Medicare Advantage

[policy doctor]

Frank, a quick reply.

What I meant by claim experience is when those co=pays pile up for the client to pay. And I'm not talking a hundred dollar claim. The big; one, focus on the big one like a cancer or heart bypass/stent.

When you have multiple drs, esp specialists, there will be someone who does not take Medicare, or an advantage plan. (i'll post a story on News hound) That is where issues come up.

Again, I haven't had to deal with this...so it's a theory right now. But when high utilization kicks in, the worms will come out.


Far as seniors paying something; remember their liability is 20% and Medicare pays 80% for most bills Xross the board. What advantage plan PAYS their 20%? NONE...senior still pays.... (later)

 

[Frank Stastny]

Bob, that is true lack of training is a big part of it. MA plans pay in larger sums to the agent and the IMO, while supps pay, but it is over a longer period of time.

So, newer agents hear, you can make $300 to enroll them in this MA or $15 per month to enroll them in this supp, you know what they are going to focus on.

I disagree, I do not believe that it is a "lack of training". All agents selling PFFS plans have to be certified and go through the certification classes. The same ones I had to take. They also have to go through training to sell other Advantage plans. At least that is what I have been told.

All the "training" in the world is not going to make a certain percentage of agents do a "more responsible job" of selling Advantage plans, specifically PFFS plans.

Those agents, as you stated above, see only the immediate commission they are going to make. Regardless of the amount of "training" those agents are still going to see only the $300 up front commission and are going to push the prospect toward a PFFS plan rather than a Medicare Supplement.

I have never heard of a "problem" with agents who are recommending an HMO to prospects. The only "problems" I have heard are with agents pushing a PFFS plan when a Medicare Supplement would be a much better option for them.

John has a unique opportunity to provide a group of people a very valuable service and help them substantially with their health care. He will be talking to them about an HMO. A totally different animal than a PFFS plan.

 

[Frank Stastny]

With both plans, you are still in Medicare, it's just a matter of who is administering the health coverage to you.



For every horror story I hear about Medicare Advantage Plans, I hear one about Med Supps.

When someone signs up with any of the Advantage Plans they lose their Medicare. Their Medicare card becomes totally worthless, they might as well throw it away. They are no longer on Medicare.

Again, I have never heard any "horror stories" from people who are on Medicare. What am I missing? All of my clients love Medicare and having a Medicare Supplement policy. The only thing they bitch about is the premium which is only a fraction of what they paid for health care before they became 65. It is the greatest deal in the world for unlimited, quality health care.

 

[Frank Stastny]

Frank, a quick reply.

What I meant by claim experience is when those co=pays pile up for the client to pay. And I'm not talking a hundred dollar claim. The big; one, focus on the big one like a cancer or heart bypass/stent.

When you have multiple drs, esp specialists, there will be someone who does not take Medicare, or an advantage plan. (i'll post a story on News hound) That is where issues come up.

Again, I haven't had to deal with this...so it's a theory right now. But when high utilization kicks in, the worms will come out.


Far as seniors paying something; remember their liability is 20% and Medicare pays 80% for most bills Xross the board. What advantage plan PAYS their 20%? NONE...senior still pays.... (later)

I understand that copays can pile up for those on Advantage plans, however, every one of them has a max out of pocket expense each year. Regardless of what kind of treatment they receive for whatever illness they will only owe the max out of pocket.

You said there will be some doctors who do not take Medicare. In the 14 years I have been in the senior market I have never found one doctor who doesn't take Medicare. There are a lot of doctors who will not accept any of the Advantage plans or people who are on Medicaid, but none that I am aware of who tell patients who are on Medicare that they will not accept them as patients.

I can't see that claims are going to be any different than they have been or are now.

 

[senior-advisor-indiana]

I do not agree with the statement that agents are selling this for the $300 commission. Anyone who is in this business for the long haul does not look at the up front commission, we look at the renewal commisssion. My average upfront commission on med supps is $250 and thats level for 6 yrs. That beats the crap out of MA plans. At some ages I make more than $300 on a med supp. I get advanced though. What new agent gets paid as earned on med supps? I sure the hell couldn't and I have been steady at it for 2.5 yrs.

 

[Frank Stastny]

I do not agree with the statement that agents are selling this for the $300 commission. Anyone who is in this business for the long haul does not look at the up front commission, we look at the renewal commisssion. My average upfront commission on med supps is $250 and thats level for 6 yrs. That beats the crap out of MA plans. At some ages I make more than $300 on a med supp. I get advanced though. What new agent gets paid as earned on med supps? I sure the hell couldn't and I have been steady at it for 2.5 yrs.

I agree with you as a general statement. However, I was addressing that small group of agents who only got into the senior market for the fast buck and not a professional agent like you are.

It is that group of agents who are ripping off seniors and causing all the problems. You're one of the "good guys".

MA plans screw the professional agent for the very reasons you posted above.

 

[Slick]

I just got off the phone with a friend that works for Mega. He said Mega is releasing a $1,500 MOOP MA through Chesapeake Life and is preparing all their agents to ambush seniors.
I tried to research it online and came up without finding anything more.

 

[midwestbroker]

Frank - when I say training, I am referring to the "Mega" insurance IMO's. These are the ones who take green agents and hold their hand through training (usually an online cert and slideshow) then throw policies in their hand and say go sell some. I know several IMO's in Kansas City that do just that. They have supplements as well but get no training on them.

Now are there a lot of agents out there doing that? No, but enough to give this industry a bad taste in everyone's mouth. Look at the PFFS hault. I had a relationship with a senior apartment complex that I had to fight to get back in after another agent went through and screwed a bunch of poeple.

The only horror stories I have heard for supps are premium increases.

 

[senior-advisor-indiana]

Thanks Frank, I am glad I don't look like a bad guy.

 

[Bob_The_Insurance_Guy]

On page 33 and 35 of the Medicare and You - 2007 book, published by the Centers for Medicare and Medicaid Services, it clearly states that, if you join a Medicare Advantage Plan, you are still in Medicare, and you retain all your rights under Medicare.

Am I missing something?