MedSupp Help

[briko3]

Let me preface this by saying that I have NO clue about medsupps. My wife's grandfather has had one (as did his wife before passing away this past year). He pays $190/month for it and as far as I know she did too. After having a really rough year with many hospitalizations, etc., they added up the expenses and apparently she didn't even get her money worth in a year like that. So now he's convinced that he doesn't need it. He never goes to the doctor. Is he right? If not, why not?

Thanks in advance for the help.
- Chris

 

[VaDwayne]

Let me preface this by saying that I have NO clue about medsupps. My wife's grandfather has had one (as did his wife before passing away this past year). He pays $190/month for it and as far as I know she did too. After having a really rough year with many hospitalizations, etc., they added up the expenses and apparently she didn't even get her money worth in a year like that. So now he's convinced that he doesn't need it. He never goes to the doctor. Is he right? If not, why not?

Thanks in advance for the help.
- Chris

Short answer is YES he needs it. However there are a few factors to look into like:
1. Which plan does he have? He may be paying for coverage that he won't use, and would a less expensive plan work just as well?

2.What is his age and has he compared with other companies to see if he can get the exact same plan for less. Med supps are standardized by the gov't and every company's plan offer the same coverage, NO MORE,NO LESS. Example,if he has plan F, then every plan F will offer the exact same coverage. Only the premium is different.

3. Is he healthy enough to qualify for a different supp from another company?

4. Does he have a med supp or a Medicare Advantage plan?

Explain to him that he has insurance on his house and car and probably has never used it either, but he has coverage just in case something does happen. Medical insurance is the same thing.

What doesn't make sense to me is your statement that she had been hospitalized many times and didn't get her money's worth. How is it possible that they didn't? A day in the hospital would have cost her more than the annual premium for the med supp.

 

[briko3]

Like I said...I really haven't done any work in this area before so am a little lost. I'm not even 100% sure that I know the difference between MA and Medsupps. I remember helping him add up costs for her care last year and it seemed that the plan he had only covered an extra .75-$15 or so for each time it was used. Seemed like medicare covered most fo the cost. Does that help you with what he might have?

 

[GreenSky]

Without a supplement, Medicare gaps (briefly):

$1,068 for each hospital admission (1 per 60 days)
20% after $135 annual deductible for outpatient services.

Weigh the $2,300 cost for a med supp against the above. In my opinion, most people don't need a supplement, although it's hard to convince them. In the absence of dialysis or chemo, most people can't receive over $2,000 in benefits.

That being said, any client of mine that follows this advise probably will wind up with $5,000 in costs. So I pretty much just try to find the lowest cost plan for them.

Rick

 

[Frank Stastny]

Let me preface this by saying that I have NO clue about medsupps. My wife's grandfather has had one (as did his wife before passing away this past year). He pays $190/month for it and as far as I know she did too. After having a really rough year with many hospitalizations, etc., they added up the expenses and apparently she didn't even get her money worth in a year like that. So now he's convinced that he doesn't need it. He never goes to the doctor. Is he right? If not, why not?

Thanks in advance for the help.
- Chris

You said "with many hospitalizations". If there were only two and they were more than 60 days apart then the Medicare Deductible of $1,068 per hospitalization would alone have almost equaled the cost of the insurance. $1,068 x 2 = $2,136. That doesn't take into consideration the 20% paid under Part B.

Both Rick and Dwayne make excellent points. None of need insurance of any kind if we never get sick, get in an accident, have anything stolen, have our house or vehicles destroyed or die. That probably isn't going to happen though.

If we knew what state your grandfather was in someone on here could check for you and see what company and plan has the best rates for someone his age and possibly save him some money.

For example, I wrote a Med Supp yesterday on a woman who had a Plan F with BC&BS. I moved her to a Plan D with National States and saved her $57 per month, $684 per year.

Insurance is a necessary evil. It's the only thing I can think of that we pay a lot of money for and hope we never get to benefit from making those payments.



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[briko3]

South Carolina

Thanks for the help guys. So far this is some great information.

 

[Guest]

Seems to me if you said this:

"After having a really rough year with many hospitalizations, etc., they added up the expenses and apparently she didn't even get her money worth in a year like that."

Then we can conclude that they did not have the most comprehensive plan, if they were left exposed to out of pocket costs.

Being new to med supps myself, I don't know why anyone would suggest selling them an even lower priced (less comprehensive) plan, which would have caused the situation in the first place.

Can you guys explain that to me?

 

[kwimberl]

Rob, the benefits that were outlined above are benefits of EVERY med supp (basic benefits).

My guess is that they only looked at the 20% of part B and were unaware of what the supp did for them on the hospitalizations...

 

[GreenSky]

Seems to me if you said this:

"After having a really rough year with many hospitalizations, etc., they added up the expenses and apparently she didn't even get her money worth in a year like that."

Then we can conclude that they did not have the most comprehensive plan, if they were left exposed to out of pocket costs.

Being new to med supps myself, I don't know why anyone would suggest selling them an even lower priced (less comprehensive) plan, which would have caused the situation in the first place.

Can you guys explain that to me?

Rob:

May I suggest you study some of the material available from Medicare. Your conclusion is so wrong it's amazing.

There is really no such thing as a more or less comprehensive plan. They all cover virtually the same thing and the minor differences between plans could never lead anyone to a conclusion that their benefits caused "the situation."

Rob, when you train agents for health insurance, you positioned yourself as an expert. You are now offering medicare training, sales, contracts, etc. to agents without really understanding the product. How can you do this when you really haven't a clue?

Rick

 

[Frank Stastny]

Rob, the benefits that were outlined above are benefits of EVERY med supp (basic benefits).

My guess is that they only looked at the 20% of part B and were unaware of what the supp did for them on the hospitalizations...

Spot on!

After I finished my post that immediately came to mind. Thanks for adding it. It's nice to know that someone is "covering my six".