Medicare Advantage Costs

HoustonInsure

Expert
20
Hello

I just sold one Medicare advantage plan last year. I was speaking to a person who insisted that Medicare advantage does not cover 20% of inpatient costs and had to buy a Medicare Supplement plan to cover all costs. I did not see this as true, any comments?
 
Hello

I just sold one Medicare advantage plan last year. I was speaking to a person who insisted that Medicare advantage does not cover 20% of inpatient costs and had to buy a Medicare Supplement plan to cover all costs. I did not see this as true, any comments?

Medigap will not coordinate with MA, so they'd be buying something that's entirely worthless. Plus, it's illegal for an agent to sell a Medigap to someone on Medicare advantage. If they want Medigap, they need to be on original Medicare, if they have MA, they need to accept the copays and reduced network in exchange for the lower premium. Make sense?
 
Medigap will not coordinate with MA, so they'd be buying something that's entirely worthless. Plus, it's illegal for an agent to sell a Medigap to someone on Medicare advantage. If they want Medigap, they need to be on original Medicare, if they have MA, they need to accept the copays and reduced network in exchange for the lower premium. Make sense?

^^^^

They both cover costs differently as previously mentioned.
 
I would assume they are no longer on the MA anymore.

She should not have both MA and Med Supp together as mentioned already they work differently and are not compatible

If She does have both she would need to contact the Supplement company and get a refund.Unless of coarse she can qualify to get PDP another way and go back to original medicare, Such as State assistance for Prescription, change of address,

Or you said you sold the plan last year is she possibly in a trial period still?
 
I would assume they are no longer on the MA anymore.

Don't assume.

One of my first sales was replacing MA with Medigap.

Except the guy never enrolled in Part D and never cancelled his MA plan. Got a 2 yr chargeback against commissions.
 
I spoke to him standing in line at a bank. He said he had both. Because Medicare advantage does not cover all costs. He let me go ahead of him and I gave him a prescription discount card.
 
I spoke to him standing in line at a bank. He said he had both. Because Medicare advantage does not cover all costs. He let me go ahead of him and I gave him a prescription discount card.
Poor guy. Throwing away money--depending on age and location maybe as much as a $1500 to $2000 per year plus--on a policy that will never pay even one dollar for any of his claims. Maybe someday he'll run into a knowledgable agent who can convince him that he's making a big mistake before he has some big health problems and discovers he is on the hook for the out-of-pocket costs of the MA and those med supp premiums were worthless.
 
I spoke to him standing in line at a bank. He said he had both. Because Medicare advantage does not cover all costs. He let me go ahead of him and I gave him a prescription discount card.

A lot of times people on MAPDs have an indemnity plan that they think is a supplement. Could be the case with this guy.
 
A lot of times people on MAPDs have an indemnity plan that they think is a supplement. Could be the case with this guy.
A more likely explanation. We use supplement as referring to a specific type of policy. As we've no doubt all discovered, beneficiaries use it generically.
 
A lot of times people on MAPDs have an indemnity plan that they think is a supplement. Could be the case with this guy.

Good point, he could be confused about what he has. I've heard Medicare beneficiaries say they wanted an advantage plan when they were actually referring to a Med Supp! In any case, a call to 800 Medicare could solve that or you can find current coverage by him logging into medicare.gov, too.
 
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