Medicare Advantage

[edkatz]

I have sold Medicare Advantage plans for many years. If someone has medicare, lives within the service area, and does not have esrd then the policies are great for people. No health questions asked other then (do they have esrd.) They also give extra benefits like dental, vision and drug coverage. A supplement does not offer that. They also get all of their preventive care at no co pay. Thats a lot of coverage for no monthly premiums and no copays. If people can not afford a supplement then this is great for them. Supplements go up every year. At 65 premiums are about 100 a month. Then they have to add dental and drug coverage over that. Still that may not be a lot of money for a husband and wife. But then they are 75 to 80 and the costs go up to 250 or more for each. At 100 a month, thats about 20K you could save a family over 10 years. Thats a lot of money that they can free up for their lifestyle and standard of living. Plus they can buy LTC or other insurance. Additionally people are never stuck. Every year from 11/15 to 12/31 they can change or switch plans and if this is the first time they went to get an advantage plan in the first year they want to go back to their sup then they can on the first day of every month within the year without medical questions.

 

[wehotex]

MA plans for dual eligibles are sold on the stigma concept of not having to show their medicaid card which is weak, because most don't give a rat's ass about this. The newest selling point, however, is some Docs are shying away from taking new patients on medicaid, because it takes them forever to get paid because the state is behind paying claims.( in Illinois it's an average of 100 days) They are put in the HMO referrel maze which is another drawback. You have to be clear with the client how it works so they can weigh that against the added benefits as well as using it correctly. Unfortunately their are too many agents that only care about a fast buck and not helping people. I don't know which plan is training you that way, but run from it . CMS would love to know.

The Secure Horizons (excuse me- "AARP") medical groups in San Antonio are absolute whores. They want EVERY medicare-medicaid pt that moves no matter how many specialists the pt is seeing. It's not just the agents. Sometimes the medical groups are complicit in this.

 

[shauny2k3]

This is INCORRECT. I just got off the phone with United World to clarify what I had understood. Before I post the information, I wanted the company to "back me up."

Here's the bottom line:

If the member enrolls for the 1st time in an MA plan and leaves within the first 12 months, he or she may go back to their old Med Supp without proving insurability. If that policy does not exist, then they can go anywhere. Once they are past the 12 months, then they must be underwritten.

If the person moves out of the service area or their MA plan cancels, then they may go to any supplement on a guaranteed issue basis.

United World and every other carrier I know of follows the federal guidelines for guaranteed issue from an MA plan. You might be able to "slip something by the company", but I certainly wouldn't want to risk my client's coverage (not to mention my e&o) on that.

Rick

Actually he was correct. He was talking about SEP-65; whereas you're describing SEP-Trial which is a different SEP.

SEP-65
If a newly Medicare eligible enrollee chooses a Medicare Advantage plan at first enrollment, they can disenroll within the first 12 months using SEP-65 even if they have not had a med supp. I am not 100% certain, but I believe this right might expire the last day of the year, so will be less than 12months for some people. My wife works in retention at an MA plan, so i'll have her check it out at work to make sure.

The SEP you mentioned is SEP-Trial, and your description is correct.

 

[GreenSky]

Thank you for correcting something I posted 3 years ago. I've been waiting patiently for someone to do this.

Rick

 

[jayrayl]

Hi, Does anyone know the name of the website where I can go to take the medicare certification class for free? I'm in California if it matters... I paid for training, tried to do it in a day and paniced at test time... got 86%, needed 90% to pass. I don't mind repeating the test, I just mind having to spend another $149 again. Anybody have any ideas?

I know this is and old question and may be completely irrelevant to you any more but, I am assuming the test you are referring to is AHIP. If you are licensed with UHC, Anthem BC/BS or Aetna (I am sure there are more across the country as well that do this) and you sign up for AHIP through one of the companies agent training portals the AHIP test price is dropped from $150 to $100. Aetna and Anthem also send you a $100 reimbursement check if you write at least 5 MAPD's during AEP. (I don't have confirmation yet that they are doing this for the 2010 AEP, but they did last year.)

 

[brighterthansunshine]

I cant feel the advantages of Medicare. You have to be totally impoverished to qualify for Medicare

 

[midwestbroker]

I cant feel the advantages of Medicare. You have to be totally impoverished to qualify for Medicare

I did not realize turning 65 made you totally impoverished.

 

[bpenn9]

I cant feel the advantages of Medicare. You have to be totally impoverished to qualify for Medicare

Seriously?

 

[sman]

I'm assuming your screen name isn't speaking of intelligence because that comment was not very bright and definitely not brighter than sunshine.

All one has to do to qualify for Medicare is work their 40 quarters and turn 65. There are also those who become disabled prior to 65 who can qualify for Medicare.

No income limitations apply to those on Medicare. Warren Buffet qualifies for Medicare and I assume he is on it. I wouldn't consider him "totally impoverished".

Maybe you meant Medicaid.

I cant feel the advantages of Medicare. You have to be totally impoverished to qualify for Medicare

 

[arnguy]

Boy, brighterthansunshine, that was a very stupid first post!