T65 Early Enrollment Limits, Not Drawing SS Income

[kgmom219]

According to the following article, approximately 96% of physicians accept Medicare Assignment.

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services | The Henry J. Kaiser Family Foundation

So I'd say the odds of incurring Part B excess charges are small. A person can also look up their doctors (or the agent can do it for them) on the Medicare website and see if the doctor accepts assignment or not.

You're my hero.

I pitched N today, got into this discussion and he wanted "proof" it less than 5% of docs nationwide and finding something like this was on my to-do list.

 

[WCMason]

You're my hero. I pitched N today, got into this discussion and he wanted "proof" it less than 5% of docs nationwide and finding something like this was on my to-do list.

No respect for any agent who scares anyone out of Plan N due to "excess charges." Plan N is a great plan and should be a part of any pitch. I led with N until Aetna cut G premium, making premium difference btw G and N about ten bucks. Still like N, will crush any agent who tries to justify F for $40-50 more per month.

 

[sman]

You're my hero. I pitched N today, got into this discussion and he wanted "proof" it less than 5% of docs nationwide and finding something like this was on my to-do list.

All in a day's work. The excess charges shouldn't be a selling point unless the client uses providers who don't accept assignment. And in reality, they are a pittance for routine doctor visits. They amount to 9.25% of the original Medicare approved amount.

 

[sshafran]

Late to the party, but I've done lots of apps from 10/1 - 10/15 for Jan T65 over the years.

So far no issues. I can see the reasoning for waiting, but it's such a busy time anyway that it's nice to get them done.

It would be great to get a fairly comprehensive list of carriers who accept open enrollment apps 6 months out. Maybe I'll work on one...

 

[yorkriver1]

Carriers may accept the app 6 months out, but don't they need the Medicare # on the app?

The idea of starting Medicare app online mid-month in Sept sounds good. I am tracking the results of my colleague who applied 3 3/4 months ahead for August 1 Medicare eligibility.

Will keep in touch to reinforce what we are doing. Fortunately, this was a strong referral from his financial advisor. I didn't give actual pricing, just very ballpark as increases from carriers may happen in between, new PDP rates 10/1. Value is the driver here, as stated by client, not price. Vastly lower than the retiree plan, just wants great coverage.

We will also be writing the early 60's spouse on IFP, coming off the employer retiree plan they were both on. That's another situation. Will have time to see about networks. Fewer PPO's around on individual.

 

[goillini52]

Late to the party, but I've done lots of apps from 10/1 - 10/15 for Jan T65 over the years.

So far no issues. I can see the reasoning for waiting, but it's such a busy time anyway that it's nice to get them done.

It would be great to get a fairly comprehensive list of carriers who accept open enrollment apps 6 months out. Maybe I'll work on one...

Aetna, CSI Life, Companion Life, Equitable, Heartland National, IAC, Manhattan Life, Oxford Life, Sentinel Security Life and Standard Life & Accident.

There's a start. All of these carriers will issue at age 64 1/2.

 

[Longtimeagent]

According to the following article, approximately 96% of physicians accept Medicare Assignment. http://kff.org/medicare/issue-brief/paying-a-visit-to-the-doctor-current-financial-protections-for-medicare-patients-when-receiving-physician-services/ So I'd say the odds of incurring Part B excess charges are small. A person can also look up their doctors (or the agent can do it for them) on the Medicare website and see if the doctor accepts assignment or not.

All very good and valid points. I know how the %'s work with Medicare docs. The problem is that it is unknown how it will grow in the future (the 4%). I know several docs in the area i am in that won't accept assigned charges. They bill the 15%. I can't justify saving someone 20$/mth and then them having a $20/$50 office/er co pay and the 15%.
I would rather pay the 5-10$ more and then know I'm 100% covered (outside of 147$).


To each his own though.

I used to sell that AARP garbage too when it was GI. It really helped when I sold it to my gpa who was paying 375$ for Prudential med supp....180 wasn't so bad ?

 

[kgmom219]

All in a day's work. The excess charges shouldn't be a selling point unless the client uses providers who don't accept assignment. And in reality, they are a pittance for routine doctor visits. They amount to 9.25% of the original Medicare approved amount.

I agree. But I do tell them upfront, just in case. I hate calls that start with "you didn't tell me....."

The guy was a jerk. He wound up on G anyway.

 

[sman]

I agree. But I do tell them upfront, just in case. I hate calls that start with "you didn't tell me....." The guy was a jerk. He wound up on G anyway.

I agree. Plan G is my first option. I typically explain Plan F and then tell them Plan G is identical in every way with the exception of the Part B deductible. Once they understand the math it's a no brainer.

The bigger challenge comes when moving someone from F to G. Not so much in moving them, but in getting the phone call in January or February of the following year with them confused as to why they owe the doctor money. I simply explain the difference again and show the cost savings and they remember why we did it.

I'm just not one of those guys who uses the scare tactic of excess charges to make someone afraid to go with Plan N. In fact, if N is what they are leaning toward I will get a list of their doctors and look them up on Medicare to make sure they accept assignment.

 

[G.Gordon]

All very good and valid points. I know how the %'s work with Medicare docs. The problem is that it is unknown how it will grow in the future (the 4%). I know several docs in the area i am in that won't accept assigned charges. They bill the 15%. I can't justify saving someone 20$/mth and then them having a $20/$50 office/er co pay and the 15%.
I would rather pay the 5-10$ more and then know I'm 100% covered (outside of 147$).


To each his own though.

I used to sell that AARP garbage too when it was GI. It really helped when I sold it to my gpa who was paying 375$ for Prudential med supp....180 wasn't so bad ?

A. ER copay would be tied to a hospital and there are zero of those with ER's that don't take assignment.

B. A $20 copay for a dov plus the 9.25% extra still wouldn't amount to much. Say the doctor's office fee is $200 and Medicare approved $120. We're talking about the extremely rare chance that they might pay $11.10 or a grand total of $31.10 for that doctor's office visit.


I put the money where the value lies. If excess charges is even an conversation it is due to another agent trying to be a weasel. I show them company after company that have less than $2/month difference in plans with excess verses plans that don't.

AARP C verses F is $2/month currently. If it were a real risk for the client don't you think the insurance companies would see it as a risk and assign a premium reflecting that is a real risk?

No compare AARP C verses N. $49/month. The part B deductible and copays represent a greater risk to the company if you take the view that premium assignment = risk.

So, the largest Medicare supplement carrier in the USA says clearly in their premiums that excess charges is a $24/year risk.

At the same time that same carrier says that not having to pay the part B deductible and having relief by the client paying the $20 dov and $50 ER is worth $588/year.

Money talks when you have the actuarial science of the largest company to help make sense of it.