Medicare Marketing Guidelines

[Frank Stastny]

Has anyone (here) actually read all this material?

Nope! I already know all I need to know about marketing those products. I didn't become an independent agent to end up being CMS's "butt boy" and have to get their permission to go to the bathroom.

If one looks closely at their rules and regs, I believe they prevent an agent from helping the prospect make a well-informed, intelligent decision. One cannot compare MA plans or MA plans to a Med Supp according to CMS. I can't sell insurance that way.

 

[AndreaSti]

Nope! I already know all I need to know about marketing those products. I didn't become an independent agent to end up being CMS's "butt boy" and have to get their permission to go to the bathroom.

If one looks closely at their rules and regs, I believe they prevent an agent from helping the prospect make a well-informed, intelligent decision. One cannot compare MA plans or MA plans to a Med Supp according to CMS. I can't sell insurance that way.

You also can't ask them what meds they are on. Since formularies, and the copays for those tiers aren't standardized last time I checked, its' pretty hard to make a recommendation if you don't know what meds they take. We have a lot of clients that have figured this out already since they have been our clients for a number of years, so they volunteer the information. Many are insulted by the scope also. We had one, a 96 year old, state we are now living in a communist country. CMS treats seniors like they are feeble idiots. And agents are criminals just jumping at the chance to take advantage of said feeble idiots.

 

[Frank Stastny]

You also can't ask them what meds they are on. Since formularies, and the copays for those tiers aren't standardized last time I checked, its' pretty hard to make a recommendation if you don't know what meds they take. We have a lot of clients that have figured this out already since they have been our clients for a number of years, so they volunteer the information. Many are insulted by the scope also. We had one, a 96 year old, state we are now living in a communist country. CMS treats seniors like they are feeble idiots. And agents are criminals just jumping at the chance to take advantage of said feeble idiots.

I don't do Part D even for my Med Supp clients. I tell them that an insurance agent isn't an expert on Prescription Drugs, their pharmacist is. Their pharmacist also has no vested interest in the plan he recommends. Insurance agents may only recommend the plan that they earn a commission on.

They thank me for the recommendation and take a list of their drugs to the drug store.

No, I don't lose clients because I don't sell Part D. When I explain it that way it also helps prevent another agent from selling them a drug plan. They remember that I said, an insurance agent isn't an expert on drugs and that he/she is probably only recommending a plan that earns them money. It makes them very skeptical of an agent selling Part D.

 

[Bob_The_Insurance_Guy]

I decided long ago, when Medicare Advantage came out, that I was going to beat CMS at their own game. So far, I'm in the lead, and they can't even see my dust.

Every year, I meet with all the people that refer Medicare clients to me, and explain how every Medicare beneficiary should work with me.

#1: If they only want a Medicare Supplement, and have no need for a Part D or Medicare Advantage Plan. Simply have them email me, letting me know.

#2: If they want either a Medicare Advantage Plan or Prescription Drug Plan, they must email me first, letting me know whom they have spoken to, and that they are interested in discussing with me their Medicare options, including those that include medication coverage. The email must also state that, just for my information, the names and phone numbers of their physicians and a list of all medications taken. In the footer of their email must be their name, email address and phone number, with the okay of having me call them as a follow up to the email.

Full disclosure: before I work with them, I know their first and last name, who referred them, and an inkling of what their needs are. First, we meet just to have a cup of coffee, get to know one another, and no medicare is discussed. 100% of my Medicare business is referrals from my associates, financial planners I know very well, and my family. I never have a "secret shopper".

At that point, if they are a Medicare Advantage or PDP prospect, a SOA form is sent. Only after I receive it, do I then call for a Medicare meeting.

I don't buy lists, hire telemarketers, or send out reply cards. The only time I go to Walmart is to shop, not to sell. This is a relationship business, and I know my Medicare prospects and clients VERY well. The only Medicare client I had leave, left to live in another state.

That being said, I do not know what others who go through CMS regs deal with.

On my dumbest day, I'm smarter than CMS on their smartest day.

 

[arnguy]

I don't do MA's, Bob, but isn't asking for the prospect's medications a violation of CMS regulations with regard to the sale of a MA plan?

 

[GreenSky]

I don't do MA's, Bob, but isn't asking for the prospect's medications a violation of CMS regulations with regard to the sale of a MA plan?

Absolutely. But I do it also.

How can you be a professional without actually helping someone?

Rick

 

[AndreaSti]

Absolutely. But I do it also.

How can you be a professional without actually helping someone?

Rick

I agree.

From Frank Stastny: I don't do Part D even for my Med Supp clients. I tell them that an insurance agent isn't an expert on Prescription Drugs, their pharmacist is. Their pharmacist also has no vested interest in the plan he recommends. Insurance agents may only recommend the plan that they earn a commission on.

Frank: that isn't necessarily true. A good agent will want to know what scripts someone is on, so they can help evaluate their total health package, including med sup MA, PDP whatever, and whatever the client can afford and/or benefit level they are comfortable with. All a pharmacist cares about is the drug part, and many pharmacies (such as CVS, and Walmart for one) are partnered with one insurance company. Who do you think they are going to recommend? I think any agent who wants to keep the client long term will do a better job than a pharmacist any day.

Also, agents sell health insurance and they aren't doctors, so maybe in your minds doctors should sell health insurance too? Enlighten me on your thinking here please.

 

[Frank Stastny]

I agree.

From Frank Stastny: I don't do Part D even for my Med Supp clients. I tell them that an insurance agent isn't an expert on Prescription Drugs, their pharmacist is. Their pharmacist also has no vested interest in the plan he recommends. Insurance agents may only recommend the plan that they earn a commission on.

Frank: that isn't necessarily true. A good agent will want to know what scripts someone is on, so they can help evaluate their total health package, including med sup MA, PDP whatever, and whatever the client can afford and/or benefit level they are comfortable with. All a pharmacist cares about is the drug part, and many pharmacies (such as CVS, and Walmart for one) are partnered with one insurance company. Who do you think they are going to recommend? I think any agent who wants to keep the client long term will do a better job than a pharmacist any day.

Also, agents sell health insurance and they aren't doctors, so maybe in your minds doctors should sell health insurance too? Enlighten me on your thinking here please.

Are you saying I'm not a "good" agent and that my clients do not stay with me "long term"? I think you have totally missed the point of my post.

I didn't say it was always true. I also didn't say that "good" agents do that. I said that is what I say because I don't want the exposure of having to deal with CMS.

What I did say is that I don't do Part D because I refuse to comply with CMS. I am not interested in making a sale nor do I want to make a recommendation. If I recommend a plan and because of changes in the formulary it ends up sucking who do you think they are going to blame, the drug company or me? I think you know the answer to that.

I am not going to put my credibility and Med Supp policy at risk just to make a couple of bucks off of a drug plan. I have never had a complaint from someone who I suggested that they talk to their pharmacist. On the contrary, they thank me.

I also have not lost a client because I didn't write them a PDP Plan. I have, however, picked up new Med Supp clients because they were displeased with the drug plan that an agent sold them.

Answer this for me. Agents who sell MAPD Plans, is the client always getting the best drug plan or are they forced to take the PDP plan that goes with the MA plan they were "sold" even if there are better ones available? It seems to me that if the agent was working in the best interest of their future client they would sell separate plans.

That would make the sale more difficult though. The agent would have to do more work finding the "best" PDP plan and the prospective client would be faced with having to pay an extra premium. Are MAPD plans sold because they are "easier" and cheaper or is the client always getting the best PDP Plan with their MA?

I'm surprised that you typed this. I really don't think this comment is worthy of a reply: "Also, agents sell health insurance and they aren't doctors, so maybe in your minds doctors should sell health insurance too? Enlighten me on your thinking here please."

 

[DS4]

Those of us that work the Part D market, know the drill. First, get a list of the insureds current Rx's. Input into plan finder and get the ranking from best to worst.
If the best PDP is a carrier I'm certified for, I then enroll. If not, I will still electronically enroll the insured directly.
This approach is very unbiased.
Now if the pharmacist at CVS inputs the Rx's, and, the best plan is Humana Walmart Preferred, what is the CVS pharamist going to do???
The CVS pharmacist will do what is best for CVS.

 

[Frank Stastny]

Those of us that work the Part D market, know the drill. First, get a list of the insureds current Rx's. Input into plan finder and get the ranking from best to worst.
If the best PDP is a carrier I'm certified for, I then enroll. If not, I will still electronically enroll the insured directly.
This approach is very unbiased.
Now if the pharmacist at CVS inputs the Rx's, and, the best plan is Humana Walmart Preferred, what is the CVS pharamist going to do???
The CVS pharmacist will do what is best for CVS.

I don't disagree with any of what you do or said. I have also looked up plans for them. I just don't want to sell it to them or "recommend" one. I tell them that this is what I found but I also make sure they know I'm not necessarily recommending it.