Stop Me if You Have Heard this Before

Jan 14, 2016

  1. somarco
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    somarco GA Medicare Expert

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    Female, age 67,smoker. On leave from employer from Aug 2015 thru December. On Mcare A. Employer has 20+

    Continued on group plan through 12/31 as a FT employee even though she did not receive a paycheck while on leave.

    Woman first contacted me before turning 65, so this has been going on for a while. Fired her a couple of times but like a bad penny she comes back.

    Rather than taking COBRA for 1/1/16 she added Part B, D and a Medigap. She has ulcerative colitis and other issues. Rx expensive when she has flare ups.

    Today she said she thinks she can return to work early March and get back on the group plan. Group will only be $80/mo.

    I covered all her alternatives last year and told her to pick COBRA OR Medicare but not both.

    She wants to keep A & B + the supplement plan. Group has $2600 deductible and no copay's. Wants to know if Mcare and supp will cover what group plan doesn't because of deductibles and coinsurance.

    No, they won't.

    Mcare probably will pay $0. Not even sure you can keep the Medigap if Mcare isn't primary, but probably not. If you drop your supp you probably won't be able to get another. Even if you can it won't be at the current price.

    All this was discussed many times and followed up via email.

    I feel like an accountant whose client comes to them and says "This is what I did. Can you fix it?"

    Think I need to fire her for good.
     
    somarco, Jan 14, 2016
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  2. G.Gordon
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    G.Gordon Guru

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    She either goes on group and keeps A or stays off group keeping A/B and the supplement. Not both. If she messes it up, fire her.

    There is nothing saying she can't keep A/B and the supplement, but she is wasting B premiums and also the supplement premiums. You don't need that kind of stupid on your books.
     
    G.Gordon, Jan 14, 2016
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  3. TDFnCali
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    TDFnCali Guru

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    Per your title.... I'm going to stop u, cause I've never heard this before.

    Only been doing Medicare 17mos, but there was no qualifier, so STOP, lol!
     
    TDFnCali, Jan 14, 2016
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  4. sman
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    sman Guru

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    You're a patient man Bob.
     
    sman, Jan 14, 2016
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  5. somarco
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    somarco GA Medicare Expert

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    Up to a point, Scott ..........

    If she goes back on the group plan I am done. Not devoting any more energy to this. Let her talk to Mcare about her options. She does that anyway, plus talking to her friends. Then I have to correct her misinformation.

    I got out of the U65 market because this was less stressful.

    At least it is most of the time.
     
    somarco, Jan 14, 2016
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  6. sman
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    sman Guru

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    Don't you just love those clients who have friends that tell them incorrect information?
     
    sman, Jan 14, 2016
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  7. somarco
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    somarco GA Medicare Expert

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    What bothers me more is when they tell my client/prospect "your agent" doesn't know what he is talking about.
     
    somarco, Jan 14, 2016
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  8. sman
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    sman Guru

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    That's always a nice one.

    I get this one sporadically.

    "My friend has a supplement and it includes Silver Sneaker's. On top of that, they say I'm paying way too much because they don't pay a monthly premium for their supplement"

    So then I get to re-educate them on the difference between a Med Supp and MAPD. I remind them we discussed MAPD's and either their doctors weren't in the networks or they didn't want a plan with networks (just depends on the situation). I go on to tell them that we can get them enrolled in a Medicare Supplement that offers Silver Sneakers and that it will only cost them $80, $90 or $100 more per month. That's when they say their gym membership is only $30 per month. I also let them know if they now want to switch to a MAPD we can do that at the next AEP. Virtually none of them take me up on the offer to switch Med Supps or move to a MAPD.

    Fun stuff!
     
    sman, Jan 14, 2016
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