U65 Medicare Advantage

[lks288]

Currently, I am working with a company starting up an agency for SSDI clients who are becoming eligible for Medicare. This is a brand new venture for us and we were told by the person who I assume is my "upline" that this business was a great way to maximize the revenue overall and it would be extremely easy to get people signed up in a plan.
I've done all the testing, licensing and contracting needed and am currently licensed in MN, MI, WI, & OH. One thing I've noticed since starting this project is many of our SSDI clients are covered under a spouse's insurance plan or they receive county benefits and are not interested in our service. This is making me question whether or not there is really enough profit to be made in the U65 market.

Does anyone else here focus on U65 or have any training sites/information to help overcome a lot of the common obstacles involved in this market? At this point, I am willing to try almost anything to help boost our sales and start seeing the numbers we were planning to see. Thanks in advance!

 

[kstein]

Where would you be getting leads from? Are these people in the 24 mo window between SSDI and Medicare? Or already on Medicare?

 

[lks288]

The law firm that I was previously employed with has since started their own insurance agency. Once the clients are approved for SSDI, they are sent my way to start the Medicare process at 24 months of SSDI payments. Of course during AEP, we can focus on all of the previous clients as well who are already on Medicare as well.

 

[GreenSky]

The law firm that I was previously employed with has since started their own insurance agency. Once the clients are approved for SSDI, they are sent my way to start the Medicare process at 24 months of SSDI payments. Of course during AEP, we can focus on all of the previous clients as well who are already on Medicare as well.

Sounds illegal. You can't bring up MA without the prospect asking.

Beyond the legality, it's just sleazy.

Rick

 

[kstein]

I was actually thinking about the same process but approaching attorneys that focus on disability. Why would this be illegal? This would be no different than a referral or a T65 who wants to know their options or are interested in Medicare supplement insurance.

I am thinking of how to approach attorneys that I don't have relationships with at the moment but it is a consistent flow of leads for people who need help and have to do something.

I could see the possible "sleeze" factor but given the potential, would look the other way.

In fairness I'm in Missouri where med sup rate are decent for u65 so that may be a difference maker.

 

[GreenSky]

I was actually thinking about the same process but approaching attorneys that focus on disability. Why would this be illegal?

The law firm is also the insurance agency so they're double dipping.

They're not referring to an agent, but making a commission themselves. As I wrote, if not illegal it certainly is sleazy.

Rick

 

[kstein]

Would it be illegal if the role were reversed, an agent who is also an attorney assisting with insurance then 6 months later helping with their trust?

I've seen this happen before and would imagine it is legitimate, almost a value added service (as long as all rules are followed and disclosures met) To the OPs main question of how to crank up volume, where is the main disconnect? Are these clients unaware that the firm also provides these additional services? Is there ongoing communication during the 24 mo gap between disability and Medicare? What type of systematic follow up is in place to reach out to clients at the appropriate time?


In my experience, it is usually a better deal to grab Medicare and supp or mapd then to stay on spouses employer plan (donuthole being the most common deal breaker) so that reason doesn't seem to be a consistent objection imo

 

[lks288]

I guess I should have elaborated a little more. The law firm is NOT the insurance agency. They are two completely separate companies and the clients are signing paperwork allowing the insurance company to contact them in regards to medicare. There has been about a year long process getting everything established legally and ethically. I didn't include that in my original post because that was not the main focus for my questions.

----------

Would it be illegal if the role were reversed, an agent who is also an attorney assisting with insurance then 6 months later helping with their trust?

I've seen this happen before and would imagine it is legitimate, almost a value added service (as long as all rules are followed and disclosures met) To the OPs main question of how to crank up volume, where is the main disconnect? Are these clients unaware that the firm also provides these additional services? Is there ongoing communication during the 24 mo gap between disability and Medicare? What type of systematic follow up is in place to reach out to clients at the appropriate time?

In my experience, it is usually a better deal to grab Medicare and supp or mapd then to stay on spouses employer plan (donuthole being the most common deal breaker) so that reason doesn't seem to be a consistent objection imo

There is not usually much communication during the 24MO gap between getting approved for SSDI and becoming effective for Medicare. Most of the clients have no idea how much their spouse pays for employer coverage and just assume that it's cheaper in the long run because they have no doctor visit copays. I've also been seeing a lot of people who are deciding to opt out of Part B to avoid paying the monthly premium while covered under a spouse.

 

[G.Gordon]

The thing to watch for is drug coverage. Those that can stay on spousal benefits and use expensive medications might be best served on the group plan with the unlimited medication benefit.

Those on SSDI are the least served in the Medicare book. They typically don't know about the time limits, get a Medicare and You book and that is the extent of their indoctrination to Medicare. An agency that has the ability to catch them in the critical first three months would be doing a service even if it is to advise them to "do nothing" or stay put.

 

[unic.consulting]

I agree. Once you get the initial approval from them, reach out to them immediately. First, this makes sure that they are aware of all of their options from the beginning and makes sure they are in the best situation for themselves down the road. Second, it gets you name and face recognition so 24 months later, it won't be something out of the blue for them. Third, the scope that they would sign from the insurance company only has a limited duration. I don't think it'd actually be worth anything two years after it's signed.