InsuranceKnight
Expert
- 37
Follow along with the video below to see how to install our site as a web app on your home screen.
Note: This feature may not be available in some browsers.
I haven't attended any carrier meetings as I don't sell MAPD or PDP. I'm trying to help our Medigap clients and I came across the above situations a few times. Medicare.gov sometimes produces odd results and was trying to ascertain if that was what was happening here.Winger is correct. They take the higher of the standard 590.00 or the deductible their drug plan has. In this case if the plan has 0.00 deductible they still apply the 590.00 towards 2000.00 max. Then next month they take what is higher, the client’s copay or 25% of the total drug cost. I have 1 client taking 4 expensive drugs for a total of 41000.00/year. He is going to pay around 600.00 total on the BCBS MAPD due to 0.00 deductible and 47.00 copay on all 4 drugs.
You should have learned this in every carrier meeting you attended. It’s been known since beginning of September.
You should broaden your horizons and show clients all their options rather then just one. They would really be amazed how good they come out with no premium, no deductible and 47.00 copay. That being said the full cost of drugs is still way off depending on which plan you are looking at but they will still hit their max well before 2000.00 depending on the plan.I haven't attended any carrier meetings as I don't sell MAPD or PDP. I'm trying to help our Medigap clients and I came across the above situations a few times. Medicare.gov sometimes produces odd results and was trying to ascertain if that was what was happening here.
Does she post her videos somewhere public or are they just for her group?I belong to a group headed up by a pharmacist who really knows her stuff. She has Zoom meetings, makes videos and produces material with "talking points" about TrOOP, M3P and so forth. She shows examples of how a higher premium plan can result in a lower total cost including one recent example where choosing the high premium, $0 deductible satisfied the formula and $600 in copay's allows you to hit the $2k cap.
My eyes just glaze over and I am sure the same will happen with my clients if I ever tried to explain how it happens.
Most of my clients don't really care HOW they can get to their OOP cap, all they really want to know is how much with the plan cost them.
Rather than telling them how to build a watch I just tell them what time it is and let the PDP software do the heavy lifting.
I loved to watch Greg Maddux pitch. Sometime he would be interviewed and asked how he makes the ball move the way it does. I probably heard him say how he does it at least a dozen times but there is no way I could do what he does.
Same principle applies here.
YMMV