MA vs. Supplement

[MAPDagent]

I beg to differ Mr. Stastny...I sell MAPD plans almost exclusively, and I have no problem explaining the difference between Original Medicare/Med Supp/Part D vs. MAPD PFFS in one visit, no less. And I am a "real" insurance agent, by the way, and I do thoroughly understand how Medicare works.

And since when should an agent selling Medicare Advantage in any form, feel guilty about getting paid a commission for doing it??? As if you don't get paid to sell Med Supps!? Why don't you just go around singing the praises of Original Medicare only, and that way none of us will earn a living! I got into this business because I believe in Medicare Advantage and what it does for poeple, and I enjoy working with Seniors. You make it sound like only low-life scum sell MA's. I think only old-school insurance agents who are pissed about the new kid on block still push Med supps and bad-mouth MA's.

I do agree that Original Medicare is actually not a bad health plan as it stands, but as soon as Medicare was introduced in '65, private insurers had to point out the "huge gaps" in Medicare and have been scaring seniors into med supps ever since.

As for doctors accepting PFFS plans, yes, technically they don't have to accept the insurance, but then again, what patient is going to want to see a doctor that takes their money one day, but not the next? Any doctor that does that to a client is just asking for that client to leave and find another doctor...not a good business practise, and one that I venture to guess not a lot of doctors are going to pull on clients. Although I'm sure that kind of thing happens, it's never happened to my 300+ clients.

Do you realise that the whole impetus behind Medicare Advantage was to reduce over-utilization of health care services, so as to reduce overall costs in the health care system as a whole? Ever notice how HSA-qualified health plans for people under 65 seem to echo the same sentiment? They look an awful lot like Medicare Advantage, don't they? Pay those premium dollars to yourself instead of the insurance company, and use them for future health care needs. Sounds famililar, doesn't it?

Bottom line is, I don't think that Medicare Advantage is pulling the wool over anyone's eyes...they are popular because people like them, they work, and they're hear to stay.

 

[dandan]

Actually Medicare Advantage was created as a political power move along with standardizing Medicare Supplements.

I do not think the advantage PLANS are bad for the people that know what they are getting. Unfortunately most are buying only because of monthly premium.

If you tell somebody on an Advantage plan that what they have is not a Medicare Supplement, they look at you like a deer caught in the headlights.

I think the low income individuals are really getting the raw deal, just wait until you go back and have the gentleman that was paying his supplement and no out of pocket expenses and find out he was put on oxygen and he is now paying 80% of the cost.

Mr. Stastny was correct when he said it brought in a new breed to collect commission maybe not you but many!

 

[senior-advisor-indiana]

You sound just like what Frank is talking about. You obviously do not understand the difference. You are a career agent that is drinking the Kool-aid. I know that over here there are a couple MA's that aren't much better than original medicare.

 

[GreenSky]

Do you realise that the whole impetus behind Medicare Advantage was to reduce over-utilization of health care services, so as to reduce overall costs in the health care system as a whole? Ever notice how HSA-qualified health plans for people under 65 seem to echo the same sentiment? They look an awful lot like Medicare Advantage, don't they? Pay those premium dollars to yourself instead of the insurance company, and use them for future health care needs. Sounds famililar, doesn't it?

Do YOU realize that what you wrote is absolutely incorrect?

How does a $5-10 copay reduce utilization? It has done just the opposite. When I worked for Secure Horizons in the mid '90s I used to move people from their almost idential coverage into SH only because the office visit was a zero copay instead of $3. Doctors hated and still hate a very low copay. It encourages seniors to come in and "chat."

HSA plans are nothing like MA plans. Most MA plans are managed care. HSAs have no management component. PFFS plans are not like HSAs because they encourage visit to the doctor for $5-10. They are not designed for people to insure only what they can't afford. They are designed for seniors in rural areas to have access to low cost care.

While I appreciate the value of MA plans and have probably written somewhere in the neighborhood of 750 in my life, I would NEVER equate them to the benefits of a Med Supp or an HSA. They are simply an alternative that may or may not be what is best for a senior.

By the way, I still write Medicare HMOs, PFFS and PPOs. For some it's the best they can do. (I don't have an issue with PPO plans as I'm covered with one and probably, so are you.) However, if I am asked what the best plan is the answer is always the same - Medicare and a Supplement. If the person is broke, then they might want to see an MA alternative.

I appreciate your viewpoint but when you show that you don't have the slightest clue as to what you're talking about, please expect to get flamed (or at least educated).

Rick

 

[arnguy]

Frank, doesn't the Medicare recipient have to meet a deductible for Part B services before the 80/20 rule kicks in? I think the deductible is $135.00 that the patient would have to pay before the doctor office visits would be $10.00. Is that correct?

 

[scottfree]

OMG, Let's all hail the only "REAL" INSURANCE AGENT!! Frank!


I am going to send all my clients to you since anyone that sells MA plans are just in it for the money. I take it you donate all your commissions to charity.


I just love the comment on the 15 min presentation for MA plans, if that is all you think it takes then I believe you need to get some training on these products.


So you would choose Medicare only over these plans? You had better stop donating your commisions so you can afford that open heart sugery or bypass that you end up having from all the crow you ate in your earlier years. Probably only cost you about 80k but if you had been on an MA plan that I have sold, it would have only cost $550 for the hospital and Dr. Hey, you may have even avoided it if you had gone to those finess classes to stay in shape. Bargain basement plans, get a clue! My clients have not skipped a beat in their healthcare. I could or would not put someone at risk.


And where do you get the idea of HUGE COMMISSIONS? Plans I sell and have sold range from $240 to $400 first year with a huge second year commissions of 100 to 150. I guess you don't make near that on your Med Sup plans, but then I forgot you donate what you make on your sales.


The MOOP on the MA plans doesn't get hit very much but I have talked to people that have hit $2000 plus in costs for the year and if they had been on Original Medicare would have blown through 5, 6 and even 15k in bills.


I am sick of people thinking that agents that sell these plans are doing it for the big frickin commisions when the ones that make the most money are agents that sell only sups and make much more money.


BTW, I do sell Sups and I sell the least expensive ones from quality companies and give my clients the "CHOICE TO CHOOSE" I also let them know that if they don't like the plan, they have the right to get back into their old sp if it is still around. BTW, I have even helped someone that was on an AFLAC sup ($225 month)in 2006 that could not pass underwriting to get on a United World ($104 month) so they joined an MA and since AFLAC does not sell that plan anymore in my state, I now have them on United World whih is $115 a month now since this is a rule that Medicare has if a plan does not sell anymore in the state.


Well I guess I am just a lowly agent that knows nothing and in it for just the HUGE commission.

 

[senior-advisor-indiana]

Frank, doesn't the Medicare recipient have to meet a deductible for Part B services before the 80/20 rule kicks in? I think the deductible is $135.00 that the patient would have to pay before the doctor office visits would be $10.00. Is that correct?

The deductible is $131 for 2007, $135 for 2008. Yes they do have to meet the deductible before they get the part B services.

scottfree, seems like you are reading Frank wrong. Maybe you should go back and read his post and steam down a little bit. Obviously he is not talking about you if you did not jump in this biz to ride the PFFS rollercoaster. MA's are better commission than supps. Unless you just leave your clients on the same plan every year ( which if you did then you are not doing the correct thing). So that is $350-$450 every year There hasn't been a plan in IN that has been the top dawg every year. Its been Secure Horizons 06, Pyramid 07, Pyramid and Coventry ( depending on county) 08. Unless you like to sell the new players like chesapeake or cigna.

 

[midwestbroker]

MA Vs Supp all really depends on the area of where you are selling.

Major metros will have numerous plan options, mostly HMO and PPO plans. With defined networks, low MOOP (typically $2-$3,000) and have been around longer then Part D. That is what I offer. I still have supps in my back pocket

Rural markets are another situation. There you have PFFS plans with no network, doctor offices all in confusion about how they work, and seniors reading warning stories about them (last AARP newsletter had a story about it).

I do not sell PFFS plans as the local PPO's out here have similar coverage for less money. If I was in the rural markets, I would present both the PFFS and supplements. The first page of the Medicare and you Book for 2007 has a great chart to show the difference.

 

[Frank Stastny]

Frank, doesn't the Medicare recipient have to meet a deductible for Part B services before the 80/20 rule kicks in? I think the deductible is $135.00 that the patient would have to pay before the doctor office visits would be $10.00. Is that correct?

Yes you are correct. For 2007 the Part B deductible is $131.00. I understand that it is going to $135.00 for 2008.

The Medicare Part B deductible in essence is the first $131.00 (for 2007) of their doctor bills starting Jan 1 of each year.

 

[Frank Stastny]

And since when should an agent selling Medicare Advantage in any form, feel guilty about getting paid a commission for doing it??? As if you don't get paid to sell Med Supps!? Why don't you just go around singing the praises of Original Medicare only, and that way none of us will earn a living! I got into this business because I believe in Medicare Advantage and what it does for poeple, and I enjoy working with Seniors. You make it sound like only low-life scum sell MA's. I think only old-school insurance agents who are pissed about the new kid on block still push Med supps and bad-mouth MA's.

Bottom line is, I don't think that Medicare Advantage is pulling the wool over anyone's eyes...they are popular because people like them, they work, and they're hear to stay.

I didn't say anything about feeling guilty about getting paid to place a PFFS plan. Is that the way you feel?

If you can't make a living selling Med Supps then maybe you are not using the correct approach. I still make a lot of money selling Supps every month.

Why would an experienced, successful agent be pissed about some new kid trying to place a PFFS plan? Those plans really are "placed" more than they are "sold". Many of my clients have been approached by some new agent trying to place them in a PFFS plan. I tell them that I also have them available and set an appt to talk to them about changing.

When I take the time to explain how the differences will affect them they most often stay with their Supp. The one comment that most of them have made is, "the other agent didn't tell me that". That's what pisses me off.

I agree, PFFS plans are not "pulling the wool over anyone's eyes". The problem I have is that there are agents who are out there doing that. My comments were not directed to you unless you are one of those agents. I know a lot of agents who are placing PFFS plans who are doing it very responsibly.

My position on PFFS plans has been the same since the discussion of them began. I feel that they are okay in some cases, however, I still believe that traditional Medicare and a Med Supp provides superior coverage.

Rick said it best, what is your health worth? Selling insurance to me is not just about finding the cheapest thing. Quality and access to the best medical care is far more important.