First WellCare, then...


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What a week! This week has been very volatile. Now I'm looking for another carrier.

MEGA scars me. Just Google...

Coventry will not allow any application distribution prior to November 15th. I can't see everybody between Nov 15th till Dec 31st. Some will have to wait till the like-to-like season. And their stock slipped 6.7%* yesterday?

Maybe UnitedHealth? Though just like Aetna they have limited market strengths in their product lineup. Great names though!

UAFC pops back up on radar, again, though my past experience was one of the worst of all carriers last year.

* 10-26-2007 Quote: "Now Thomas Carroll, the health services analyst at Stifel Nicolaus, said rumors were circulating that Humana may be the subject of a similar investigation. Carroll said that speculation is that the raid at WellCare was related to Medicare and Medicaid fraud..."

So my question for the Forum:

Which MA/MAPD carrier are you going with this season, and am I the only one whom has concerns?
I'm sticking with the AARP brand - UnitedHealth. I don't think any senior wants to hear anything bad about the AARP..... Wienie, huh?
While I sent in paperwork for UH - AARP, I've not heard anything back yet so I don't know if they are actually 'serious' in my area (Sacramento, CA).

I'll sell mostly the Blue Cross Freedom One plan. It may not be the 'best' plan, but no matter what you can say about BCC, they have a trusted name among seniors here and they DO pay their claims. Their 'gold' drug plan is pretty good as well. Finally, my wife has been on their Freedom plan for the past year and she has used a lot of medical services (being under-age/disabled) and she has not had one issue with them.

One other thing... which I think is far MORE perception than fact... but which seniors TELL me about... when you go to the doctor/hospital/clinic... or make an appointment on the phone..and they ask what insurance you have or ask to see your card, and you show/tell them "Blue Cross" as opposed to "Medicare" you often get the date YOU want... or you go to the font of the line because the office staff know (or believe) that the practice or provider will get paid sooner, easier, less hassle, etc. BC does pay quickly if EOB receipts are any indication.

There is no way I can quantify this perception but I hear it from others and my wife has experienced it... or at least she BELIEVES she got 'preferential' treatment by having a plastic blue/white BCC card instead of her previous red-blue Medicare card.

I'll hear something like "My friend Mavis has a Blue Cross medicare card and we go to the same doctor and she always gets the appointments on the day SHE wants and I never do." Go figure.

Of course I would NEVER try to "sell" that in a presentation... but you don't have to. It is something a lot of people believe... true or not.

I had to switch a client from a MA plan back to a Med Sup yesterday.

This started out a couple of months ago with the report that Pyramid's T.O. PFFS was not paying several claims of hers. I called Today's Options provider relations, and they said they would get on it, but they admitted being behind in claims settlements because they underestimated their sales success and had to hire and train more staff.

The client finally called me a couple months later and said she wanted to go back to her Med Sup because her providers were not taking MA plans. When I inquired about switching to another MA carrier, she said NO MA PLANS. Her daughter was present, and told me she had tried to deal with her mother's provider billing reps and was told that they would not accept any MA plans anymore. As a matter of fact, the hospitals and doctor offices were posting this on their doors.

This client's husband had a Coventry MA plan earlier in the year (I enrolled him into a SNP this summer). He is happy now, but tells me there are still some bills Coventry never paid and the providers and Coventry are at odds.

I see the problem growing political volleyball. IMHO, the doctors (AMA) are mad about money going to MA plans while they are getting pay cuts from Medicare. By taking a firm stand against MA plans, they are sending a message.

It is no secret that the Democrats are irritating the Republicans on the SCHIP bills being sought and subsequently vetoed by Bush. This volley between SCHIP and MA funding is also sending a message.

MA plans will not go away, but the constant media contortions will make seniors (who read newspapers more than the younger generation) shy of MA plans. This is another reason to carry Med Sups as well as MA plans.