Why are there so many rules to Medicare Advantage??

[InsuranceGuy29]

Is the 29 in your forum name your age? If so, that explains you reasoning. "Most" seniors re not destitute..In fact people 65 and over own 33% of the nation's wealth but they only make up around 15% of the population.. The media always focuses on the poor seniors, but that is not the average senior.. Oh, they all like to poor mouth about being on fixed income but they don't tell you about the money in the market or the income from their pensions.. The average senior can and will afford a med supp if it is explained to them that the MA severely limits their doctor choice and medical care..

I'm older than 29. Just a number. It depends on geography. A zero dollar Medicare Advantage PPO doesn't limit anything, in terms of doctors and hospitals. I simply don't see the reasoning in throwing away $150-$200 per month if you don't have to. Hell, even if I had a ton of money, that wouldn't make sense to me. Granted, it certainly isn't going to be a good fit for everyone, but for many people, it makes perfect sense.

 

[InsuranceGuy29]

Your attitude and viewpoint might change the more you are exposed to the senior market. As I have said before, and will undoubtedly say again, the agents that think the MA vs Medigap is all about money are clueless.

For many it is not a no-brainer to pick an MA plan.

I don't know that the plans are any better than 10 years ago but some of the bad actors pushing those plans are now gone. And that is definitely a good thing.

I don't understand how a maximum-out-pocket of $2700 would put anyone in a bad position -- of course, a good amount of this depends on geography, but in my neck of the woods, it largely makes no sense for most people to go the supplement route. They'll end up throwing damn-near that amount away in premiums, every year, even if they're perfectly healthy.

 

[goillini52]

The plans have gotten better-and-better, every single year.

I couldn't disagree more. I sold MA the first 3 years they were out and the plans were much better then than they are now. I'm on Medicare and it was a no-brainer for me. I got a Med Supp.

 

[rousemark]

I'm older than 29. Just a number. It depends on geography. A zero dollar Medicare Advantage PPO doesn't limit anything, in terms of doctors and hospitals. I simply don't see the reasoning in throwing away $150-$200 per month if you don't have to. Hell, even if I had a ton of money, that wouldn't make sense to me. Granted, it certainly isn't going to be a good fit for everyone, but for many people, it makes perfect sense.

So if I have your PPO MA plan, I am going to pay the same even if I choose a non network (preferred) provider?

 

[goillini52]

I don't understand how a maximum-out-pocket of $2700 would put anyone in a bad position -- of course, a good amount of this depends on geography, but in my neck of the woods, it largely makes no sense for most people to go the supplement route. They'll end up throwing damn-near that amount away in premiums, every year, even if they're perfectly healthy.

How many MA plans do you know of that have $2,700 MOOP's?

 

[goillini52]

So if I have your PPO MA plan, I am going to pay the same even if I choose a non network (preferred) provider?

I don't think he understands what a PPO is.

 

[rousemark]

How many MA plans do you know of that have $2,700 MOOP's?

None .. especially if you use an out of network provider.. Besides even if it is $2700, that is more than most folks are paying for a plan G...

 

[somarco]

they all like to poor mouth about being on fixed income but they don't tell you about the money in the market or the income from their pensions.. The average senior can and will afford a med supp if it is explained to them that the MA severely limits their doctor choice and medical care..

Thomas Stanley's "The Millionaire Next Door" recited several true stories about wealthy people who lived a simple lifestyle.

Truett Cathy, founder of Chick-Fil-A, lived a very humble life and drove an older model car. Yet his worth was estimated at $1.2 billion when he died.

Most of my clients are middle class but I do have a few with a very nice nest egg. One relatively new client sold his medical practice last year for $1.5 million.

Another client is a retired Sr. VP from Axa. He knows how to manage money and 6 years ago bought a Medigap plan for him and his wife. Three years ago she was diagnosed with breast cancer, stage 1.

A few months later I was reviewing his drug coverage and asked how his wife was doing. He told me that she was treated at Sloan Kettering and his only medical bill was the Part B deductible.

He also thanked me for helping them find the coverage and mentioned many of his friends have MA plans. While in NY he discovered that Sloan Kettering had no problem taking their Medicare plan but they don't take any MA plans.

Tom, I believe there are a few MA plans in GA with $4900 OOP but most cap at $6700.

 

[goillini52]

None .. especially if you use an out of network provider.. Besides even if it is $2700, that is more than most folks are paying for a plan G...

There was one around here a few years ago that was $3,400, bot they're all $6-8,00 MOOP. My Plan G runs me $1,285 a year and I don't have a network.

 

[goillini52]

Thomas Stanley's "The Millionaire Next Door" recited several true stories about wealthy people who lived a simple lifestyle.

Truett Cathy, founder of Chick-Fil-A, lived a very humble life and drove an older model car. Yet his worth was estimated at $1.2 billion when he died.

Most of my clients are middle class but I do have a few with a very nice nest egg. One relatively new client sold his medical practice last year for $1.5 million.

Another client is a retired Sr. VP from Axa. He knows how to manage money and 6 years ago bought a Medigap plan for him and his wife. Three years ago she was diagnosed with breast cancer, stage 1.

A few months later I was reviewing his drug coverage and asked how his wife was doing. He told me that she was treated at Sloan Kettering and his only medical bill was the Part B deductible.

He also thanked me for helping them find the coverage and mentioned many of his friends have MA plans. While in NY he discovered that Sloan Kettering had no problem taking their Medicare plan but they don't take any MA plans.

Tom, I believe there are a few MA plans in GA with $4900 OOP but most cap at $6700.

Yeah Bob, but he's from Illinois. I know some states like Florida have some MA plans that aren't bad.