HMO SNPs

[honestagent]

Hey there all,

I am wondering if any of you have any experience selling HMO SNPs? If so, what are the pros and cons of such a plan?

 

[somarco]

OK, I'll bite.

What is an SNP?

 

[Guest]

SNP = Special Needs Plans

I have never sold any--I do not touch HMOs for seniors.

 

[somarco]

I do not touch HMOs for seniors

Why not?

 

[g1bass]

So many people attach stigma to HMO's and in a perfect world, where private health care is affordable HMOs seem like ground turkey instead of prime rib, BUT private health care simply isnt affordable. Not only is it not affordable for working people who are in the midst of their earning years, but it is a large black hole emitting a loud sucking noise for people who worry about outliving their income.

The Good things about an HMO is you are still able to see a doctor, without having to pay exorbitant premiums or co-payments, the bad thing is there are many corporate hoops to jump through if you need anything other than standard care. In saying that, I have to add that an HMO is only as good as it's network of providers.
"Ohhh, but my doctor isn't on the provider list!" OK, don't join the HMO continue paying for your Med Sup (which in my state run runs $160- $200 per month out of your $1000 per month income). Yes, this sounds harsh, but that is the reality many here in Florida face.

What is even worse is the disparity in managed care between urban and rural areas. I would kill for a decent HMO in our area, instead we are stuck with PPOs and PFFS which many doctors refuse to support because of either their own ignorance or the ignorance of their staff regarding billing procedures.

I am afraid whether we like it or not managed care is here to stay and it is a viable option for those seniors who by misfortune or bad planning can't afford $2400 a month for a med sup. jmho

 

[g1bass]

sorry that should read $2400 a year, my bad

 

[somarco]

HMO's for seniors have been a mixed blessing in GA. Personally, I am at the point where I prefer the HMO model over the PPO plans.

Quite a few carriers jumped into the HMO for Gramps market a few years ago. Most lost their butt & pulled out (including Blue). Now Blue and a few others are inching back in.

We have seen similar action in the MA & Part D plans. I expect more shake out in that market for at least 1 - 2 more years.

But all things considered, HMO's deliver more value than any other model.

You (bass) hit the nail on the head. If they want to pay more, not only monthly premiums but OOP for meds & doc visits then stay where you are.

 

[Sam]

I have no experience with senior hmo's, but I love my carefirst (BC) hmo here in MD. At the end of the day, you know what you are getting, and you do not get stuck with high bills because of any network issues.
In a state like Miss, or Alabama, where Blue has a monopoly on providers, that would be even more true.

It is interesting that most of the objections that my clients have to HMO's, especially when they are open access, as is increasingly the case, are no longer applicable. Yet, there are several reasonable oppositions that I rarely hear about.

 

[Guest]

Why not?

I too have an HMO for myself and like it.

But for Seniors in my area (Delaware) HMOs are batting .000
We have had 5 HMO companies dump everyone and leave the state since 1999. If there is a PFFS plan, that will always be my first choice.

 

[arnguy]

The HMO is quite successful in The Philadelphia PA 5-county area. It is also doing quite well as MA. A few years after BC/BS introduced HMO's they came out with PPO plans that were beating up the HMO plans. But now the tables have turned as PPO premiums have skyrocketed past the HMO premiums.