medsupp vs MAPD

[axeman462]

I just saved a lady $2,500 on her medsupp premium, $3,000 on her Rx costs, and another $2,000 on her Part B premium costs, totaling $7,480 next year, by switching her from a medsupp to a C-SNP MAPD.

All her doctors accept the plan, as does every hospital within 100 miles.

The MOOP for the plan is only $1,500 - appox $1,000 less her her annual premium for her medsupp.

She was being stressed financially before meeting me.
Next year she will have an extra $600/mo.

I'll bet there are some medsupp only hacks here that will honestly think that I screwed her over, and she will probably die by springtime next year because they believe their own propaganda.

 

[Midlevel]

But what if a new Dr comes in from India and decides not to join the network. Then what she gonna do?

 

[Truce]

Florida is an interesting laboratory for the evolution of MA.

That's a big change on the drugs. She was set to max out the stand alone Part D and now has little to no costs on the c-snp? It's a complelling story for sure with the low MOOP, and of course an agent who knows their health condition should present them with this option (or someone else will) even if they opted for OM previously.

I can think of many clients who would not make a change for $600 mo, and many who would. But I'd present it to all of them.

 

[fed up]

How often does she visit the doctor?

 

[Chazm]

$3k on drugs to $0 is a huge change. Did she go to Ultimate health? I have to move someone to that plan.
I’m trying to think of a CSNP that saves on that expensive of a drug. Not that I doubt you.

 

[axeman462]

$3k on drugs to $0 is a huge change. Did she go to Ultimate health? I have to move someone to that plan.
I’m trying to think of a CSNP that saves on that expensive of a drug. Not that I doubt you.

sorry, meant optimum not freedom.
and the moop is 1,750 not 1,500. I guess that changes everything

Rx with it are right bout $400 with it, vs. about $3,400 total cost with a PDP

I never wrote anything with Ultimate, I know theres a niche somewhere for them but never found it.

 

[Limozine]

In our area, a savings of $1000 or more going from a PDP to an MAPD is not uncommon. I'm about to move a supp client (my own) to an MAPD where he'll save in excess of $5000 a year. His MOOP will be less than his supp premiums alone, and his copays are the same in and out of network. The MAPD is as close to a supplement as possible, but without a premium.

 

[straightnochaser]

Yea but can he go to MD Anderson? /s

 

[axeman462]

Yea but can he go to MD Anderson? /s

Doubtful. And since there's not a single other qualified medical facility or doctor in the South that treats cancer or any other kind of disease, he's just going to have to die.
But at least he's saving some money, and I made a massive commission

 

[vic120]

Ive def modified my view, and the MA plans have modified their benefits

I have def moved some who could not qualify for lower rate because there premiums got high enough

But even though at this time it seems in most areas there has been some stability this is not a guarantee

I have one client that reminded me of this when I changed him to a plan with a $3K out of pocket max a year ago and now his lowest option is $4500 for 2024

still as much as he complained his premium was $500 was stuck on an old equitable plan at the time, and no matter what he is still better off

And he is stuck because he has a large PDP penalty so he has to have a no drug MA plan
But remember it used to be the other way around the no PDP MA plans used to have the lower max out of pocket

There is no guarantee we don't go back to the $20 primary $50 spec, $350 a day hops with little extra,s and the high max out of pocket plans

and it can happen fast