Postal Retirees - Medicare

[vic120]

There are lots of posts in the forum from 2016 and after describing difficulties forum member clients have had with Medicare Advantage coverage. There are also other posts describing how well the plans have worked for others.

As I said, I think it becomes a value judgement about how much risk one wants to take. I think some of the focus on additional Medicare Advantage "additional features" may be misguided because I think I have seen posts from agents who have looked carefully at these things talking about how, once one goes beyond the surface of a catchy benefit category such as "dental coverage" or "gym membership" that one finds there are a number of unanticipated restrictions in the character of those benefits. If I had Medicare Advantage coverage, I would be worrying, at least every week of the remainder of my life, about the quality of my coverage. Applying value judgement, I refuse to inflict that on myself or those I care about.

Were I to become an agent, that presents an interesting ethical problem for me. I could not be an agent without extensive support from an IMO. My IMO of choice requires agents to do some work developing business plans, and part of their approach to that planning strongly suggests agents should be selling Medicare Advantage as well as Medigap. I am not sure how I would deal with that, but since I am not an agent, I can sidestep that issue at this time.

That is the Best Part about being an Independent Agent, You can sell in honesty and sell what is right for the client Not the company

 

[AgentSixNine]

If cost is the only concern getting the MA plan may seem like a no brainer however keep in mind....

• The postal plan tends to have superior drug coverage compared to most MAPD plans so if they currently take expensive drugs or end up needing expensive drugs in the future the postal plan might be better bet.
• Once they exit the postal plan they might not be able to get back into later. Although I believe there is an option to "suspend" coverage which allows them to re-enter the plan later vs just cancelling their coverage.
• While they don't have to sign up for Part B, if they decide later to enroll in an MAPD plan (which requires part B) If I'm not mistaken I believe they'll be subject to the 10% penalty for not enrolling in Part B when they were eligible.

just my two cents.

 

[JustinTime]

I know that you're not considering drug costs in your example, but I think it's something you have to consider, because this can make or break someone's Medicare Advantage plan and their budget...I think your step dad has a valid concern.

My recommendation is going to www.medicare.gov and plug in their current prescriptions and see which Medicare Advantage plan is going to be the best fit for their prescriptions. Then you should also consider the following:

Are their preferred doctors, specialists, hospitals in network?
Are they open to using other providers if theirs are not in network?
What about adding a hospital indemnity plan to help cover an inpatient hospital co-pay, potential costs associated with skilled nursing, cancer, etc.

Here's a tip...if they are taking a Tier 3 or higher prescription see if they qualify for a prescription assistance program by looking at www.goodrx.com or have them talk to their doctor to see if other prescriptions (possibly generics, free samples) are available or a better fit.

One other thing, another good fit for them might be going with a Medicare Supplement Plan G / Plan N and a standalone PDP.

Hope this helps.

 

[LostDollar]

Things such as current health, previous major medical events, broader family medical history and current drug usage were kinds of things to which I was referring when I said there was insufficient information provided to make value judgements.

In my opinion, the value judgement a person applies to those things and the level of risk they want to assume for the financial implications of a medicare advantage plan become choice criteria.

In speaking of the Lasso MSA, Jim Handlin stresses multiple times that the key element for a holder of that coverage is to "have a plan".

I think the same thing, "having a plan (to cover the deductible)", should be a key element of purchasing a medicare advantage plan. My personal opinion is dad will live a more stress free, risk free life with more "traditional" coverage, rather than Medicare Advantage.

Many would disagree with that. I think "advisors" role should be to see that dad has given a well rounded consideration (going beyond just cost) to his options.