How is the $2000 MOOP calculated?

[Gwen Redington]

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That's about it. I think UHC is the only one who got it right. They explained it like this--- They base the MOOP on the standard coinsurance of 25% or something like that. Take a tier 3 drug. If it's $47/month copay, but 25% of the retail cost of the drug is more like $100 they'll credit the $100 toward the MOOP. So some people will pay 2K and reach the MOOP and some will pay far less. According to Sunfire calculations, I have a lady and her husband who will hit the MOOP in October and neither one of them will pay more than 8 or 900 for the year.

All the other companies I went to training said it was actual MOOP. I haven't look on medicare.gov to see what they say.

 

[axeman462]

just show the customer the print out from drug cost calculator you use (S&S, Medicare .gov etc..), walk them through it, and let the print out do the math for you.

 

[MedicareWAA]

Cool, that's your prerogative. No skin off my ass.

Caveat, not a software engineer.

The dude is insufferable. I think he has a daily quota for the number of vacant replies he must publish every day. He’s like the beta version of ChatGPT, before they discovered how to make it valuable.

 

[Jim Wright]

That's about it. I think UHC is the only one who got it right. They explained it like this--- They base the MOOP on the standard coinsurance of 25% or something like that. Take a tier 3 drug. If it's $47/month copay, but 25% of the retail cost of the drug is more like $100 they'll credit the $100 toward the MOOP. So some people will pay 2K and reach the MOOP and some will pay far less. According to Sunfire calculations, I have a lady and her husband who will hit the MOOP in October and neither one of them will pay more than 8 or 900 for the year.

All the other companies I went to training said it was actual MOOP. I haven't look on medicare.gov to see what they say.

It's a little more complicated than that. The recording of that webinar Millwood mentioned is here. There are some really good visuals that explain it in detail

Missed our MP3 & TrOOP Webinar?

 

[rmhaire]

Caveat, not a software engineer.

The dude is insufferable. I think he has a daily quota for the number of vacant replies he must publish every day. He’s like the beta version of ChatGPT, before they discovered how to make it valuable.

Caveat, I beat up software engineers.

Be careful Toto. He's in Kansas.

He's liable to drop an entire house on your ass.

 

[Gwen Redington]

It's a little more complicated than that. The recording of that webinar Millwood mentioned is here. There are some really good visuals that explain it in detail

Missed our MP3 & TrOOP Webinar?

well, naturally. LOL It's always more complicated. I don't bother trying to understand it fully. on Sunfire, I'm definitely seeing that most of my clients who will hit the catastrophic won't actually be paying 2K next year.

 

[Jim Wright]

well, naturally. LOL It's always more complicated. I don't bother trying to understand it fully. on Sunfire, I'm definitely seeing that most of my clients who will hit the catastrophic won't actually be paying 2K next year.

While I understand your sentiment, you will likely be the person your client turns to when they don't understand it. It's possible their pharmacist won't understand it either and your client will be calling you to explain.

This is a year to win a lot of trust with people by helping them navigate the major changes in their healthcare. If an agent isn't able to help them, they'll find another one who will

 

[HealthGuy]

Heres the way I will explain this : $2000 divided by 12 is $166 per month and add back your premium (if there is one) LOL Seriously, is anyone going to try to explain how these drug plans work, really? This can't be explained clearly and succinctly. I defy anyone to try explaining this to someone else, especially Suzie Senior.

 

[straightnochaser]

Heres the way I will explain this : $2000 divided by 12 is $166 per month and add back your premium (if there is one) LOL Seriously, is anyone going to try to explain how these drug plans work, really? This can't be explained clearly and succinctly. I defy anyone to try explaining this to someone else, especially Suzie Senior.

2k is the TrOOP not the MOOP

 

[HealthGuy]

2k is the TrOOP not the MOOP

I know, I'm simply quoting the worst case scenario for annual OOP. Nobody can explain how these plans work, and trying will simply confuse your clients more. Im sending them directly to medicare.gov to find their own plan or call the carriers direct, 1 800 WELLCARE !!!