- I'm Rebecca Gordon. - Hi I'm Sylvia Gordon.
In this episode, we're gonna talk about what's happening
with the Medicare Blue Button during AEP and...
- As well as a bunch of under 65 updates,
so stay tuned.
(upbeat music)
Hot off the press,
AEP is off and running.
We're having a successful year,
and I'm seeing one glitch so far,
which I'm sure there's probably more,
but I'm aware of this one.
Anthem's encrypted numbers.
So way back in the day,
Anthem gave everybody their own agent number
based on their state.
So, if I saw a G number number,
I knew that was Ohio.
They're only accepting your encrypted numbers.
And a lot of people are not doing this,
so business is not showing up in their dashboard
or on our reports.
- What are they putting on their applications
instead of their encrypted numbers?
- They're using old numbers that--
- Got a new number?
- We've always had encrypted numbers.
They've just never insisted
that that's the only number they'll use.
- Ah ha.
- So the encrypted number,
and we've sent out...
We're trying to send out stuff
every single day on this.
- Because I would delete that.
When I see that, I'm like "What the hell"--
- It's all letters. - Right.
- It's like 12 letters.
Random, weird...
And that's your encrypted.
If you're to using your right encrypted number,
you're not gonna get paid.
Because that business is in a holding tank.
- That will get my attention.
- You will not get paid.
So yeah, you are getting Ringless Voicemails from us.
You're gonna get a mayday text from us.
I wanna do everything I can to be proactive now.
So I'm not getting a call in March, or whenever,
"Why haven't I gotten paid?"
- Remember, when you don't-- - Ahh!
- When you don't do it correctly,
with any other of the carrier,
than you don't get paid electronically
in a timely manner.
And then it rolls to a manual payment.
- Terrible.
- But somebody has to go find it.
- Yes.
- And cut it, and it takes a long time.
So, after AEP, when you're trying to sort this out.
You want your money.
It's not gonna be fast.
- You ain't gonna have no money.
So look, make sure you're using your encrypted number
for all Anthem states.
If you're not sure, or if you don't have it,
go ahead and reach us in these comments,
and I'll have your marketer reach out to you.
But this is serious, important, very very very important.
- Now, nobody else has the same problem.
But every carrier has their own agent writing number, okay.
It might be cool if they use the NPN number.
Just putting that out there.
But, everybody has their own agent number.
And agents get confused.
- [Rebecca] Heck yeah.
- So, then they write the wrong number.
They write their Aetna Coventry Number on their Humana,
and then they're mad because they didn't get paid,
and they're furious at us or Humana.
And then we finally pull the app and see,
buddy you made the error.
- That's why it's always really important,
check your dashboard every week.
You know that when you're submitting apps,
either fax or electronically,
dear god please do electronically,
there's gonna be a bit of a lag.
But check your dashboard.
If you don't see your client,
it's a heck of a lot easier to catch it now and fix it,
then to wait.
- Yeah so, I'd probably write 25, I don't know,
25 cases during the AEP you know.
Not a lot, but I'm out there.
And, as soon as I write one,
I go log into the portal the next day,
and make sure it's there.
- [Rebecca] Make sure it's there.
- You know, and I try to do them all electronically.
But still, make sure--
- [Rebecca] It's super easy.
- Because it's way easier to do it now
when I'm thinking about mister or missus Smith,
than in February try to go back and say,
"Why didn't I get paid?".
- "I screwed up, I just screwed up."
- So, ideally best practices, e-app.
Yeah, we're a broken record,
but we know you guys aren't doing it, okay.
Those of you that are,
hats off because it's cutting down on so many problems.
So if you're not gonna do e-apps.
If you're like the majority of agents that said,
"I will go to my grave doing a paper app,
I want to retire out of this business and not learn that."
And there's a lot of you that have told me that.
And I kind of respect it,
because I kinda think when I'm your age I might be the same.
But, take a piece of paper with all of your agent numbers,
write them down there,
so every time you pull out an app you verify it.
And then have your assistant reverify it.
Because you guys have cases and cases of business
that won't get paid,
and the carriers don't expend a tremendous amount of
labor to get you paid.
And I've talked about this before.
That a lot of the stuff that they can't read,
your agent number, even if they can read your name,
they just throw it in a pending file.
And if you don't come claim it
after a certain amount of time,
it accretes to them and they keep it.
So they're not gonna go,
"Oh dang, we can't figure this out.",
ring ring, email, no.
They're just gonna sit there and wait for you to call them.
- Be proactive.
On a good side with Anthem,
we have a super awesome incentive.
This went out last week from our office.
For the great states of Texas and California,
we've got some great bonuses here.
So just for our Texans and Californians,
however everybody else I have a good feeling
bonuses will come to us.
But they've got some great bonuses from 11/1 to 12/31.
Extra $500 in co-op marketing.
Any combination of five
Anthem Medicare plans or Amerigroup Plans.
So take advantage of this.
Marketing money, co-op money, 500 bucks, sweet.
If you guys didn't read this in your email,
go ahead and hit us up in the comments,
we'll send it back out to you.
But I love seeing where we can
help our partners get a little extra co-op
for doing their job.
- So the Medicare Blue Button
is continuing to be a sore on the side,
a thorn in our side.
- A giant thorn.
- It is what it is right now, okay.
So it is...
They are making enhancements as we go along.
Like I said last week,
if you have specific incidences
of things that are replicable,
repeatable, I don't know what I'm trying to say.
But, something that you can email CMS and say,
"This happens when you do this."
And they can do it, they can repeat that mistake,
their ears are open.
They are trying to fix this.
So, keep sending your information.
Send it to us, or send it to them.
They are listening,
and they have made some changes.
Since this started in August,
things are happening.
One of the things that is alarming
is that when you do sign your client up.
You go to Medicare.gov and you sign them up,
and you help them create an account for the Blue Button,
if they do put in their email,
then they are going to be getting solicitations,
emails from Medicare.
So if your client wants that,
and your helping your client set it up,
then just warn them they'll be getting emails.
And the emails may not be necessarily in the best
interest of their agent/client relationship.
So, that's code for
the government's trying to push them to go around us.
- So we talked about this in the last episode
that we had a situation where a client got an email
from Medicare.gov suggesting
a new Humana plan, I believe.
- They said your Humana plan costs $22 for 2019,
your price is going up for 2020.
Click here to go search for a better plan.
Well that might be the best plan.
- Right.
- Even with the price going up.
That Humana plan might be the very best plan
for a variety of reasons that the client
might not be able to take into consideration.
Where the client is just gonna reduce it to price.
So, I understand the government is trying to
put more power and the control
in the hands of the Medicare beneficiary,
and that's a good thing.
I think we can agree on that.
However, I think it's unnecessarily
trying to push agents out of it, the equation,
and there is plenty of room where they could put,
"Here's your agent, talk to your agent.
"Maybe your agent can help you,
"or you can go search on your own."
They need to keep the agent in the conversation.
- This would be a great opportunity for you, the agent,
to be sending out something on social media
to your book of business.
It's a great touch point.
"This is happening."
"If this happens, contact me."
But a way to put something out
so that your clients are a little bit
in the know of when they get that solicitation, if they do,
how to react the most successfully.
And it helps you keeping to touch your clients.
Then your clients are gonna think,
wow you're really proactive.
Proactive, could be a really good thing.
- So Part D clients this AEP.
The people that spend a lot of drugs.
- Spend a lot of drugs?
- Spend a lot of money on drugs.
Those people, we found, are going to be spending about
over $400 more this year.
Because one of the provisions of the ACA expired
that impacted the cost of drugs in the gap.
And now the gap has closed for 2020,
so you actually have coverage,
but you'll be paying a larger percentage
of the cost of your drugs.
So, the people that take a lot of drugs,
are gonna find they end up paying more in 2020,
than they did in 2019.
And they might be under the mistaken impression
that since the coverage gap is "closed",
that that means they're going to be paying less.
And we don't want you guys caught in the lurch
maybe thinking the same thing.
- Yeah, if something's closed,
I'd think it's over.
- You think it's better.
But it doesn't mean your copays are lower.
So, that's happening.
Kaiser Family Foundation
found that out-of-pocket drug costs
will increase by nearly $400
from 2,275 in 2019 to 2,650 in 2020.
That's for Part D enrollees
who take only brand name drugs
and annual total drug costs that reach
the catastrophic coverage threshold.
Okay, this catastrophic threshold will increase by 1,250,
or nearly 25%.
Rising from 5,100 in 2019 to 6,350 in 2020.
- Hm.
So let's switch gears to the AEP young folks.
Open enrollment for people under 65
kicked off on Friday, the day after Halloween.
Ooh hoo!
No, it is exciting, because it is still a viable market.
So the open enrollment for under 65
goes November 1st to December 15th.
Remember it's only for ACA plans.
And also keep in mind that
over 50% of the counties in the country
don't have an ACA plan.
But if you have a client
who can afford an ACA plan
and it's their best option, beautiful.
Just keep in mind that this year the out of pocket max is
$8,150 for individual and $16,000 for a family.
- Holy crap.
- And every year that goes up.
$16,300, right there.
That's your new car folks.
- Wow.
- That's what they call ACA.
They call it getting a new car every single year.
Yeah.
- Wow.
- That is, that's a lot of money.
But keep in mind, you have options.
And we're gonna touch a little bit
on short term in one second.
- Okay, so have people calling in that are confused about
the extra fee they can get with Centene Allwell.
Because they're giving a health risk assessment.
And they're also giving you money to set up,
and help migrate--
- Blue Button
- The Blue Button.
So when you initiate, they call it the VBE.
- Value Based Enrollment.
- [Sylvia] You get $50.
Then when you do the Blue Button,
you get an additional $30.
So these payments have already started.
So that's good news.
The Blue Button payments start on November 20th.
And they want you to merge in the,
your client's Blue Button information with a send.
So what's on the client's Blue Button?
What do they want?
36 months of claim history.
- Claims.
- They want the claims--
- They get everything.
- Well, not everybody has a email.
But they're going after the claims history.
Okay, so clients are asking me why their drugs
are costing more this year than last year.
Because they heard the donut hole is closing,
and they thought that meant they would have to pay
less or very little on drug costs.
So that's not the case,
and that's what I talked a little bit about last time.
Or a minute ago.
So, I know we don't have that many people in Missouri,
but since this is craziness,
I'm just gonna put it out there.
So, Centene bought Wellcare.
And so, because of that,
they were forced to get rid of
- Their (mumbles) block.
- Their (mumbles) block in Missouri,
and they sold it to--
- Anthem.
So, right now there's no (mumbles) on commissions
I stress right now.
The agents will still go through Wellcare
for assistance until it's communicated otherwise.
There are no changes in the DSM's at this moment.
I'm gonna give you the phone number,
if you are in that state,
Okay, agents still use their Wellcare portal
for these plans.
And, as of right now the members are not going to effective.
Part of the agreement,
Anthem has to actively be pursuing
the doctors and facilities to join their network,
so they can match Wellcare's provider network.
So they're ordered to pursue it,
but that doesn't mean that it's gonna actually happen.
Okay?
Encourage the members to call member services,
or check online to confirm that their daughter...
Their daughter, doctor is in network.
Okay, right now the product will keep the Wellcare name.
The PDP is not part of this transaction,
and will not be impacted.
So if you are not following the fact that
Aetna and CVS merged,
and sold of Aetna Part D to Wellcare,
and then Centene Allwell bought Wellcare.
And now, they are getting rid of this in Missouri to Anthem.
Okay, you got a lot of catching up to do.
And this is not gonna stop.
So this is how you really get your cred in the industry.
This is what we all do and we sit around a cocktail parties.
In the industry, we're like,
"Yeah, remember when American Express
"sold their long-term care block of business to G.E.,
"and then G.E. sold it to Travelers."
And then, "Oh yeah, and I used to have a contract with..."
That shows you've been around.
- It's a remember when conversation.
- When you can track back these carriers.
Like who used to own that,
and where'd this come from.
Where'd that block of business...
And it is very difficult.
For the people that coming new into the business,
they're just like whiplash, like "what?".
- Hey, got one more thing to cover real fast.
On the short-term side,
we're doing webinars just about every Friday.
It's especially a good time to be selling your clients
short-term plans during the under 65 enrollment.
But look, United Health One,
they're giving it away.
They've got a great incentive going now,
where you're looking at a $250 bonus,
all the way down to 25
on how you package these plans together.
If you're licensed with UH One,
you would've received this email last week.
And with them,
you always have to register for their incentives.
So you're only eligible if you register.
Make sure you do it.
They're looking for a minimum of 20 AfS.
You get those done (whistles).
Right there's your holiday spending money.
- I want to call out to a great agent and friend Scott.
Will not mention his last name.
Who said he always watches us on the treadmill.
So I was talking to him about something last week--
- Oh and he's on a...
I'm like we've never been on a treadmill.
- He watches our shows--
- He's on the treadmill.
- And he's like "Yeah I watch it.
"I'm embarrassed to say I watch it."
- Guilty pleasure.
- "I'll never admit it publicly but I watch it."
But anyway, so I was trying to tell him
that he needed to do something.
And he goes, "Hey, I don't have time during AEP,
"make me a video."
- Oh my gosh.
- He goes, "I'll watch it on the treadmill."
- Make me a video.
- So I thought that was hilarious.
- That, okay Scott, we're gonna make you a video.
- We're gonna make you a video.
(laughing) And in the video,
I'm going to say that this health assessment,
or VBE as Allwell's calling it,
is a lot of money people are leaving on the table.
And yes, I am talking about it every week.
Now, I personally have been trying to do my first.
And I personally am quite frustrated as an agent.
Now Mike, a great agent in Oklahoma...
Call out to Mike.
I think he's 18 of the UHC--
- Oh UHC.
- And so, I'm like "I can't even get my thing to work."
So I did it and it came out this summer.
I did the 2019.
So then when AEP started, and I tried,
I went in to do an enrollment,
it said I wasn't eligible.
And I'm arguing by email with Producer Help Desk,
"Like no I did it."
- [Rebecca] Right.
- Why can't I, why am I not doing it?
They came back and they said
because I haven't done the 2020.
And I said, "I don't care about 2020.
"Maybe I won't sell any 2020 effective dates.
"The one I needed to write was for an
"11/1 2019 effective date."
But Revel still, to this day,
and I happen to be the FMO,
I still can't do it.
So this is why, people say "Why do you bother selling."
I sell so that I can actually talk to you
with authority, being in the trenches what it's like.
Because, I'm feeling your pain too.
So all of you guys that gave up on it...
- Don't give up.
- It's stressful, it's not easy, it's a new year,
but it is a lot of money.
And I want that money too.
So, so far, haven't been able to claim any of that money.
And the carrier gets thousands and thousands of dollars
extra every time we are able to accomplish one of these.
So Mike in Oklahoma said it took him a long time,
and he worked hard, and he finally got it,
and he's gotten 18.
So 18--
- Sweet, great job.
- 18 times 50, if I can do the math,
I would tell you how much money that is.
- That's a lot of money.
- It might be a million dollars, I don't know.
- Just shy of a million.
- Might be. - Just shy.
- But those of you that haven't even started yet,
go into the portal with United Healthcare,
do the Revel 2019 and 2020.
It's very simple.
Then they will send you the link when you're ready to do it.
And that's the delay that I'm waiting for is to get that.
Before then, I can go in and use it.
- Are you sure it hasn't gone to your junk or anything?
- I'm looking everywhere, we're all working on this.
Because I wanna be able to talk about how it...
How easy it was.
I wanna be able to do one.
And I haven't been able to do one.
So once I am, then believe me,
I will come to you and talk to you about it.
So thank you guys for tuning in.
Happy AEP.
- Happy AEP!
(upbeat music)