MAPD PPO vs Medigap?

Jun 10, 2019 at 8:18 AM

  1. Chazm
    Offline

    Chazm Guru

    Posts:
    4,938
    Likes Received:
    1,036
    State:
    Florida
    Mapd plans work just as well (unwell?) as a pdp Plan. In fact, in my state, they are better
     
    Chazm, Jun 11, 2019 at 9:32 AM
    #11
  2. vic120
    Offline

    vic120 Guru

    Posts:
    3,001
    Likes Received:
    765
    State:
    Tennessee

    It all depends, Most generic users do as well if not better on MA, But Depending on the area and plan many times those that have tier 3 like inhalers and so forth can do much better on PDP, Some areas little dif some big dif
     
    Last edited: Jun 11, 2019 at 10:01 AM
    vic120, Jun 11, 2019 at 9:36 AM
    #12
  3. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,829
    Likes Received:
    591
    State:
    Kansas
    This goes back to the discussions about MA/MAPD vs MedSupp + PDP.

    I am pretty sure I have seen comments about some MAPD plan holders finding their drug coverage to be more expensive than it would have been with a PDP plan or they have found that some of their drugs turn out to not be covered by the MAPD plan.

    OP was asking about gotcha's, and based on my memory of those comments, I would be being careful in checking out prescription issues, as well as reviewing provider network issues, when looking at MAPD plans.

    Again, as you have often commented, concerns may be much less for your customers than those in some of the other states.
     
    LostDollar, Jun 11, 2019 at 9:45 AM
    #13
  4. Chazm
    Offline

    Chazm Guru

    Posts:
    4,938
    Likes Received:
    1,036
    State:
    Florida
    It has much more to do with Florida. I have a plan that will cover all these at a $0 copay.
    • Basaglar Kwikpen
    • Fiasp Vial
    • Fiasp Flextouch
    • Levemir Vial
    • Levemir Flextouch
    • Novolin 70/30 Vial (excluding ReliOn Brand)
    • Novolin 70/30 Flexpen (excludingReliOn Brand)
    • Novolin N Vial (excluding ReliOn Brand)
    • Novolin R Vial (excluding ReliOn Brand)
    • Novolog Vial
    • Novolog 70/30 Flexpen
    • Novolog Flexpen
    • Novolog Mix 70/30 Vial
    • Novolog Penfill
    • Tresiba Flextouch
    Many plans cover tier 1 and tier 2 for $0 in the gap, including one PPO.

    Actually, I don’t think I’ve EVER seen a pdp Medicare comparison look better than MAPD. But again this is in FL and probably not anywhere else.
     
    Chazm, Jun 11, 2019 at 11:05 AM
    #14
  5. Chazm
    Offline

    Chazm Guru

    Posts:
    4,938
    Likes Received:
    1,036
    State:
    Florida
    Not trying to defend MAPD plans. Believe me I’d much rather do Med supps. Already done 2 today.


    To the OP. You’re fine just doing a MAPD vs med supps. Believe me, if you start trying to confuse them more, they will be. Find out if the client is in need of a Med supp or a MAPD. If it’s a MAPD then compare hmo vs ppo. Not the other way around.
     
    Chazm, Jun 11, 2019 at 11:08 AM
    #15
  6. vic120
    Offline

    vic120 Guru

    Posts:
    3,001
    Likes Received:
    765
    State:
    Tennessee

    100% MA is Different in Fl then say NC,TX, IL,SC, And many others

    Different in many ways from price, copays, to how many docs are in the network, Especially when you get to more rural area's You will find the plans are not as good in many ways
     
    vic120, Jun 11, 2019 at 11:09 AM
    #16
  7. Travis Price
    Offline

    Travis Price Guru

    Posts:
    344
    Likes Received:
    258
    State:
    Michigan
    The world is very strange in FL.
     
  8. DeeDee Whitlock
    Offline

    DeeDee Whitlock New Member

    Posts:
    2
    Likes Received:
    0
    State:
    Louisiana
    My biggest concern about any Medicare Advantage Plan is that it is annually renewable, so benefits can change each year & if they are under going something serious health wise, they can not qualify for a med supp
     
  9. Travis Price
    Offline

    Travis Price Guru

    Posts:
    344
    Likes Received:
    258
    State:
    Michigan
    Then move them to a different Med Adv plan that better suits their need/want.

    I mean, they're already paying out for medical care anyway.

    Med Supps are definitely better, but if you explain both and they still want a MA plan, that's the risk they take.
     
  10. Tom S
    Offline

    Tom S New Member

    Posts:
    12
    Likes Received:
    6
    State:
    Pennsylvania
    Here is Pa. MAPD's are in a wide variety. Much comparison should be done (speaking PPO's only) … not all prescriptions associated with MA's are a good thing...it is important to study that aspect of the plan as it pertains to the prospect. It can certainly be a decision maker. When I see prospects who do not know which "world" to chose (original medicare vs. MA) it would be injustice to them to just speak of one avenue to travel.
    I do this on my radio program and it is well received.
     
    Tom S, Jun 11, 2019 at 1:45 PM
    #20
Loading...