- 1,255
Now that the former Senate Majority Leader Tom Daschle has been named to lead the non-partisan CMS we can all rest assured that things will be taken care of!
Bloomberg.com: Science
Bloomberg.com: Science
Last edited:
The Future "O" Medicare Advantage Program
- Thread starter MedSuppPro
- Start date
-
- Tags
- medicare
- 1,908
It's a shame if the Medicare Advantage style of coverage goes away. Those that can't afford $150 - 200 a month for coverage, and who don't mind a pay-as-you-go system, will have no alternative.
Just as I believe that Public, Private, and Home schooling all has it's place, I believe that having more than one option (Med Supps) for Medicare Beneficiaries would spark healthy competition.
My Medicare Book of Business is 60/40. 60% have Medicare Supplement Plans, and the other 40% have mostly HMO or PPO versions of the Medicare Advantage Plans. A few have PFFS.
Just as I believe that Public, Private, and Home schooling all has it's place, I believe that having more than one option (Med Supps) for Medicare Beneficiaries would spark healthy competition.
My Medicare Book of Business is 60/40. 60% have Medicare Supplement Plans, and the other 40% have mostly HMO or PPO versions of the Medicare Advantage Plans. A few have PFFS.
MA plans are great if you don't have to go in the hospital or receive skilled nursing care. If you do they can be as costly, if not more, then med-supps.
The MA plans in my area have MOOP under 3k, and there is only one hospital co-pay with no limit on days. Someone who is seriously ill and needs to stay in the hospital longer would be better off with an MA plan. With a med sup they're screwed after they use their reserve days.....
I have been writing supplements for 21 years. I've had one person go into their reserve days.
What do you mean by "only one hospital co-pay"? Only one day or for how many days are you referring to?
Yes...plans(MA), in my area have MOOP under 3K, but annual cost for med-supps are under 3K too, plus you can choose any hospital or doctor.
I'm not saying MA plans have no market(if you're healthy and only require a few dr. visits a year their a great alternative), but how many seniors are?
- 19,647
What MA plan is that. I've never seen one with only one hospital copay. Did you mean only one copay during the 60 day window?
- 1,070
The plans are different in every state. www.medicare.gov is a great resource center for an agent.
There are plans that offer a single admittance fee (Humana PPO maybe) for the hospital.
In Florida, I write mostly MA plans. Very few sups. We are lucky to have AARP/Secure Horizons PPO here. It saves a lot of money over a sup and D and will do the job just fine.
There are plans that offer a single admittance fee (Humana PPO maybe) for the hospital.
In Florida, I write mostly MA plans. Very few sups. We are lucky to have AARP/Secure Horizons PPO here. It saves a lot of money over a sup and D and will do the job just fine.
- 307
I've been wrong before, but I think you will see a middle-of-the-road compromise when it comes to evaluating the spending and continuation of these plans. I do not think you will see them go away. We may even see them expanded if Senator Max Baucus proposal Health Beat: Max Baucus’ White Paper on Reform: Courage, Honesty, Facts…It Will Take “At Least Three Years†(Part I) or something similar is adopted.
The sad reality is our government has to do something to revise our health care system. Insurance companies do not really want the risk of the disabled or the age 50-64 population without government backup. They prove this point when we as insurance agents have to offer Individual Major Medical policies from $4-800/month per person for this age group and if it is issued, slimmed down by riders for everything pre-existing. These persons are now not really great prospects for insurance agents now; they are usually unacceptable or the client cannot normally afford our offerings.
We age like an old car with parts breaking down the older we get. Seems everyone thinks the system is fine and we need no intervention; until it hits home and affects them, their relatives or friends. Then the question is why has our government not previously done something to plug this gaping hole?
I feel there are plenty of good reasons these plans cost 13-19% more than Original Medicare. Simply look at the underwriting; one remote question. It opens the doors for more people to access the medical system and receive care where previously the 20% and no-limit out-of-pocket would not be affordable to get needed treatment. And, yes they are more open to over-usage and abuse than Original Medicare.
These Medicare Advantage Plans can be god-sends for the underage disabled, older elderly that cannot afford to keep spending $2-300/month for a medicare supplement, those who do not qualify for a supplement because of health issues, and those that cannot qualify to get out of an aging block of business with sky-rocketing premiums.
I think you will see the new administration more micro-managing the program, but I do not really see doom and gloom for our industry. I did not pay attention but I was old enough to when Original Medicare was established in 1965, and without it now where would we be now in dealing with elderly and disabled health care? Doom and Gloom was predicted, but it really expanded the insurance company's role in a previously untouchable segment of the population. I think we will probably see the same in the coming revisions.
- Thread starter
- #9
- 1,255
Ike and Johnson The History of Medicare
Last edited by a moderator:
- 7,066
I'm not quite sure where you sell Medicare Supplement policies or who you are contracted with but I live in Missouri and I don't know of any company that is charging $200 to $300 per month for Med Supps. I wrote a policy today for a woman 65, non smoker for $95.03 per month. Her husband is also turning 65 and his premium is $109.32 per month. Both took a Plan D, that gives them all the coverage they need since virtually all doctors in Missouri "Accept Assignment". BTW, my commission on those is 23%.
I have suggested to several people who have called me and asked about MA plans that they take a close look at just having Medicare Parts A and B. Actually that is very good coverage for someone who says they can't afford a Med Supp.
MA plans have a MOOP of usually between $2500 and $3000 don't they? With only just traditional Medicare that amount of money will pay a lot visits to the doctor considering the patient will only have to pay 20% of what Medicare approves.
I have heard numerous agents say that the reason they put their client in a MA/PFFS plan is "because they are healthy". They also stated that if their client "wasn't healthy" they would have recommended a Med Supp.
That makes no sense to me. If they are "healthy", and that is the real reason for putting them in an MA plan then why take them away from traditional Medicare? I think I know why but I may be wrong.
Similar threads
