Turning 65 seniors increasingly favor lower-cost Medigap options

[sshafran]

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?

Travis mentioned this as well but when you factor in the Medicare re-pricing and 80%, it's really not bad at all. Sometimes lower than the MAPD copay.

I'm comfortable enough with the other options though to simply not advertise it. I don't find it to be "categorically better" because I put a lot of weight on Rx cost. Rx coverage is almost always head and shoulders abover Stand Alone Part D. I've never been successfully refuted on this and I've said it for years. And people on Medicare spend a lot on Rx's...

I think there are probably 25+ "levers" or "weights" within the category of "Healthcare in retirement."

Access to care matters. But some weigh it more than others.

Cost matters. Dental matters. This month I helped a T65 who lost a tooth get a MAPD plan with $2,000 towards dental - implants included, no Pre-ex exclusions. Had I just talked about access to care... she would have missed out of help needed today.

And I'm not concerned, at all, that I've somehow messed up her entire future on Medicare because she didn't pick a med supp.

If one day she does have access to care issues, or high out of pocket, I won't lose sleep. She's paid $0 monthly... had better insurance than my family has, utilized many benefits with great success, and is still protected with a very reasonable max OOP. All good!

 

[Cornelius]

Why is it no one ever came up with enroll in Medicare Advantage and save the difference?

 

[kgmom219]

Sigh. Its not about the plan you buy at age 65. Its about the plan you want at age 90. Same reason I rarely sell Plan N. Or MAPD.

"My grandmother at age 90 had the money to pay the $20 copays. What she didn't have the physical or cognitive ability to do so"

 

[kgmom219]

Travis mentioned this as well but when you factor in the Medicare re-pricing and 80%, it's really not bad at all. Sometimes lower than the MAPD copay.

I'm comfortable enough with the other options though to simply not advertise it. I don't find it to be "categorically better" because I put a lot of weight on Rx cost. Rx coverage is almost always head and shoulders abover Stand Alone Part D. I've never been successfully refuted on this and I've said it for years. And people on Medicare spend a lot on Rx's...

I think there are probably 25+ "levers" or "weights" within the category of "Healthcare in retirement."

Access to care matters. But some weigh it more than others.

Cost matters. Dental matters. This month I helped a T65 who lost a tooth get a MAPD plan with $2,000 towards dental - implants included, no Pre-ex exclusions. Had I just talked about access to care... she would have missed out of help needed today.

And I'm not concerned, at all, that I've somehow messed up her entire future on Medicare because she didn't pick a med supp.

If one day she does have access to care issues, or high out of pocket, I won't lose sleep. She's paid $0 monthly... had better insurance than my family has, utilized many benefits with great success, and is still protected with a very reasonable max OOP. All good!

It all matters. Its our job to present the options. Not to make the decision.

But I love the "I'm not going to lose sleep over it" because I feel the same way. You can have the MAPD or Plan N or Plan G. But you aren't going to yell at me later. Ever.

 

[somarco]

Why is it no one ever came up with enroll in Medicare Advantage and save the difference?

Possibly because it works just as well as buy term and invest the difference . . . which usually translates into buy term and SPEND the difference

Its our job to present the options. Not to make the decision.

Yup . . .

 

[Travis Price]

Cost matters. Dental matters. This month I helped a T65 who lost a tooth get a MAPD plan with $2,000 towards dental - implants included, no Pre-ex exclusions. Had I just talked about access to care... she would have missed out of help needed today.

I think there's always an argument for MAPD. Again, less than 10% of my bookis hdg. I do think you have to explain access to care and dental is the first thing that gets slashed under cost savings.

All of that being said, if the client understands options and chooses MAPD.. it's not my job to convince them otherwise.

 

[sshafran]

Sigh. Its not about the plan you buy at age 65. Its about the plan you want at age 90. Same reason I rarely sell Plan N. Or MAPD.

"My grandmother at age 90 had the money to pay the $20 copays. What she didn't have the physical or cognitive ability to do so"

And I have no issue with this other than med supp affordability at age 90 if they weren't able to change carriers due to UW issues. It's high, plus a lot of cheddar on premiums for the 25 year ramp up period to get to 90...

Even the bigs (UHC, BCBS) go high after someone is on the books 10+ years. I have a few from circa 2012 who are paying more than double what it started in 2012.

Not sure what they'll be paying in 2037 but I doubt it'll be under $450/mo. My guestimate is $600+ for G for those 2102 T65 @ 90. Some will afford it - some will have to drop it.

If the MAPD trend keeps going strong - do we anticipate higher rate hikes with med supps from 2022-2037 than we saw from 2012-2022? If I were a betting man (I'm not), I'd say yes.

 

[sshafran]

And I have no issue with this other than med supp affordability at age 90 if they weren't able to change carriers due to UW issues. It's high, plus a lot of cheddar on premiums for the 25 year ramp up period to get to 90...

Even the bigs (UHC, BCBS) go high after someone is on the books 10+ years. I have a few from circa 2012 who are paying more than double what it started in 2012.

Not sure what they'll be paying in 2037 but I doubt it'll be under $450/mo. My guestimate is $600+ for G for those 2102 T65 @ 90. Some will afford it - some will have to drop it.

If the MAPD trend keeps going strong - do we anticipate higher rate hikes with med supps from 2022-2037 than we saw from 2012-2022? If I were a betting man (I'm not), I'd say yes.

Meanwhile my 2012 T65s that took Humana Gold Plus HMO are still paying (checks notes) $0.

 

[Travis Price]

Meanwhile my 2012 T65s that took Humana Gold Plus HMO are still paying (checks notes) $0.

In premium. JS. There's more to healthcare expenses than just insurance premium. YMMV

 

[somarco]

Not sure what they'll be paying in 2037 but I doubt it'll be under $450/mo. My guestimate is $600+ for G for those 2102 T65 @ 90.

How much do you suppose those 90 year old's will be paying OOP for healthcare?

Bill Clinton (not a fan, just using his campaign pitch) used "It's the economy, stupid" as a reminder to him, and prospective voters, to drive home the fact that all the other things talked about to sway voters really don't matter when you don't have a job, and can't pay your bills.

Healthcare is the same.

Paying a $0 premium is meaningless when your medical bills are running in the hundreds or thousands per month . . . and that is only for in-network approved claims . . .

So . . . it's not JUST the premium, stupid . . . it's your total OOP that really matters (plus access to care).