MA plans under attack

[Slick]

In Eastern Missouri, the MA plans are nearly universally accepted. Most providers that don't accecpt PFFS are simply in need of an education.
I can offer the Coventry plan for $0/month with a $3,000 MOOP. Wrap it with a indemnity plan that will help offset the copays for hospitals stays and SNF for $27/mo. So a bad year with one hospital stay will cost about $2,300. A heathy year may cost $200 or less.
At this point, I still reccoment a Plan D, but I have a hard time backing up that vs. MA.
My biggest questions for the MA plans are; If the Dems get office what can they do to MA? Can they kill it? Change the funding? What is the current MA fundng agreement and how long does it last?
I would hope that if they can and do kill funding, a gauranteed enrollment period would be set for them to enter into a Medsup.

 

[arnguy]

There is a front page article in today's New York Times entitled "Methods Used by Insurers Are Questioned." It specifically addresses problems with the sale of Medicare Advantage PFFS plans. It is four pages long on the internet but can be accessed without cost from www.nytimes.com. It is too long to paste here. The article states that two insurance agents in Georgia were arrested last month and accused of conspiring to defraud Medicare beneficiaries. It also refers to problems in Mississipi, North Carolina, Kansas, Oklahoma, Wisconsin, and Louisiana.

Here in the 5-County Philadelphia (PA) metropilitan area, the majority of Medicare beneficiaries appear to have opted for the Keystone (BX) Part C HMO or the Aetna Part C HMO plans. United Healthcare is a new player in this area, but I do not know how they are doing since I do not market to seniors. The Keystone and Aetna HMO subscribers appear to be pleased with their plans, at least from those with whom I conversed about the plans.

BTW, the article John referred to in the Baltimore Sun may or may not be the same article as in today's New York Times. I know that the Times does syndicate their articles, but I always thought that was a day two later to the other newspapers after appearing in the Times.

 

[Crabcake Johnny]

It wasn't the same article in the Sun, however the Sun did reference that 5 DOI's now have investigations ongoing into the sales tactics agents use to sign people up for MA. They really seem to be hot on "agency incentives" to sell MA plans.

The Sun's outright advice was for seniors to sign nothing if an agent came to see them. Instead, just start doing a lot of research.

 

[sman]

Is Catfish Hollow still around? At the corner of 54 and 72, I think.

Close. It's 154 and 34. I haven't eaten there in quite some time. As a matter of fact, the last time I ate there it was still in Tyrone.

Sounds like you know the area pretty well. I'll shoot you a line and you can fill me in.

 

[Bob_The_Insurance_Guy]

You are correct.

 

[midwestbroker]

Bad insurance agents come in to play in all lines of insurance.

The senior market seems to generate the most press since it has the political tie in.

Dems could do away with the program, but I do not think that will happen. Approx 30% of Medicare beneficiaries are covered by a MA plan. They may revise the program, but that will be years down the road.

I always offer both types of plans, MA and supplement. I have followed agents who only offered MA and the clients were thankful that I showed them all their options.

 

[Frank Stastny]

I believe that the way Advantage plans are set up that it was inevitable
that the kind of problems pointed out it the articles were bound to happen.

There are a group of agents, not anyone on this board, that when you tell them that they can practically "give" a policy away and get $350.00 deposited in their checking account three weeks later are going to push the hell out of it. It really doesn't matter to them if it is in the best interest of the client or not.

Seniors are very easy targets for anything that is cheap. Like most people, they only believe that "bad things" happen to others, not to them. So the fact that a doctor or hospital may not accept an Advantage plan is of little concern to them until they actually need care.

My clients know that I have Advantage plans available. They also know that I do not think it is in their best interest to take one assuming they can still afford their Med Supp. There is a definite place for Advantage plans, but I do not think they are for everyone.

I believe it is almost a mute point since I think Advantage plans are going to go the way the HMO's have. In three to five years the govt. will have another plan to "help us".

Even though Mike said 30% of seniors are on Advantage plans doesn't mean that it will be the best for them when they actually need it. Since the first of the year I have sold several Med Supps to people who were "talked into" taking an Advantage plan because it was cheap and now are not happy with it.

Doctors and hospitals in large metro areas may be accepting them but I have heard from quite a few agents who sell in rural areas say that seniors who were talked into taking an Advantage plan are now back on a Med Supp because doctors are not accepting them. An agent in SW Missouri told me it is a real problem down there.

I agree with Kyle. Advantage plans can be for anyone who throughly understand the ramifications and potential hassle of having an Advantage plan over a Med Supp. (Unfortunately that may not be everyone who is on an Advantage plan.) Also for those who cannot afford a Med Supp, like HMO's, Advantage plans are better than nothing at all.

Yep, your are right. I am not sold on them. I think the premiums will increase dramatically over the next few years. In an earlier thread it was pointed out that Advantage plans were costing the govt. 13% more than for people who were still on Medicare. (Correct me if I'm wrong.)

The sad thing is, most people will be beyond their 12 months when they could have gone back to a Med Supp, and now may not be able to change because of health reasons, when they find out that their Advantage plan doesn't work like the Med Supp they use to have. Especially those who travel extensively. Then they are "stuck".

 

[Guest]

I think the premiums will increase dramatically over the next few years. In an earlier thread it was pointed out that Advantage plans were costing the govt. 13% more than for people who were still on Medicare. (Correct me if I'm wrong.)

Remember Frank said this...it will happen. Eventually MA plans will be the new Med Supp plans at $100/month and Med Supps will be closer to $200+...it may take another 5-7 years when boomers hit but it is pretty easy to see that coming.

 

[midwestbroker]

I am in a different market then most, since MA plans have been here since 1991. Providers are used to them in the Kansas City Metro area.

I think we should watch AARP on this. In 2000, Medicare tried to do a lock-in like they have now, but AARP prevented it from happening (they were the largest force opposing it). However, United Healthcare said not too long ago that they are going to further their MA plans. So, what I see in the future is AARP and UHC starting to offer MA plans. The only things I see coming from them now under the AARP logo are supplements.

For quite a few seniors, if AARP says it is good, it must be good. Right, wrong or indifferent.

 

[Frank Stastny]

I am in a different market then most, since MA plans have been here since 1991. Providers are used to them in the Kansas City Metro area.

Mike I'm confused, I thought that Medicare Advantage plans were rolled out sometime in 2005. I first really heard of them or got information in 2006 when I certified with PacifiCare.

I worked the St. Louis market from 1995 to 2004, that is where I lived. The only thing I was aware of during that time was HMO's.

I know you have a lot of expertise in Medicare Advantage plans so I am really curious as to why they were in KC and in St. Louis I didn't know they existed.

Maybe I was just concentrating so heavily on Med Supps that it flew right by me.

Who was offering Medicare Advantage plans in 1991 in KC?