Selling a MediGap to Po' Folks in an MA City

Jun 2, 2016

  1. wehotex
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    wehotex Guru

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    I got so excited that I received a phone call from a woman turning 65 who was referred to me by an existing customer, but didn't qualify her correctly. Come to find out, she's been on a popular Medicare Advantage plan for several years here in San Antonio (Medicare Advantage city), but is getting the run-around from her medical group to see a decent orthopedic surgeon. Her in-house physical therapy for her 2 bad knees, while FREE consists of nothing more than a warm towel and TINS stim treatments. She merely wanted me there to suggest another PCP to her on this appt. I explained to her that she could indeed change PCP, but wouldn't be effective until July 1, and no guarantee that the new PCP would treat her any differently. I also noticed that she and her husband are limited income (combined SS $1,500/mo; enough for SLMB and LIS, but not FULL Medicaid). Since she is just T65 with no LIS , she qualifies for the open Enroll with Medigap, no questions asked on pre-existing at I believe $96.21/mo for a Plan G. I explained to her "Simple Medicare" + secondary vs MA, option of choosing your providers, no referrals needed and no nickel and diming from copays on the specialist visits, hospital, x-rays, ambulance and such. I explained to her that it could be temporary until she gets back on her feet or forever. Since she would enjoy an MA SEP, I explained to her that I could always place her back on it at some time in the future if she chooses. I empathized with her by sharing my mom's experiences with her 2 total knee replacements and what is involved with recovery, nickel and diming of physical therapy visits, etc. Since the husband was not there, she wants to speak with the husband. I don't know what to expect, since I've never really pitched Medigap with the po' folks.
     
    wehotex, Jun 2, 2016
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  2. TN_agent
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    TN_agent Guru

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    Good job wehotex.

    I have an SLMB that I placed on a cheap F due to a GI and MAPD terminating her former plan.

    She has called me twice thanking me since January and raves about it. She sees several specialists each month, so the premium for the plan is just a little more than what she was paying OOP in co-pays, plus she had some procedure done and didn't have to pay anything (would have paid at least $500 OOP). Also glad no referrals needed anymore. SLMB covers 100% of her PDP premium and part B.

    I told her it is going to go up as she ages, she said if it got to be too much she would call me and switch back to an MAPD, but she is very happy for now.

    I think that the T65s who were disabled and previously on Medicare are ecstatic to get on supplements when they T65 and it is a fit almost 100% of the time. They were disabled because of medical reasons, they tend to have a lot of medical appointments and have co-pays that add up to well over the T65 rate for a G.
     
  3. wehotex
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    wehotex Guru

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    Gee thanks, Tennessee
    I've never encountered such a person, but her situation just falls into place. I'm probably going to have to go back to the home and Ben Franklin the husband on it. But. I honestly do think that she would be happier. Thanks for your input!
     
    wehotex, Jun 3, 2016
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