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428,000 Medicare Advantage Customers Need New Coverage in 2010

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2010 continues to shape up as the year of change, as this week saw both Coventry Health Care Inc. and WellCare Health Plans, Inc. announce the end to their Medicare Advantage private fee-for-service (PFFS) contracts as of January 1, 2010. Both companies cited the Obama administration's policy to cut payments to Medicare Advantage insurers as the primary reason, as well as a government mandate that such insurers will need to develop networks starting in 2011.

428,000 customers now need to find new coverage. Currently, Coventry has 318,000 customers under its PFFS Medicare Advantage plan, while WellCare has 110,000 under its plan. It will be interesting to see if other PFFS Medicare Advantage providers will attempt to pick up these customers, or drop their own PFFS plans due to the significant increase in costs caused by new government polices.

If you are, or were, an agent of one of these customers, what do or would you recommend as the best course of action? Should they stay with a similar plan, but with a different provider, change to another plan with the same provider, or change to another plan with a different provider?

If you're an agent contracted with PSM to offer Coventry's Medicare Advantage products and need advice on what to recommend, call us at 1-800-998-7715.


Comments

YES! What a fiasco Medicare Advantage plans have been. I don't know that there has ever been an insurance product that lent itself so much to confusion and, consequently, deceptive practices. I was pretty high on the idea of Medicare Advantage plans back in '06. The insurance companies we represented made them sound so great. I mean who wouldn't want an "all-in-one" Medicare plan that includes your part A & B, your drug plan, kinda provides the protection of a supplement, and offers dental, vision, and ... oh ... what's this? A free membership to the YMCA? Oh, and I can go to any doctor I want (in very small type or under the agent's breath ... that is willing to accept the terms of the plan) just like regular Medicare. Well, what are you waiting for? Sign me up. <1 year later> What do you mean I can't go see that specialist? They take Medicare. What do you mean my drug is no longer covered in the formulary? What do you mean this only covers 80% of chemotherapy? Why is the insurance company telling me they won't pay for that treatment because they felt it wasn't necessary? It was a very necessary procedure and I don't think Medicare would've declined the procedure. 
 
 
 
Good riddance to MA's!
Posted @ Friday, May 08, 2009 10:57 AM by Medicare Supplement
Medicare Private Fee for Service plans may be a nightmare for people in metropolitan areas, but they are a God send for those of us in rural areas, as we have no HMO or PPO networks. I hear a lot of complaints from agents in large cities. Where I live they work fine for both agents and clients. It is often times for us a blessing to offer them as our clients that cannot afford a supplement have onlyn A&B to rely on with no maximum out of pocket limit.  
 
Sure there are problems, but it has been my experience that they are great deal for us poor country folks.
Posted @ Friday, May 08, 2009 11:54 AM by Kandis Mortvedt
Not every drug is covered under the medicare plan D so i dont know why the person who posted as "Medicare Supplement" wants to blame and MA plan for that. Also, i have MANY people who do not qualify for supplements due to age and health - not to mention who dont have the money to afford a supplement. I personally have seen these plans make a possitive difference in their lives - they go from endless piles of bills to either no bill or to one they can pay off quickly. We as people walking on this Earth need to realize not everyone can afford or qualify for the same things - if we did this would be a cookie cutter world. MA plans need to stay!
Posted @ Friday, May 08, 2009 12:01 PM by Karen Parker
PFFS MA plans work great! I should know. My wife and I have a Coventry Advantra Freedom #5 plan, and thats what I sell. It has worked beautifully and I will be sorry to lose it.  
 
Yes, we will no doubt return to a supplement plan with more money out of our pocket. And by the way, "Medicare Supplement", The brokers that work with me don't hide anything under our breath. We are right up front with the "accept the terms and conditions" statement.
Posted @ Friday, May 08, 2009 2:16 PM by Jerry Duerk
Also, just because you have Medicare doesn't mean the doctors are going to accept that. In the area I live in, I have a couple of towns that doctors do NOT accept Medicare or their supplements but open the MA plans with open arms. And there are MA plans that are PPO's also, they need to stay.
Posted @ Friday, May 08, 2009 3:51 PM by Karen Parker
This is unfortunate but there may be a light at the end of the tunnel for some. Many of these insureds may live in a managed care area and based on economic reasons may choose this option. Others who were not previously eligible for Medigap may have a 63 day right to purchase certain Medigap plans in their state. The last option would be to sign up for another PFFS plan, especially in areas where population is low and the managed care option might be unavailable.
Posted @ Tuesday, May 12, 2009 12:17 PM by Anthony Boratino
i'm a senior agent in texas and i have a medcare advantage plan that i'm very happy with.things have been tough and the savings from my "0"monthly premium has been a godsend.all of my dr's and hospitals are in my plan and gladly take my plan for which i'm very thankful.i also was given the opportunity to join a health club which was a life saver that is part of my medicare advantage plan that is a blessing that i could not have been able afford otherwise.i happily recommend medicare advantage to all my clients and they are very apprecitive.
Posted @ Monday, May 18, 2009 11:58 AM by tom farmer
I think if the beneficiary lives in the network, they need to enroll in the PPO. I have several PFFS clients that i will be contacting to switch them over. In regards to my medicare supplement clients....it's basic math, really. If a medicare advantage plan accepts their doctors and the maximum out-of-pocket cost is less than what they are currently spending for their med supps on an annual basis....then switch over!! The med supp rates are only going to go higher since 100% of claims are supported by premiums. At least MA plans are getting some kind of subsidy. And once Obama is ousted, i have faith that MA plans will become more popular again. Let's admit it....medicare insurance is the best out there compared to any private insurance plan....bar none.
Posted @ Wednesday, August 05, 2009 1:42 PM by Michelle Grigsby
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