sup. She didn't retire until Feb. of this year and had group coverage until then. She got part B as of March 1 when her employer coverage ran out. Nobody told her about her GI period to buy a med sup. She has congestive heart failure and will not qualify for a med sup. She asked if there was anything available for her to help. I told that there was a very good MA plan coming to her county for '09 but that she couldn't enroll until after Nov. 15 for a Jan 1 effective date. She asked me to call her back as soon as I could do something. I told her I would. Now, one MA company has told me that I cannot call her back or it would be considered "cold calling" by CMS. I disagree with that, but, is that a correct ruling? I don't know.

This kind of stuff makes the MA business too cumbersome and worrisome to continue if you are a diligent agent and trying to do what's best for your client.

[The Rabbi]

Honest people have nothing to worry about. In my 40 yrs of business, if you are doing right by the client, no one is going to complain. The rules are so stupid.

MA plans are a hot item in Florida. The Med Sup premiums are chasing away long time payers.

My impression is that Med Sups are over insuring. You're selling a zero out of pocket plan. Why don't you call your P & C agent and have him change your home and auto to zero deductible.

A MA plan provides catastrophic coverage with a max OOP. Preventive care and Rx usually without a premium.

Is a sup better? Of course, but is it worth the money?

[jdeasy]

[quote=The Rabbi;105047]Honest people have nothing to worry about. In my 40 yrs of business, if you are doing right by the client, no one is going to complain. The rules are so stupid.




I'm not so sure about that. Right now, a county near me has about 100 Today's Options members that I enrolled. The premium in that county has now gone to $69/mo. and reduced benefits. Wellcare has not been a player in that county. They are for '09.

It would be in the interest of all my TO clients to, at least, look at the Wellcare plan. CMS and Pyramid are both saying that, if I contact those people to tell them about Wellcare, I am in violation. I know many are going to contact me anyway when they get their ANNOC, but, if I iniitiate contact, they say I'm wrong. And, they will be looking to make an example out of someone.

[Frank Stastny]

Originally Posted by MOHEALTH

This (these) questions go out to the veterans in the senior market:

My market segment for a while now has always been individual health and small group. This year I am looking to add Senior products to my portfolio. I pride myself on ALWAYS doing the right thing for my clients and looking out for their best interest.

As I read through the posts on this forum there seems to be some conflicting information. Some have stated that MAs are bad plans for consumers vs Med Supps.

My question(s) are as follows:

What makes MAs a bad option?

What are actually the best products for my clients?

Where can you receive QUAILTY training in this field that isnt geared towards a carrier or FMO's interest? Unbiased training.

Do the rules of CMS make this market segment to complicated to make it worth entering?


Now, as much as I love to hear people's opinions, I prefer to hear facts. I dont have time to read a bunch of BS and people arguing about who knows more than the next guy/girl. So please keep your responses on the topic.

Thanks,

A New Guy Trying to Get Clear Answers

MA plans include everything that falls under Medicare Part C. This includes HMO's, PPO's and PFFS plans.

Almost all of the discussion is about the PFFS plans. It would be so much easier to understand all of this if agents would specify which of the three they were talking about instead of just saying "MA plans".

There is a huge difference between PFFS, HMO, and PPO plans.

What may be "good for your clients" is pretty much going to depend on the geographic area in the state where you sell. If in a large metro area, KC and St. Louis, any of the three that are available may be something your prospects would consider.

I'm sure you know by now, I work in rural Missouri. HMO's and PPO's are not available for me to sell. I only have two options, PFFS plans or Med Supps.

If you have followed any of the discussion about PFFS plans and have read any of my posts you will know why I do not offer PFFS plans to the prospects I talk to.

Forget about "quality training", it does not exist regardless of what marketing companies or general agents tell you. Lots of research on your part and wading through the threads on this board is the best way for you to learn.

If your only reason for wanting to get into the senior market is to sell MA plans, specifically PFFS plans then I would suggest that it may not be a good choice for you at this time. Especially if you sell mostly in rural Missouri like I do. I say that because you stated, " I pride myself on ALWAYS doing the right thing for my clients and looking out for their best interest". I do also, that is why I do not write PFFS plans in rural Missouri.

However, if you would like to also offer Medicare Supplements I will be more than happy to discuss the Med Supp market with you over the phone.