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New to MA's question:
What is the most concise way to describe or understand what an MA does compared to Original Medicare-Parts A and B?
Obviously, some companies are offering a few more benefits beyond original medicare. But, in general it looks like MA's nickel and dime you more up front on hospital costs etc (whereas the original medicare deductible might have convered it all for shorter hospital stays). In return, the MA's offer require no payment past a certain number of hospital days and also cap the entire out of pocket somewhere around 2800-3500 give or take.
So, the naive question is, where are the areas where clients are most likely to run beyond the MOOP level if there is no cap? I could see the dollars piling up fast for hospital stays beyond 15 days (for example) which would otherwise covered by an MA but 15 days would cover the vast majority of stays. What are the other areas where clients have major exposure that an MA covers. How would you reply back to a client that says that they think that people are more likely to have a short hospital stay where the MA's pay less and the MOOP does not do much for them because they would have to go through a pile of co-pays, deductibles, and excess charges to get there.
Other than longer hospital stays, I don't have a feel for where the dollars pile up fast in a way that could really be helped with an MA. Sure the doctors visits add up and all of that but still you would have to do a lot to reach the moop. And then there a lab tests etc. Could someone offer up a couple scenarios that would help me to understand this better.
Thanks for any info.
Winter
What is the most concise way to describe or understand what an MA does compared to Original Medicare-Parts A and B?
Obviously, some companies are offering a few more benefits beyond original medicare. But, in general it looks like MA's nickel and dime you more up front on hospital costs etc (whereas the original medicare deductible might have convered it all for shorter hospital stays). In return, the MA's offer require no payment past a certain number of hospital days and also cap the entire out of pocket somewhere around 2800-3500 give or take.
So, the naive question is, where are the areas where clients are most likely to run beyond the MOOP level if there is no cap? I could see the dollars piling up fast for hospital stays beyond 15 days (for example) which would otherwise covered by an MA but 15 days would cover the vast majority of stays. What are the other areas where clients have major exposure that an MA covers. How would you reply back to a client that says that they think that people are more likely to have a short hospital stay where the MA's pay less and the MOOP does not do much for them because they would have to go through a pile of co-pays, deductibles, and excess charges to get there.
Other than longer hospital stays, I don't have a feel for where the dollars pile up fast in a way that could really be helped with an MA. Sure the doctors visits add up and all of that but still you would have to do a lot to reach the moop. And then there a lab tests etc. Could someone offer up a couple scenarios that would help me to understand this better.
Thanks for any info.
Winter