More insurance brokers would choose traditional Medicare over Medicare Advantage: Report

[somarco]

I've seen an uptick in this specifically related to SNF. I had 3 MAPD clients last year who either had their request for SNF denied or greatly limited (two denied, one limited to 6 days). And on all of these plus a few more who used SNF after a hospital stay, the SNF facility encouraged these patients to go back to original Medicare and get a Med Supp. I understand why the facility encourages it, but this also shows their ignorance since the patient obviously can't get a Med Supp.

One of the more frustrating things we deal with as agents is when a client gets bad info/advice from an admin person at a doctors office or facility. The patient believes the people at the doctors office know what they are talking about because they deal with insurance claims. Many times they don't have a clue. Even worse, the admin person is adamant they know what they are talking about when they are clearly misinformed.

Had the same issue (doc says get a Medigap and then we can proceed). Not so much with SNF because I am not aware of this other than with a new client where it came up.

I had a lady, about a year ago, that needed an MRI before the surgeon would operate due to spinal stenosis. Aetna MAPD giving doc the run around and repeat denials for pre-authorization. After 5 months of this nonsense he told her to come back when she had a Medigap.

My rule is, I won't practice medicine if the providers stop giving insurance advice.

 

[Patty Cake]

Being a broker I have always had to budget in the high premiums, high deductibles and high MOO. I could not wait to get to Medicare. Gives me the piece of mind that I can go anywhere across the country and as long as they take OM I am good to go. I know exactly how much out of pocket I will have each year. I have been a broker for over 34 years and I have had a few clients (my sister included) that has went to Doctors in Texas that actually saved their lives. However, with the premium increases on the Medicare Supplements eventually it may make more sense to go to MAPD if the numbers work out.

 

[somarco]

clients (my sister included) that has went to Doctors in Texas that actually saved their lives. However, with the premium increases on the Medicare Supplements eventually it may make more sense to go to MAPD if the numbers work out.

Is the possibility of saving a few dollars worth giving up access to providers that could save your life?

Premium is just one side of the equation when evaluating cost . . . the other side is how much your health care cost . . . then add in the hassle factor of dealing with an insurance carrier who thinks they know the type of care you need vs what your doc says.

 

[kgmom219]

I'm only 52. My mother is 73. She will be on a MAPD when I am so poor that I live in my car.

Any questions?

 

[rmhaire]

I'm only 52. My mother is 73. She will be on a MAPD when I am so poor that I live in my car.

Any questions?

I've got a question.

I've never met you or your mother. Never been to Texas. But based on your use of sarcasm in your posts I'm just curious .... Are you sure you're not my daughter?

Keep it up. Love it.

 

[InsuranceGuy29]

(Caveat, not an agent)

What do you see as a long term possibility of the government reducing funding to MAPD carriers -- the funding that I assume enables them to offer some of the supplementary benefits like Dental, Vision and Part B buyback.

If that happened, you'd just see some of the copays and/or premiums going up by a dollar here, two dollars there, etc. Dental, vision, and hearing are huge competitive benefit points of MAPD's between all the companies.

This is the benefits of the private sector/competitive free market (insurance companies) being involved in Medicare. There's a lot of companies and they're all trying to constantly outdo each other.

Some companies are willing to give consumers back more and take less of a profit. Intelligent consumers generally will go with those companies (as long as they have a good reputation, of course).

Rest assured, there's still plenty of money in the system, and still plenty of money to go around and be potentially generated.

 

[DonP]

Has anyone factored in with the huge migration to mapd over the last 5-10 years . Med sups could have a much higher mix of sicker people stuck on the plans . Many healthy people T65 in the past that would have chosen a sup now choose mapd as they say “ I’m in good health and don’t go to the dr much “ . This tilt of sicker people on med sups could affect premiums greatly in the future .

 

[rmhaire]

Has anyone factored in with the huge migration to mapd over the last 5-10 years . Med sups could have a much higher mix of sicker people stuck on the plans .

I haven't. For the simple reason there's no huge migration down here where I'm at. Maybe this huge migration has something to do with where you're at. Your thingamajimmy says you're in Arizona. Exactly where in Arizona. Downtown Phoenix?

I'm in South Georgia and nine other states. I purposely avoid the big cities for a reason. And in all ten states I'm not seeing anything like you're talking about. 7 out of every 10 people I talk to go with OM. And yes, I give them a choice. I could probably get that up to 8 or 9 out of 10 if I tweaked my minimum income filters.

Med Supps have always sick people stuck on plans. It's been that way since time began. They're called blocks. And when a block closes, the ones that can move do so and the ones that can't are left behind to pay the rising premiums. That's why you need to shop your client's plan every two or three years.

 

[sman]

Has anyone factored in with the huge migration to mapd over the last 5-10 years . Med sups could have a much higher mix of sicker people stuck on the plans . Many healthy people T65 in the past that would have chosen a sup now choose mapd as they say “ I’m in good health and don’t go to the dr much “ . This tilt of sicker people on med sups could affect premiums greatly in the future .

That's a fair and valid point. Personally, I'm not seeing a ton of "sicker" people at T65. However, when I do get the prospect who has health issues that would cause them not to qualify for a Med Supp if they had to go through underwriting, I will recommend they go with the Med Supp.

I've not followed Med Supp rates in Alabama closely (I am licensed there and have a handful of Med Supp clients in the state), but UHC just announced one of the highest rate increases I think I've ever seen by them. We'll see if it's the new norm or just an anomaly.

 

[rmhaire]

I've not followed Med Supp rates in Alabama closely (I am licensed there and have a handful of Med Supp clients in the state), but UHC just announced one of the highest rate increases I think I've ever seen by them. We'll see if it's the new norm or just an anomaly.

I'm going with anomaly.

When I run a quote on CSG they usually show up in the top 2 or 3. For a T65 in Dothan, I've seen them come in at just under a $100. When I run them in GA they always show up at or near the bottom.

I think that they are finally getting around to adjusting to the market.

But don't forget we're talking about Alabama. Alabama is where the guys go to family reunions just to meet the women.