Turning 65 seniors increasingly favor lower-cost Medigap options

[Insurance Forums Staff]

Insurance Forums Staff submitted a new article

Turning 65 seniors increasingly favor lower-cost Medigap options

AAMSI’s Jesse Slome finds two reasons why he expects the trend to continue in examining coverage choices through the first six months of 2022.

Continue reading the Original Article.

 

[Travis Price]

Who would have thunk it? I've been telling MAPD agents this for over a year. HDG gives the savings of MAPD with the claims processing and freedom of OM.

You don't get paid as much, but it's still a great plan.

 

[Midlevel]

I have to come out of retirement for this one. How in the world can anyone think they are better off paying premiums for a HDG and then paying $2490 deductible for a total of around $3000/year vs. paying $0 for a MAPD and adding dental, vision, gym, hearing aids, OTC, meals, transportation, etc worth at least a couple thousand and have a max oop of $3500?

Spare me the rhetoric of having Drs not in network, having trouble getting tests approved, etc. That hasn't been an issue in my area for several years. But what if I get cancer? Then you max out the $3500 and you are still ahead of the game. You could literally do that every year and still come out ahead.

I suppose the clients that are being talked into this HDG are the ones that have lived paycheck to paycheck and made dumb financial decisions all their life so they are told this is the safest way to go. Anyone turning 65 and coming off a group plan or Obamacare surely can see which way they would be better off if both options were explained to them.

At some point common sense has to take over. OK, back to retirement.

 

[sshafran]

Yeah, still not going to actively sell it.

A long time ago a seasoned agent gave me a "mantra."

Help people. Truly seek to do that with your work. But you must have an objective to help at a profit.

A huge book of HDGs ... I'd rather go sell siding.

 

[Travis Price]

Spare me the rhetoric of having Drs not in network, having trouble getting tests approved, etc. That hasn't been an issue in my area for several years. But what if I get cancer? Then you max out the $3500 and you are still ahead of the game. You could literally do that every year and still come out ahead.

Independent studies from OIG prove differently. I'm quite sure clients aren't calling you when doctors get denied claims.. why? Because only 1% of denials are appealed.

I'm assuming you're selling a HMO, which further restricts access to providers. But please, pretend it doesn't.

All those extras you talk about are not Medicare approved services, and the company can remove them at any time. MooP? Can change annually. Ask UHC and Silver Sneakers, or when companies change from a dental plan to a lump sum which is usually bleh.

As I'm certified to offer both, it's always what's best for the client. Sometimes MAPD is great. Sometimes HDG is the better route. However, your argument that it NEVER is literally proves that you're not offering both options.

When your present the two OBJECTIVELY they almost always see that HDG is the better plan.

What's silly to me is your argument is that "if both options were presented." It's moronic. We have a financial incentive to offer MAPD over HDG. 700+ vs 100+ pdp.

HDG is superior MEDICAL coverage to every MAPD on the market, period. All that other noise is TBD annually. Either people want stability and are willing to pay for it or don't want to pay for it and get MAPD.

PUSHING MAPD, like you do, shows how you're not "presenting both options." It's fine if you're not, just be honest about it.

A huge book of HDGs ... I'd rather go sell siding

I agree. I don't sell it on a consistent basis. I think less than 10% of my book is HDG. It's usually when someone is crying poor, but has a really chronic condition that likely needs better medical.

 

[somarco]

I end up writing maybe half a dozen HDG's per year . . . last year I wrote 9.

G is still my go to. When someone balks at the premium (rarely), sometimes they will ask about N . . . T65 N vs G premium (looking at established carrier) saves about $15 or less.

If they still want a lower premium I show HDG. Premium catches their eye (about $60/mo savings) but the $2500 deductible is a concern. "So, I gather the MA plans with $6700 OOP is not appealing?".

They usually end up with the G plan and everyone is happy.

 

[Midlevel]

Independent studies from OIG prove differently. I'm quite sure clients aren't calling you when doctors get denied claims.. why? Because only 1% of denials are appealed.

I'm assuming you're selling a HMO, which further restricts access to providers. But please, pretend it doesn't.

All those extras you talk about are not Medicare approved services, and the company can remove them at any time. MooP? Can change annually. Ask UHC and Silver Sneakers, or when companies change from a dental plan to a lump sum which is usually bleh.

As I'm certified to offer both, it's always what's best for the client. Sometimes MAPD is great. Sometimes HDG is the better route. However, your argument that it NEVER is literally proves that you're not offering both options.

When your present the two OBJECTIVELY they almost always see that HDG is the better plan.

What's silly to me is your argument is that "if both options were presented." It's moronic. We have a financial incentive to offer MAPD over HDG. 700+ vs 100+ pdp.

HDG is superior MEDICAL coverage to every MAPD on the market, period. All that other noise is TBD annually. Either people want stability and are willing to pay for it or don't want to pay for it and get MAPD.

PUSHING MAPD, like you do, shows how you're not "presenting both options." It's fine if you're not, just be honest about it.



I agree. I don't sell it on a consistent basis. I think less than 10% of my book is HDG. It's usually when someone is crying poor, but has a really chronic condition that likely needs better medical.

I have never sold an HMO, I show Plan G as an option along with MAPD and Medica Cost Plan but I can’t imagine anyone wanting that high deductible even if the premium is a little less. How can you say HDG is superior medical coverage when they are paying all that out of their pocket vs having very little copays on Drs and 300.00 for outpatient surgery etc on an MAPD? Not looking at getting Into an argument again but this one really threw me for a loop that anyone with even a little common sense would choose the HDG.

 

[Midlevel]

I end up writing maybe half a dozen HDG's per year . . . last year I wrote 9.

G is still my go to. When someone balks at the premium (rarely), sometimes they will ask about N . . . T65 N vs G premium (looking at established carrier) saves about $15 or less.

If they still want a lower premium I show HDG. Premium catches their eye (about $60/mo savings) but the $2500 deductible is a concern. "So, I gather the MA plans with $6700 OOP is not appealing?".

They usually end up with the G plan and everyone is happy.

I agree the G plan is a great option for some people. I just can’t see why anyone would go on a HDG. I would put them on an N plan if price was a concern and they did not want a MAPD. I would worry about Med Sup clients getting picked off if you didn’t present all their options including MAPD. In most area now many are leaning towards MA plans and each year the % gets higher and higher towards MA. Looking at 2023 plans they are even more attractive then they were this year.

 

[Travis Price]

I have never sold an HMO, I show Plan G as an option along with MAPD and Medica Cost Plan but I can’t imagine anyone wanting that high deductible even if the premium is a little less. How can you say HDG is superior medical coverage when they are paying all that out of their pocket vs having very little copays on Drs and 300.00 for outpatient surgery etc on an MAPD? Not looking at getting Into an argument again but this one really threw me for a loop that anyone with even a little common sense would choose the HDG.

Premium isn't "a little less." It's about a third to a quarter of Plan G.

I can't say for your area, but there is no PPO in my area with a 3500$ MooP. Those are HMOs, if anything and are usually 4600+.

Choice matters to people. You literally made my point. "I offer Plan G or MAPD."

I'm not sure you understand how HDG works.

Medicare STILL pays its portion after the Part B deductible. The 20% is actuarially the same as most PPO costs for doctors visits and the hospital stays (without HI) are cheaper, usually... obvs depends on the plan.

Furthermore, while you may not need a referral to see specialists, you still need prior authorizations that can and are denied for other services.

Managed care is managed care.

I'm sorry that you don't understand how Medicare works vs how private insurance works.

 

[Midlevel]

Premium isn't "a little less." It's about a third to a quarter of Plan G.

I can't say for your area, but there is no PPO in my area with a 3500$ MooP. Those are HMOs, if anything and are usually 4600+.

Choice matters to people. You literally made my point. "I offer Plan G or MAPD."

I'm not sure you understand how HDG works.

Medicare STILL pays its portion after the Part B deductible. The 20% is actuarially the same as most PPO costs for doctors visits and the hospital stays (without HI) are cheaper, usually... obvs depends on the plan.

Furthermore, while you may not need a referral to see specialists, you still need prior authorizations that can and are denied for other services.

Managed care is managed care.

I'm sorry that you don't understand how Medicare works vs how private insurance works.

To each their own. If I ever run into a HDG there is no doubt they will be switching to a MAPD after I show it to them. Obviously plans are a lot better in my area then wherever you are. Read a few other posts and it has really gotten boring since I quit posting, just moved onto everyone wanting to move out of the U.S. I guess when you just have a few people who only believe in Med Sups there isn’t much to discuss on the forums. Anyone, I’m back out. Good luck to everyone this AEP.