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- #21
- 424
The Only time I can see a benefit in part c is if you are on Medicare disability or can't qualify for a supp!
Are Your Eyes Open Yet?
- Thread starter dandan
- Start date
Depends on where you live, the availability of networks, your health and finances. It is not so simple as to dismiss them without consideration. Medicare Part C, Medicare Advantage Plans, are important for several reasons to many seniors.
Well said, Chuck. I think with the present economical crisis (Dow down another 700 pts yesterday), they will be the direction seniors will turn in the near future. This is not all that good, because it will remove a leg from under the Medicare stool... we need Med Sups, too. If everyone goes MA, Med Sups will crash. This is a looming concern to me. When enough seniors wake up in the hospital and recognize they have a $1200 co-pay for their week's stay, they will regret having given up their Med Sup. Others that will not experience catastrophic loss will be glad for the $1200 they saved. It's always a crap shoot, but that is the name of the game. Insurance is supposed to provide protection against the odds. Some may say "What's the problem? Your protection is against the $100K+ liability",... but I say both MAs and Med Sups w/Medicare do that. It's still the pocketbook that speaks.
Sorry but I beg to differ. I have probably about 25% of my clients that are on LIS for drugs. They could not afford a supp. There is also the group of people that don't qualify for LIS and if they have a supp it eats up 20% or more of their income.
I have a great example from 2006 of someone in this category. When I worked for Humana in a Walmart store I had a couple come to see me about a PDP. They had waited till the last week to sign-up for one because they wanted to save money for the 6 months before the deadline. I told them about the Humana PFFS and the zero premium and the signed up. All they had was Medicare and told me they were just to expensive. Six months later they came to see me and thanked me so much for getting them on the Gold Choice. At that time it was $180 a day for 5 days in a hospital $900. The husband had a heart attack and had spent 2 weeks in the hospital. Their total cost for the year for him was around $2000 and they were extremely happy.
You can say that if he had a supp at $120 a month he would have been better off. With lets say a $20 pdp and his wife also needing the same coverage, you are talking $3300 dollars even if they don't have any catastrophic problems.
More than 50% of my clients did not have a supp or were struggling to pay those premiums. I have always told my clients that had a supp and switched to have a savings account that they put 50% or more into for any hospital stays for a back up.
These plans are perfect for a large portion of people, and even suggesting that supplements are the only way to go is ignorant IMVHO.
- Thread starter
- #25
- 424
Well, your opinion is just that Yours!
If your old buddy was put in the nursing home for 8 weeks for skilled care, and then sent home to be on oxygen for the rest of his life, how much better off would he be?
If your old buddy was put in the nursing home for 8 weeks for skilled care, and then sent home to be on oxygen for the rest of his life, how much better off would he be?
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He would have still been better off than just having Medicare alone. That was the other alternative according to the story.
And that was Humana, which is, IMO, the worst MA plan available
In your area, the PFFS must not be a good option. The way Frank has described his area, they are not good there either.
In rural Western Ky and Southern In, the PFFS are great plans. I wish we had good PPO/HMO options here as they would be much easier to expalin. We don't have any HMO plans and the only PPO plans are Anthem's at $24/mo and it's a terrible plan or Humana's PPO for $65/mo in most areas and it's not accepted. We have one large medical clinis with over 100 doctors and they do not accept Humana's PPO. They take everyone's PFFS, including Humana's.
The PFFS plans have been a Godsend to many people in this area. I don't know of a doctor or hospital that doesn't accept PFFS plans from every carrier.
I suspect that it may be on the horizon, but, MA plans will be gone here by 2011. We will not have the required networks here as medical centers just won't be tied to them in this part of the country.
Well he would have been out a lot less than on straight Medicare since he was not able to afford a supplement that it seems you believe everyone can afford. BTW he is now on Today's Options and his max OOP is only $2500. The hospital bills and everything else on straight Medicare at 20% would have been over $15,000 for that year alone with all he had done.
I guess if you ran across someone that couldn't afford a supp you would just say sorry I don't have any other good options for you. I believe that there is a different option for each individual person and that supplements are just one of many options available.
BTW, it may be my opinion but I believe that its one that most would agree with. You sure seemed to take my comments as a personal attack and not as constructive criticism that you could possibly learn from and help your clients.
The plans have maximum out of pocket limits. In many cases that is less than the total premium for a Med Sup. If they are not right for customers in your area, don't sell them, but a blanket statement and implied condemnation without even comparing plans seems opinionated. 
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- #29
- 424
Yes that is my opinion..They all suck. Quit waisting your money on cigarettes, beer and the lotto and you could easily afford a quality supp! jmvoo
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I had a client and his wife cancel their Med Supp this summer.
When I asked why they said the couldn't afford it anymore.
I have been to their house and I didn't believe what they told me so I asked a few more questions. I found out that they think they are in "good health", they are in their late 70's, so they went out and bought a new Lincoln, they said they are on a "fixed income" and needed the money they were paying for their Med Supp to make car payments.
Since they don't, do you think I care a rat's ass about their future medical bills or how they are going to pay them when their health goes south?
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