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Tags: Humana Medicare Plans, Bishop Marketing Agency, Medicare supplement plans, selling Medicare Advantage Plans, MAPD enrollment, Medicare legislation, Total HIPAA, Medicare Health Plans, PDP enrollment, marketing Medicare Advantage, CMS guidelines, HIPAA compliance and training, MAPD Distribution
Prospecting in the Medicare space requires creativity, professionalism, and optimizations of the remaining pathways to Medicare beneficiaries allowed by CMS and your state DOI. One opportunity that has proven to be a powerful way to engage new clients is through the Walmart workstations made available to authorized agents during AEP.
It is said that 80% of Medicare beneficiaries live within 15 minutes of a Walmart! Through Humana’s strategic alliance with the world’s largest retailer (3,700 stores), an agent may cover a shift in the store of their choice, provided they are equipped and certified to represent the portfolio of Humana products available in their market, and can commit to a predetermined shift of at least six hours per week (e.g. Monday/Wednesday 1pm-4pm). This pathway is deemed an unadvertised seminar by CMS, meaning hours committed to must be reported to CMS for secret shopping opportunities. Nevertheless, it is a wonderful resource for engaging new Medicare beneficiaries (or their friends and loved ones) in their quest to determine the best product available for their specific needs.
In our experience, over 70% of the best performing agents last year played a role at a Walmart workstation last season, so there’s a high correlation between productivity and this resource. Of course this is also predicated on the degree of effort and focus the agent demonstrates while present. Interfacing with the local store and pharmacy managers and staff also helps drive interested parties to your workspace accordingly.
Like anything else, you get what you put into it. We believe this to be a wonderful opportunity for ambitious agents out there in the Medicare space, and provide over 500 store coverage opportunities nationally on behalf of Humana. Want to learn more? Fill out this form to get started.
As I have indicated in the past my wife and I went onto Part A and enrolled in Part B of Medicare this year. I started on May 1st and my wife February 1st. Just some background, the past eight years I have had a high deductible plan with Life Wise of Washington state. We had a $6000 family deductible plan and was paying about $700 per month the last year we had the plan. I had also enrolled in an HSA eight years ago as well so today the balance of my HSA account is over $50,000. As most of you know this fund can be used for co-pays for doctors visits as well as prescription drugs.
My wife and I both chose the $0 premium MA only PFFS plan available in Washington state. (My wife does take some prescription drugs so I enrolled her in Humana's WalMart standalone PDP, as I do not take any drugs, I chose not to enroll in a PDP.) This is a Medicare look alike plan meaning I am responsible for the Part A hospital deductible and 20% of the Part B outpatient expenses, however, there is no Part B deductible, I pay 20% from the first dollar of charges.
I have used this plan three times so far, twice at the ophthalmologists and once at the dermatologists. I could not be happier with how the plan works. First of all, I am not paying for my healthcare in advance in the form of a premium. Not for a high deductible plan like I did before going onto Medicare or for a traditional Medicare supplement. I am only paying for 20% of the Medicare approved charge and that is a lot less the than the $8400 in premium I paid for Pat and I last year. If I had chosen a traditional Plan F my premium would have been around $200 per month for me and $200 for Pat or about $4800 per year.
I have my annual physical scheduled for the fist week of August with the doctor I have had the past several years. In past her office accepted Life Wise. Before going onto Medicare I called my doctors office to explain I was planning on enrolling in Humana's MA only PFFS plan. The office manager explained they did not officially accept Humana but as I was currently a patient, the office would accept Humana's terms and conditions and bill them directly so I could continue to keep my current doctor.
So far I could not be happier with the choices I have made. I now go to the downtown YMCA using Silver Sneakers and no longer pay $55 per month to OZ fitness. The best part is on October 15th I can look at all the options available for 2014 and make a new choice if I find a better option with no pre-existing conditions or waiting periods. The new choices today really are a win win situation for Medicare beneficiaries like me.
Tags: Humana Medicare Plans, Agent Testimonial, MGA Testimonial, Bishop Marketing Agency, Humana, Medicare supplement plans, selling Medicare Advantage Plans, ICEP, Medicare choices, Medicare Health Plans, PDP enrollment, Medicare Annual Enrollment Period, Medicare options, seniors choose Medicare Advantage, Medicare Advantage growth
A LIS qualification also triggers a SEP, and can be validated by member attestation, redetermination letter, or SSA award letter. The SEP is continuous, as long as the beneficiary is eligible for the Part D subsidy.
For those recently losing their status, the SEPs are as follows:
- Loss of subsidy at the end of a calendar year yields an election period of January 1 through March 31.
- January 1 may be used as a proposed effective date in this case if the enrollment is done prior to the end of the year.
- Loss of subsidy occurring at any other time runs similarly to the loss of dual status, beginning in the month in which the beneficiary is notified of the loss, and ending two months following the month of notification.
Here’s the scoop on Dual Eligibles:
Dual Eligibles are defined as those having both Medicare and either partial or full Medicaid benefits. Here are some qualification items you can ask to verify their status: Medicaid Card, Medicaid Award Letter, Medicaid #, or Member Attestation Form.
As long as they are eligible for dual status they have a continuous open enrollment period. For those who have recently lost their status (which can be verified by member attestation or state notice showing loss of status), then the SEP begins the month of lost dual eligibility and runs for two consecutive months following the first month.
Okay, so we’re all familiar with the basics... AEP runs October 15 to December 7 (six months from tax day to “A day which will live in infamy”), MADP runs January 1 to February 14 (New Years to Valentines Day, piece of cake), and the rest of the year, or ROY as they call it at Humana, runs February 15 through December 31.
Then there’s those “other scenarios,” hundreds of them it seems. I need an overhead projector and a flow chart to make sense of them all. Well, rather than chew up our entire morning reviewing the scenarios, let’s take a look at one each day until we nail down five of the most common.
If you must use paper (like during pre AEP, October 1 - 14), write legibly and complete the entire form. Any enrollments received by Humana that have even a single blemish go right into the pend file.
Larry drew his approach to the industry from a value system instilled in him while growing up in the heartland of Wichita, KS. After graduating from Wichita State University with a bachelor’s degree in education, Larry began his career as a kindergarten school teacher in 1972. Over the next seven years he would go on to serve as a third grade teacher and become a K-8 school principal, earning a masters degree in educational administration along the way.
Responsible for supporting a young family at that time, Larry pursued a career in the insurance business in 1980, and began selling Medicare supplement plans. After six years, he joined Union Bankers Insurance Company in Dallas, TX as a Field Vice President, responsible for growing Medicare Supplement and Major Medical business in 14 western states. In 1992 he started the Bishop Marketing Agency in Overland Park, KS, and now supports over 2,000 agents and agencies throughout the United States.
Since 2005, Larry has focused his efforts exclusively on Humana’s Medicare health plans, supporting the production of over 160,000 MAPD, PDP, and Medicare supplement enrollments for Humana to date.
Larry recently celebrated 42 years of marriage to his wife Patricia. They have two children, Sara and Bridger, both of whom have become educators. In his spare time, he loves to travel, exercise, and follow college basketball.