Why are there so many rules to Medicare Advantage??

[NewbieNewbie]

I do not do MA so I am somewhat familiar with the rules I am far from an expert. That said the barrier to enter the insurance market is so low and I think that has led to more regulation across all product lines.

Think about it, how many fields where one can make six figures can you get into with

No college degree
A test you can cram for and pass in a week or less
A criminal background. I know a guy with a felony in 2011ish who is licensed

 

[Newby]

And this is why I don't "produce" MA for profit... If one of my clients needs one or a PDP, I'll get them set up on Medicare.gov and sing them up on line...

Stupid test... stupid rules... and way too much regulation...

Yep! I’ve never been the agent on an RX plan. But somehow my clients all know which RX plan to sign up with each year. They can keep their stinkin $25

 

[somarco]

how many fields where one can make six figures

How many (percentage) of agents actually MAKE 6 figures?

I’ve never been the agent on an RX plan. But somehow my clients all know which RX plan to sign up with each year. They can keep their stinkin $25

ROFL.

Same here

 

[NewbieNewbie]

Probably 5 percent but it is sold a that opportunity daily.

 

[somarco]

Probably 5 percent but it is sold a that opportunity daily.

I would say 5% is generous.

Recruiters and sales people can say anything they want but all that matters is what is in the contract.

 

[LostDollar]

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 months of chemotherapy do cancer patients in your neck of the woods usually need?

 

[KavemanKev]

It is not a no brainer to always recommend a Medicare Advantage plan over a medigap Plan. First off, you should allow your clients to make that choice. Second, any time you choose an MA plan you are always limiting your choice of providers. That’s right - even on a ppo. Any out of network doctor can say “I’m sorry but I will not agree to see you with that PPO plan”. As was pointed out also, Mayo Clinic is not par with any ma plans. The only way to guarantee access to Mayo or Sloan-Kettering, etc is to choose a Medigap plan. The best thing to do is keep an open mind and present these facts so your client can make their own decision.

 

[InsuranceGuy29]

It is not a no brainer to always recommend a Medicare Advantage plan over a medigap Plan. First off, you should allow your clients to make that choice. Second, any time you choose an MA plan you are always limiting your choice of providers. That’s right - even on a ppo. Any out of network doctor can say “I’m sorry but I will not agree to see you with that PPO plan”. As was pointed out also, Mayo Clinic is not par with any ma plans. The only way to guarantee access to Mayo or Sloan-Kettering, etc is to choose a Medigap plan. The best thing to do is keep an open mind and present these facts so your client can make their own decision.

At any point, did I say I don't allow my clients to make that choice? I'm not swaying them either way. I give them the facts of both, and they make the decision. All I'm saying is that in my neck of the woods, it makes way more sense for most (not all) people to go to the Medicare Advantage route. All doctors are looked up before-hand (even when I put them on a PPO), and are verified as in-network, or out-of-network. If on a PPO, they can still go to them, but they'll obviously pay a little more. It's not a drastic difference. Obviously, if the doctor doesn't take it, another plan of action would be taken. Also, one carrier here will accept absolutely anyone for a Med Supp. plan G or F. So, if needed, they can be immediately put on that if things got really bad. So, a final time, in my particular geographic area, the MA plans make more sense, in most cases -- not all. Also, finances are huge issue in many parts of my area. There are a ton of people here that simply can't afford it. So, finances also play a big factor. As soon as I tell a lot of people that the supplement will cost money, they shut down. They might not make sense by you, but they do here. It is what it is. I also didn't mean for this thread to devolve into a MA versus supplement plan. They both have their place.

 

[InsuranceGuy29]

I do not do MA so I am somewhat familiar with the rules I am far from an expert. That said the barrier to enter the insurance market is so low and I think that has led to more regulation across all product lines.

Think about it, how many fields where one can make six figures can you get into with

No college degree
A test you can cram for and pass in a week or less
A criminal background. I know a guy with a felony in 2011ish who is licensed

I hear ya, but at the same time, a lot of new agents can't hack it. Either because they aren't smart enough, or they just don't have the resources/support structure. That, in and of itself, is a pretty big barrier. Also, a lot of agents have to come in and cold call, which they hate, and won't do.

 

[InsuranceGuy29]

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

I most definitely do understand what a PPO is. Thanks.