Medi C & D Insurers Plummet

Mar 12, 2008

  1. MedSuppPro
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    This is the time of the year carriers are designing and submitting 2009 MA / MAPD / PDP's.

    Any guess which direction these plans will head for 2009?

    Will we get any 2009 plan information before November 4th?

    online.wsj.com/article/SB120532620556430155.html
     
  2. midwestbroker
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    While Humana is struggling, there are others who are not.

    Humana here in KC spends a lot of money in advertising and other misc expenses. They should be spending it on benefits. I know nationwide they are loosing a lot of captive agents.

    They also were hell bent on being the lowest priced part D plan . Now they are seeing that was not a good move.

    If MA plans go higher in price, who is that really going to hurt? Seniors.
     
  3. MedSuppPro
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    Is this is a “self-correcting issue” and plans will simply be “re-priced” for the 2009 season?

    Um, so where does that leave the consumer?

    Higher co-pays?

    Increased premiums?

    Abandoned counties?

    Looks like there will be a lot of movement this fall. We all know the consumer will self-correct!
     
  4. midwestbroker
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    MA plans are adjusted every year. This reflects the Medicare capitation fee, claims, number of members, etc. Some years premium will go down, others it will rise.

    Humana has been all over the place. Their HMO in KC this year is $16, last year $19, year prior $8, year prior $20ish, year prior $30ish, etc.

    Coventry has been $0 since 2005, prior to that is was about $19.

    Both carriers (and I use them because they are the main carriers in KC) have picked up counties in the last few years.

    So, for now, they are on the upswing. Will this always be the case? Who knows. We can only go year by year.

    I can tell you there will be no new SNP plans next year as Medicare put a freeze on expanding them. Why? I do not know, but that is what I have been told.
     
  5. dimpil1
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    In NC they have a part C&D together at $0.00 per month prem. However the max out of pocket is $5,000 with 30% out pateint and $695 per stay in hosptial. Skilled nursing is $100 after day 5 I think.
     
    dimpil1, Mar 13, 2008
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  6. MedSuppPro
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    June 18, 2008 Reuters

    "Coventry also cut the midpoint of its revenue outlook to 21 percent growth from about 24 percent, citing less commercial growth in some segments and lower-than-expected Medicare membership.


    Chief Financial Officer Shawn Guertin told analysts on a call that the company failed to accurately gauge the claims cycle time with some Medicare patients. It underestimated claims that were denied because they didn't meet certain Medicare requirements when first filed.


    "We never saw them as inventory. ... We didn't know that this liability was out there," Guertin said.

    The company is making adjustments to pricing to temper the unexpected hospital costs, they said. (Reporting by Kim Dixon, editing by Mark Porter and Phil Berlowitz)

    :mad:
     
  7. InsuranceJosh
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    You are talking about the PFFS plan and Midwest was talking about an HMO.

    Not the same.
     
  8. Winter_123
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    2009 will be a year of adjustments to premium etc. 2010 will be the year to watch out for. New administration but also regardless of who is elected the subsidy to PFFS plans will go away and those funds will be used to prevent planned reimbursement cuts to physicians. So premiums will need to rise substantially rather than just the usual bump up. Unlike other products though, MA's have a ceiling as to how high you can go and still convince folks that it is worth not going with a med supp. Gets to be more and more marginal at a certain point. Those gym memberships only get you so far.

    My take. 2009 will just be a holding pattern with premium increases here and there but Congress will be doing a hatchet job on 2010 at the same time.

    Winter
     
  9. policy doctor
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    HR.6331, The House Medicare Improvements for Patients and Providers Act, will give doctors a modest pay raise instead of the drastic 10 percent Medicare pay cut that will take effect if Congress does not act. A pay cut could make more doctors reluctant to take on new Medicare patients and make it harder for older adults and people with disabilities to get the care they need.

    The bill also makes long overdue improvements to Medicare by providing improved access to preventive services as well as additional provisions for pharmacies,
    community health centers, ambulances, e-prescribing, rural providers, social workers and others.

    HR.6331 will create improvements and provide extension of payments for rural providers. The provisions that require Private Fee-For-Service plans to establish provider networks, rather than "deeming" doctors to be part of the plans, will protect people with Medicare. Far from limiting consumers' choice of plans, this provision will help ensure that people with Medicare who choose a Private Fee-For-Service plan will have adequate access to specialists and other providers. Many people with Medicare have signed up for a Private Fee-For-Service plan and are unable to find a doctor or hospital in their area that accepts the plan. It is vital that people with Medicare have access to the care they need, when they ne
    ed it.

    With your help, many Republicans and Democrats will vote for HR.6331. Write your representative and urge a vote for HR.6331 or call 1-866-622-2184 to connect toll-free to the Capitol Switchboard. Ask for your Representative by name, tell them you live in their district and you want them to cast a vote for HR.6331 and for people with M
    edicare.

     
  10. Bob_The_Insurance_Guy
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    You can cite House and Senate Bills all you want. The bottom line is, and I've been telling all my Medicare Beneficiaries this for the past two years, Medicare Advantage Plans will change, year to year.

    That is why there is Annual Enrollment Periods. This gives the enrollee time to explore their options.

    This is a GOOD thing.

    This allows you, the agent, reason to meet with them. It gives them the confirmation that they've selected what is right for them.

    Those of us who actually research this topic on a regular basis, and don't freak out when there is an exaggerated headline, have seen changes in the Med Supp market, to compete (a good word for your Medicare clients) against Medicare Advantage Plans.

    The real reason the numbers have not met expectations is because WE, AS INSURANCE PROFESSIONALS, PUSH WHAT WE WANT, AND NOT WHAT THE CLIENT NEEDS.

    If you have a penchant against Medicare Advantage Plans, then you are not going to try to sell them. If, on the other hand, you think they are the "end all be all" you will never sell another Med Supp plan. They are both viable options to attack the same problem. It is up to the individual, and their circumstance, as to which is the better plan.

    These plans are not marketed correctly.

    These plans are still, somewhat new, and not very well understood.

    It's the Term vs. Whole Life debate, just with Medicare.

    If you do your due diligence, not of these fanatical headlines, or changes, will make a difference.
     
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