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If you are reasonably healthy and want to gamble a little bit, you could do HDF and save the difference.
Advice of Explaining MAPD and Med Supp Options to Age Ins
- Thread starter timeflies
- Start date
If you can't pay a Medigap premium you can't afford to get sick with an MA plan.
But some folks think they will never get sick.
I don't have a large block. Enough to keep me comfortable without working too hard. But over the last 8 years I have been working the Medicare market I have had a number of clients with large $50k+ claims. Including a few over $100k. And several that were sick for more than one calendar year.
Too many agents think affordability is the only issue.
Access to health care should be a bigger concern.
Some of my clients have been to Mayo (JAX), M D Anderson and at least one to Sloan Kettering.
Those places either don't take any MA plans or are selective.
Not everyone needs or wants specialized cancer care. However I also have diabetics and several with heart conditions. They don't have to worry about losing their doc when January rolls around and their doc is no longer in network.
I tell my story in several places on my channel. In case anyone is interested.
I enrolled in Medicare in September, 2015. Cancer is a word I know too well. My mothers twin sister and older sister died of cancer. My wife’s father and mother died because of cancer. All 5 of my father-in-laws siblings died of cancer. Two of my mother-in-laws siblings died of cancer.
I have seen what cancer can do to the human body and the misery that accompanies this dread illness. If you are diagnosed with cancer, the last thing on your mind should not be “How will I pay for my treatment?”
I know how quickly things can change. When my health changes I want to control the direction of my care. Insurance carriers are not going to give me a list of doctors and tell me this year I can only use these, and next year the list may change.
I am enrolled in original Medicare plus Medigap plan N.
and this . . .
The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.
Some cancer centers, such as Mayo Clinic, Sloan Kettering and MD Anderson may not participate in certain Medicare Advantage plans.
Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.
Chemotherapy drugs administered in a doctor's office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.
This is why most of us chose a Medicare supplement plan in 2018.
According to the Mayo clinic, "new cancer treatments are routinely priced at over $100,000 per year of treatment."
MedicareMillionair
Guru
- 413
This often depends on the area of the country the medicare beneficiary resides. Some areas MA plans have extensive networks and great benefits at $0.00 premium. This in addition to low average income drives many to MA. More affluent areas you'll find most will want medsupp for the obvious reasons. I often explain it just that way to my clients. I find that most with reasonably decent retirement income will choose medsupp, while those without will choose med MA. I also explain, if I were to have to make a choice for my personal coverage it would be medsupp, thus I recommend the same for you.
Having said that, I find it highly unusual that an individual, on a MAPD plan, will spend as much as the cost of an medsup plus a good drug card over the course of a year. This is especially true if you add these costs and compare after a number of years. It's highly unusual for someone to reach MOOP on these plans.
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For the record, I am not an insurance agent and my personal preferences run to Med Supps. I have been reading posts in the senior forum off and on for almost 2 years and some of my most bitter detractors on the site are agents who sell MAPD plans.
(bold and question marks in the quote below are my additions.)
If you are training new agents to sell both MAPD and MedSupps, you are doing both them and their clients a potential disservice by planting these mindsets in the heads of the agents. (See the posts in another thread I referenced above.)
You are overlooking facts which another agent posted after your post, including the remark I quoted below:
MAPD's and Med Supps are meant to address the same issue a Medicare Beneficiary might have with the Medicare system. There is some point of accumulation of wealth and financial resources where an MAPD can make just as much sense for a wealthy person as it does for an FE prospect. I am not sure where that dividing line might be, but a possibility I wonder about is an asset level of 2-3 million.
(bold and question marks in the quote below are my additions.)
If you are training new agents to sell both MAPD and MedSupps, you are doing both them and their clients a potential disservice by planting these mindsets in the heads of the agents. (See the posts in another thread I referenced above.)
You are overlooking facts which another agent posted after your post, including the remark I quoted below:
MAPD's and Med Supps are meant to address the same issue a Medicare Beneficiary might have with the Medicare system. There is some point of accumulation of wealth and financial resources where an MAPD can make just as much sense for a wealthy person as it does for an FE prospect. I am not sure where that dividing line might be, but a possibility I wonder about is an asset level of 2-3 million.
Cue the latest LD rabbit trail. Surely, there is a solid reason. Wait for it....
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Just an effort to define what the bolded terms mean, in two senses.
One, in regard to the ability to pay the expenses if they come.
Two, in regard to the financial ability to easily absorb high OOP's and coinsurance over a 2-3 year period for a serious adverse medical event. There is (in my opinion-after reading the post I cited above and a lot of other posts on the forum) some financial base, after which health costs just become another cash in cash out piece of overall cash and investment management. The client's risk tolerance and opinion of their family medical history will determine how they want to "gamble" on health insurance.
There is some financial base, below which the costs of an adverse medical event could financially destroy the holder of an MAPD plan-again see comments of others earlier in the thread. You and Scott might put the dividing line at $500K. You might put it at $10 mil. The precise amount will be different for different people, just as people will think different about their insurance. The big point is that educating new agents who are being certified and licensed to sell both MAPD and Med supps that wealthy people will just buy med supps and that the agent should say my preference is a med supp is bad agent training.
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Kind of Off topic but did you see we have a $0 premium plan with $2,250 moop next year? Nuts.
I don't feel the wealthy should necessarily take a Medicare Supplement. Most of them are wealthy because they had some sense of how to save money. I know when I get to Medicare I will take a MAPD if there is one available wherever I retire. I am going to have probably close to $40000.00 in my HSA by then so the $4900 maximum out of pocket just doesn't scare me at all. Everyone's situation is different but I have multimillionaires and also people down to their last $500.00 on MA plans. I currently have a $4500 deductible on my health insurance but also max out the $6900 into the HSA every year so don't see it as a big deal if I do have to use it.
Present both and let the client decide is my theory. Like I have said before an agent can persuade a client either way they want to. You don't want MA plans because you will have copays every time you use it. Or why would you spend $3000/year on Med Sup and PDP premiums when you could save all of that and only risk $4900/year maximum out of pocket. Or it makes me no difference which way you go, it's a personal preference and you have to be able to sleep at night.
Present both and let the client decide is my theory. Like I have said before an agent can persuade a client either way they want to. You don't want MA plans because you will have copays every time you use it. Or why would you spend $3000/year on Med Sup and PDP premiums when you could save all of that and only risk $4900/year maximum out of pocket. Or it makes me no difference which way you go, it's a personal preference and you have to be able to sleep at night.
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I'm not saying that I approach every prospect with that simple question, I was mostly trying to answer the OP with an oversimplification. There are several different ways to approach this with a prospect, and it will vary based on the situation. Most people I talk to are not going to analyze the details the way you are, and if I do it with them, I will lose them. The old adage is "the devil is in the details" or the when people buy a car they don't want to know how the engine works, just the important parts.
Now I did meet with a retired banker on Monday, and he liked details, and he had done a bunch of research, and since I knew all the details, I was able to earn his business. He got a low priced issue age plan G. He didnt want an attained age, or community rated.
The debate about which is better mapd or medsupp will go on forever, but I think it's all relative. If you compare them to the options that people not on medicare have, like a self employed individual paying $500/month for a $6,000 deductible, suddenly mapd looks pretty dang good, and a medsupp too! I'd love to have an MAPD in place of what I have now, and I imagine a few forum mapd haters would too haha.
Do you ask your clients how they feel? Since you started your post with this comment it appears you have prejudged your client NEEDS regardless of what you say in the rest of your post.
BTW, the MA vs Medigap discussion is not JUST about $$$, even though most agents seem to believe sales can be made by presenting dollars and cents.
Any good insurance broker knows that most, if not all, insurance purchase decisions are based on EMOTION, not logic.
Too bad the MA vs Medigap almost always comes down to financial arguments.
I don't offer MA plans and freely pass them on to an agent I trust if that is what my prospect wants.
I also have NEVER offered a financial justification for Medigap over MA. That's not the way my clients think, and not the way they make the decision.
Reading so many posts it seems I am the odd man out since most everyone else slices and dices the presentation based on money out, money in.
