What Med Supp Plans Do You Recommend?

[GreenSky]

Knowing what each plan covers doesn't take brain surgery. Anyone with an IQ higher than Luke could figure it out.

Apparently our shill from SMS hasn't a clue.

Rick

 

[Guest]

Frank, you'd know the answer to this, can this lower increase be due to a lower client count on Plan D?

Meaning 10 times the clients are on a Plan F so the risk is increased?

Yes it does, that's another reason I sell Plan D. Three years ago a company had an increase and Plan F went up 25% and Plan D only went up 9%.

 

[raven585]

What everyone here has to realize is that typically, when a T65 decides on a Med Supp, they are thinking about their health. Typically, a person with health issues T65 know they are going to use it, so Plan F they go. As that block increases in this way, so do the rate increases...hence more claims for that block or pool. Plan N should be used for those with less health issues up front. Later increases are lower initially because of fewer claims and later towards the shift in cost towards the policy holder.

I realize that you really cant use this on EVERY case, but its basically a numbers game with this theory.

 

[VolAgent]

Frank, you'd know the answer to this, can this lower increase be due to a lower client count on Plan D?

Meaning 10 times the clients are on a Plan F so the risk is increased?

Negative. Having more policyholders on the same form reduces the risk. Assuming the actuaries did the projections right, a larger pool will better track claims projections. A smaller group is more at risk of deviating from projections. It will bounce around and some years have lower claims and some years higher claims. You really need a higher percentage of reserves to protect a smaller group versus a larger group for this reason.

The only way having fewer people on Plan D versus Plan F would consistently result in lower risk is if everyone in Plan D was in better health.

 

[davidleekline]

"I wouldn't call any plan "under an F" "inferior". Since over 99% of doctors accept assignment Plan D provides a senior with all the benefits they will need and use."

I'm not sure the 99% still holds true. The trend I'm hearing about from some of the carriers---but no proof---is that an increasing number of doctors are no longer accepting assignment--they like the extra 15%. From the client's perspective they may not known about it until after the services are rendered. Drs without patient face-time eg radiologists, anesthesiologists are more likely not to accept assignment and the patient is in no position to shop around.

When this happens the client gets pissed-- they will not remember the conversation about the trade-off between lower premiums and the risk of having to pay the excess cost.

So I sell almost nothing but Plan F except in those situations when someone has found themselves outside a GI period, then Plan N from MOO works for now. ( It is also helpful when someone is on a premium based MA---the original intent for MOO not requiring u/w on Plan N.) I'll may also talk about an MA plan, if someone is accustomed to paying deds, copays and are willing to take the risk associated with the out of pocket. I only sell AARP 's $0 premium plan,

For the carriers I use I do not see enough of a price difference to sell G over F. One Dr visit a year will likely cost you the full ded and the premium difference is usually less than the ded.

Others mentioned they thought F went up at a higher %--I sure for any given year, for any given carrier, you will see other plans going up faster, Plan F is typically were the money is for the carrier. As such increases here represent the best opportunity for revenue growth at the carrier, hence the reason why Plan F tends to go up at a slightly higher rate. But, there are many other considerations like how old is the block of business, is it a closed bloc, is it actuarially creditable.

 

[Frank Stastny]

I'm not sure the 99% still holds true. The trend I'm hearing about from some of the carriers---but no proof---is that an increasing number of doctors are no longer accepting assignment--they like the extra 15%.

I think it is vary unlikely that doctors are going to stop accepting assignment.

Doctors began accepting assignment in the 90's when Medicare made changes regarding doctors who do and do not accept assignment. If a doctor does not accept assignment Medicare reduces the amount they would normally approve by 5%. The doctor can then add 15% to the reduced amount which means the doctor is actually receiving less than 15%.

Medicare also stated that if a doctor accepts assignment Medicare and the insurance company will send the check for the claim directly to the doctor. However, if the doctor still refuses to accept assignment then Medicare and the insurance company send the check to the doctors patient.

Now the doctor has to worry about billing, late pays and no pays. With the small amount the doctor receives by not accepting assignment it is not profitable for doctors not to accept assignment.

 

[davidleekline]

You make a good point. All I can say is the word I hear from my carrier contacts is that the trend is to the contrary. Maybe it is just an Iowa thing since we have one of the lowest Medicare reimbursement levels in the nation drs are "hurting".