Large Group MAPD

Oct 6, 2015

  1. saintstigers
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    saintstigers Guru

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    I've come up on a couple leads that have a Group MAPD plan for retirees. Would I be correct in thinking that in general, Group MAPD plans have richer benefits than an Individual MAPD plan. So no reason for the senior to drop group MAPD for a private MAPD plan?
     
  2. MedicareAgent
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    Not a great assumption. Meet with the customer and ask what their plan is. Many mapd plans have deductibles and higher copays, depends on what they have.
     
  3. Josh
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    Josh Retired Agent, Current List Broker

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    The biggest concern I would have is the ability for them to get back into the group plan. Individual MA plans can be volatile in terms of costs/benefits/networks and group plans tend to be more stable.
     
    Josh, Oct 6, 2015
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  4. saintstigers
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    saintstigers Guru

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    Good point. So once you disenroll from a Group MAPD, you can't go back? You have to stay on individual MAPD?
     
  5. GoPokes
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    There is a group mapd for state retirees here in OK. If they leave they can't go back. However sometimes that could be interpreted as a scare tactic, bc there may be better coverage/value elsewhere but people won't leave bc they are afraid of not being able to go back.
     
    GoPokes, Oct 6, 2015
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  6. Josh
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    Josh Retired Agent, Current List Broker

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    There may be some exceptions, but generally that's a concern.
     
    Josh, Oct 6, 2015
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  7. yogooglethis
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    yogooglethis Guru

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    In the big cities in Fl 85% of the time individual MA is better the group MA so being able to back to the group MA is usually a non issue but as with any group plan a some let retirees return but most don't. Occasionally you will see a good group MA plans with lower MOOP and rx coverage thru the gap and enhanced networks so as always due diligence is needed to be sure new plan is suitable.

    The nice thing about switching someone from group ma to individual ma is the group ma is automatically terminated at the end of month preceding the effective date of the individual ma so there is no lapse in coverage to worry about .

    sometimes retirees with group MA double hate their MA plan because at some point they where switched from their non MA retiree plan to a group MA and nobody ever explained MA to them
     
    Last edited: Oct 6, 2015
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