How badly plans want new members can be glimpsed through the enrollment process
November 4, 2009 -- I’m helping someone enroll for their first time in Medicare. Several local Medicare Advantage plans are under consideration: HN, RG and HM. I have a few of what I think are pretty basic, straightforward questions not answered in the plan materials available online. That means I have to call the health plans. Frankly, I always regard these calls as tests to see how badly each plan wants a new member.
First up is HN. Obediently, I call the number given in their Medicare information. Of course, I get a robot that kindly tells me I’ve reached their National Medicare Marketing Center. I go through a 3- to 4-step electronic sorting exercise and end up in the queue. I’m reminded every 10 seconds or so that my call is very important to HN. I don’t think I’ve ever been told of my importance so frequently. But after more than 5 minutes of very frequent reminders, very important me gives up to try at another time.
I call HN again a couple of hours later. It’s reassuring to know my call still is extremely important to HN. It’s just not important enough to get answered.
While I’m waiting to make my third HN attempt, I call competing Medicare Advantage plan RG with similar questions. My call is answered electronically but I speak with a real person within seconds. I’m feeling optimistic. I ask my first question about out-of-pocket limits. I get a bit of a roundabout answer, so I clarify. Question one, done.
I ask question two about the provider network. This time the plan representative goes out of his way to find the answer as he has to toggle around his computer to look up information. Great job! I ask a third question about reimbursement for out-of-network providers. Again, the answer isn’t as clear as it could be, so I restate what I think I heard for confirmation. We’re in agreement. WOW! Within a couple of minutes I’m on my way with the exact information I was looking for. I’m giddy. Seems like RG really wants to please.
Feeling inspired, I call plan HN again. I’m electronically placed on hold, but not for so long this time. Things are looking up. Perhaps I’ve become even more important with this third call. Before I can utter a single word, the plan representative asks for my contact information. Compliantly, I give it to him thinking this is the first stage of our information exchange. As the last number of my zip code exits my mouth, the rep immediately thanks me for calling and tells me a salesperson will contact me within two days. His attitude tells me this call is supposed to be over.
I think, not so fast my friend. I explain I need timely information. I ask if there’s anyone I can talk to about a couple of questions. Nope. He tells me he cannot share information with me because he’s not in sales. It seems the reps in this National Sales Center are specialists: they take only names, phone numbers and addresses. I try to reason. I explain I just got off the phone with a competitor who was able to give me the information I needed promptly. He doesn’t know what to say. I tell him I know he’s not responsible for the situation he’s in, and I hope he’ll speak to his management about creating a process that makes it less difficult to get timely information to potential members.
When I hang up, I think about how plan HN just dropped from first place on my mental list. I do some calculation. Would it be worth $1,500 extra premium a year to get decent customer service from RG? Seems pretty steep.
So, I call the third plan, HM. Again, I follow the dialing directions given in their Medicare materials. Again, I reach a friendly robot that tells me this call will be monitored for training purposes. The phone is answered and I’m hopeful. But it’s just another recording telling me that I’m calling at an extremely busy time. I should call back in the evening or on the weekend.
And then my call is terminated. Automatically. So I don’t exacerbate the excessive call volume problem.
I wonder how my call will be evaluated for training purposes. Is the call considered “abandoned” when the plan does the abandoning? Well, at least there was none of that phony baloney business about my call being important. Instead my call is part of a problem to HM.
I do call HM back in the evening. I speak to a pleasant enough fellow who’s unable to answer my question. He refers me to another number that’s staffed only during the day. It’s for members. I ask him how I’m going to get through the electronic welcoming gauntlet without a member number. He gives me the secret code to penetrate his company’s virtual wall between insiders and outsiders. It’s too bad he has to work so hard to not answer my question. He asks me to rate his service. I give him a four out of five for good performance, and even though he doesn’t ask for it, I give the plan a failing mark. I’m not convinced they really want new members. At least, not new members with questions.
It’s been over a week since I spoke with the HN representative at the National Sales Center. Still I’m waiting for materials or a sales contact. There’s an HN office in town. I wonder if someone there might be more interested in a new member.
Patrice Korjenek is president of Smart Health Decisions in Vancouver, Washington.
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