An Open Letter To Insurance Executive Lurkers.....

[annon123]

Y'all just have that one scare tactic and repeat it ad nauseum it's pretty insane.

It's not scare tactics when that is a reality for health care for some people. If we knew for sure what our future would bring it would make it easier to know which to choose (MAP vs OM+ supp) when it comes to this issue. If you have a lot of money likely it doesn't matter as you can afford the $12-14K for the out of network copay (presuming you have a MAP that covers out of network). Or if you live in a metro area that has top notch health care that accepts MAP's then the issue is likely far less important (presuming networks don't change) because you already have outstanding choices.

But if you live in some of the states with the worst health care in the nation where there are no in state choices that are good, this is a big problem for people who have or develop serious health conditions. Half the cancers develop in people 65+, women's heart attack risk becomes the same as men after menopause, strokes are far more common in the elderly. In this state not one MAP allows stroke victims (or, for that matter, hip replacement patients or for anything else) to be discharged to a residential rehab program even if they need it. They deny it so people have to go home with one hour a couple of times a week of in home health care and limited in home physical therapy just a couple of days a week rather than initially daily in rehab along with whatever help they need (which helps with recovery and a more complete recovery). By the time the denial is overturned - if it is overturned (most of the time it is not) it already is weeks later and so that recovery window as closed.

Those of you who are younger - you too will become old someday and likely have far more health issues than you have now. And some of those health problems in some of you will cause you to fail medical underwriting. And then, if you don't live where there are good options in network, you will be trapped with inferior heath care (because you can't go to the outstanding places, or at least places that are better than what they have access to with their MAP in one of these states) that may well kill you younger than you'd otherwise die or cause you to have more complications, be more handicapped that you otherwise would be were you able to access top notch health care.

That is not a scare tactic, that is a reality for some people. People can still make whatever choices they want and take whatever risks they want to take, but in my opinion we need to factually, in an unbiased way, lay out the pros and cons of each choice. Yes we get paid more if they chose a MAP's but I think it is unethical to try to talk people into an MAP when we get paid more if they sign up for one when it may not be an appropriate choice for them. We need to let them decide what they will choose without trying to push them in one direction or the other. Of course we can not afford to work for free or close to it, but that doesn't mean we should push them into one choice or the other when it might be not in their best interests to do so.

 

[annon123]

I keep forgetting that the Cleveland Clinic only takes Medicare + G.

I live 1000 miles away (in a state ranked worst in the nation for health care) from the CC the odds are high that the MAP's that CC accepts (and they accept a number of them - yes I caught your sarcasm) would not be ones good in my state. I'd likely need to have OM + supp to use them such that I could afford to pay for it. Or, for that matter any other top medical system out of state as this state has none.

 

[MedicareWAA]

Judging what happens for everyone based on what is happening for 3 people doesn't mean what is going on is representative for everyone

My Tricare for Life clients NEVER report any issues with their MA only plan. I know several agents with many TFL clients - same story. If they were experiencing problems, they'd just drop the MA and keep TFL.

Just be sure to put them in a MA only PPO.

 

[goillini52]

You can continue with this foolishness but just because you haven't had any clients that have had problems doesn't mean that there are not some that have had them. I only had an MA for 4 months and I experienced them. That is the reason I went back OM and a plan G. Unfortunately for most that encur problems it is too late for them to change back.

Who did you get your GI Plan G with?

 

[rousemark]

Who did you get your GI Plan G with?

Humana.. low price plus Bob got paid for it.

 

[sshafran]

I live 1000 miles away (in a state ranked worst in the nation for health care) from the CC the odds are high that the MAP's that CC accepts (and they accept a number of them - yes I caught your sarcasm) would not be ones good in my state. I'd likely need to have OM + supp to use them such that I could afford to pay for it. Or, for that matter any other top medical system out of state as this state has none.

What zip code are you in?

Or county?

I bet there are several. I can give you a count.

Education and data > hunches and old scare tactics.

I've heard the "Cleveland Clinic" line from Medigap Only people for over a decade.

It was wrong a decade ago but it got a lot of views on YouTube, and likely has sealed the deal for thousands of Plan Gs.

The problem is some of us actually prefer facts.

 

[DonP]

My Tricare for Life clients NEVER report any issues with their MA only plan. I know several agents with many TFL clients - same story. If they were experiencing problems, they'd just drop the MA and keep TFL.

Just be sure to put them in a MA only PPO.

It's funny you say this . I wrote a 84 yr old guy with original Medicare , a retired ppo plan ( I didn't know he had this ) and uses the va for most stuff . Last yr he was obsessing over some $85 to $700 bills . He had honor mapd from me . I said you can drop during aep . I called him a few weeks ago and said you can drop it now . He said hell no I want to keep .

 

[annon123]

The problem is some of us actually prefer facts.

I prefer facts too. I read a lot of peer reviewed research about health care, issues, medicare, issues with insurance, etc. and while some of it is a bit sketchy (eg poor research methods, weak stats, etc.) there is a lot published studies that are solid. I also follow the industry both from the business side and medical side.

Because of clients I have checked a number of out of state medical facilities to see which ones are in network for MAP's sold here (a fair number here want to go out of state for cancer, other major illnesses because of how poor our state's health care is and the problems with what happens locally). Some work well and give a lot of choices, others not so much so. I just present the pros and cons and let them decide what they want to do. Most, but certainly not all, of those who want to travel for health care (and would fail medical underwriting) choose OM + G. I'd rather not write MAP's despite them paying more because of limits that could potentially come back to bite clients if they no longer were reasonably healthy and would then fail medical underwriting.

While the Cleveland Clinic accepts a lot of MAP's (although some are their state only versions), MD Anderson Cancer Center only accepts, last I knew, 2. And, of course, the risk is that what is in network might change for a particular MAP someone purchased. While clients could change the MAP they are in, they may not be able to change in time for timely treatment.

I do sometimes wonder if the commissions were higher for supplements than for MAP if that would change the preferences of some (and again certainly not all) of agents with respect to what they sell and what they would argue is "best".

 

[sshafran]

I prefer facts too. I read a lot of peer reviewed research about health care, issues, medicare, issues with insurance, etc. and while some of it is a bit sketchy (eg poor research methods, weak stats, etc.) there is a lot published studies that are solid. I also follow the industry both from the business side and medical side.

Because of clients I have checked a number of out of state medical facilities to see which ones are in network for MAP's sold here (a fair number here want to go out of state for cancer, other major illnesses because of how poor our state's health care is and the problems with what happens locally). Some work well and give a lot of choices, others not so much so. I just present the pros and cons and let them decide what they want to do. Most, but certainly not all, of those who want to travel for health care (and would fail medical underwriting) choose OM + G. I'd rather not write MAP's despite them paying more because of limits that could potentially come back to bite clients if they no longer were reasonably healthy and would then fail medical underwriting.

While the Cleveland Clinic accepts a lot of MAP's (although some are their state only versions), MD Anderson Cancer Center only accepts, last I knew, 2. And, of course, the risk is that what is in network might change for a particular MAP someone purchased. While clients could change the MAP they are in, they may not be able to change in time for timely treatment.

I do sometimes wonder if the commissions were higher for supplements than for MAP if that would change the preferences of some (and again certainly not all) of agents with respect to what they sell and what they would argue is "best".

Zip? County?

 

[sshafran]

Zip? County?

I'd be interested to know how many plans are in your county, and how many of them would give access to CC.

I'm sure you used the CC line with prospects...