1986 AARP Prudential Med Sup Help....

[Dowejonez]

Picked up a new 88 year old client paying $164 for this. I told I'd review, but probably would not do anything with it.

I can't see much wrong with it. I would bet if she goes on claim, they'll jack up the premium, but she gets I believe Skilled Nursing from 101 - 365 at "twice the amount of benefit paid for day 100", if you could ever show improvement over that long a period.

Also has private duty nursing, inhospital.

I vote leave it. What say you?

 

[Frank Stastny]

Picked up a new 88 year old client paying $164 for this. I told I'd review, but probably would not do anything with it.

I can't see much wrong with it. I would bet if she goes on claim, they'll jack up the premium, but she gets I believe Skilled Nursing from 101 - 365 at "twice the amount of benefit paid for day 100", if you could ever show improvement over that long a period.

Also has private duty nursing, inhospital.

I vote leave it. What say you?

Regarding the Skilled Nursing benefit. The policy does not dictate how long a person received the Skilled Nursing benefit. (It is not nursing home coverage. It is very rare that Medicare authorizes even 100 days of Skilled Nursing. That said, it is pretty much of a bogus benefit designed to make the policy "easy to sell".

Private Duty Nursing. Again a benefit that looks good on paper. Take a look at the benefit the policy provides, then check on the cost of hiring a private duty nurse. I'm going to make a WAG that the benefit will only pay a minute portion of the actual cost.

I really can't envision an instance where someone would need or require a private duty nurse in the hospital today. If the person needs that kind of attention they are most likely going to be in the ICU. Just another benefit to make the prospect feel "warm and fuzzy".

Review the real benefits provided by the existing policy and then compare them to a Standardized Med Supp.

 

[G.Gordon]

If I can save them money I flip just about 100% of the pre-standard plans. Some companies in MO will deem them "like" plans for a plan F GI.

 

[DS4]

What say you?

She is probably most likely on a Pre-Standardized Med supp.
Is the Part A deductible paid. Part B deductible?
Is prescription coverage embedded? Or, no Rx?
Difficult to say without knowing all the facts.

 

[G.Gordon]

She is probably most likely on a Pre-Standardized Med supp.
Is the Part A deductible paid. Part B deductible?
Is prescription coverage embedded? Or, no Rx?
Difficult to say without knowing all the facts.

Not really. I've gone line item by line item through several pre-std plans and have never found any benefit that made them worth the higher premiums the bene is paying at the time. Yea, there are extra beneifits in some of them, but when a medicare beneficiary is treated at a provider do you think that provider treats said beneficiary in a manor to claim on those benefits? No. They treat them in line with current medicare guidlines so those extra benefits never get claimed on.

Standardized medsupps were designed as they are to pick up 99.99% of medicare's cost share. Taking a client from a pre-std to a std is of no risk to the client if they can pass uw.

 

[DS4]

Most of the pre-standardized plans you run into in California , the benefits will mimic standard plans A, B and D.
Some have embedded Rx coverage.

 

[G.Gordon]

Most of the pre-standardized plans you run into in California , the benefits will mimic standard plans A, B and D.
Some have embedded Rx coverage.

Oh, I see. Around here they all mimic F at a minimum. Some have private-room benefit, but no one knows it so the clients never gets a private room...

 

[Dowejonez]

Thanks everyone. I'd agree that the skilled nursing benefit and private duty nursing will never get used. I thought the only way she'd use that private duty nursing is if I knew she was going to be in the hospital and could remind her.

The plan reads like an F. The thing that struck me was the policy is so brief. At $164 for an 88 year old I just doubt anyone can touch it.

I was an agent pre-standardized plans, but can't remember what we used to sell over each other. It seems like the differences in the better plans were minimal. Monthly premiums were in the $50 to $60 range I think.