Why All the Rules for Medicare Brokers?

It appears that CMS (Centers for Medicare and Medicaid Services) has it in for brokers. Let me explain. Several new and annoying rules have been handed down from CMS which every insurance broker must follow.

The most egregious one is we must record all phone calls to clients and prospects. Usually, when we are talking to the clients or prospects it’s about their medical issues and is supposed to be private due to HIPAA laws already in the books. It is a violation of our HIPAA laws, yet CMS is allowed to implement this new program and no one at ever mentioned the HIPAA violations this rule would cause.

This did not stop CMS from changing a law without Congress approving it. That is illegal as I understand it but did not stop CMS. The reason is simple; several large national organizations that employ brokers started making TV commercials that implied the freedom and flexibility of MAPD plans. Joe Namath and several other athletes were spokesmen for the large national companies. Some of what they said was not true and could easily mislead seniors.

CMS thought it was wrong but instead of simply forcing these large companies to stop the ads, CMS imposed their will on all brokers thus lumping us with the bad guys. Not acceptable to this broker but until someone stops them, we are struck with these rules. So, when we talk to prospects or clients, we must record the conversation and tell the person on the other end we are recording them. If they object, we are to turn them over to CMS so CMS can make the sale, The issue is these CMS personnel are not licensed to sell insurance, yet they get to make a sale and eliminate the insurance broker from the equation. I see no reason to lose a sale because CMS says so. If I’ve done nothing wrong, why turn them over, It’s lost revenue to me and unacceptable.

Insurance 4U Nevada

This is wrong and simply over the top for our government to interfere with a sale made by a licensed and insured broker. We as brokers must take 30 credits of continued education every three years to maintain our license in good standing with the state.

CMS has no such requirements and most likely these CMS employees are headquartered in several locations throughout the US and not usually in the local market. How do they keep apprised of the various plans available and how do the seniors know they are getting the best plan. In Clark County, NV, there are 84 different MAPD and stand-alone drug plans. How does someone back in Washington know these plans and how can they make sure the client is getting what they need and not a plan that will not work?

The answer is simple; Washington does not understand or know the nuances of these plans and should stand down and let brokers help these clients pick what will work best for them.

Everyone’s health is important and as we age, we normally need additional services and that should not be interfered with at any level. Seniors and their families should expect this kind of service and get the best plan for them.

It is our responsibility and our charter to help these seniors without regard to any commissions or sales contests. I personally do not participate in any sales contest because I want the client or prospect to have complete faith that I am doing the best for them. I simply ask for a list of their medications because I need to verify that the new plan will cover those drugs and at what price. The same for the doctors. I need to make sure their doctor is in the plan we choose. As seniors we are set in our ways and changing doctors is not something most want to go through. I concur with that aspect wholeheartedly.

In summation, seniors need someone local to help them through the maze called Medicare, so they make the best decision for themselves. Not easy to do but a necessity to place the seniors in the best plan for them.

I hope this information is useful and if anyone has questions, please contact me via phone or email and I will respond quickly.

Also, take a look at Medicare 2023 Information.

The Barend Agency

The Barend Agency Inc.

Len Barend, Broker

Email: len@insurance4unevada.com