Why arent high deductible medigap plans more popular?

[LostDollar]

I pay $115/month for plan G
add the $240 ded or $20/month
and
$165 medicare part B premium monthly
so about $300 per month before we add the
PDP
seniors don't want to add yet another deductible-I've had ZERO clients ask for a high deductible plan in the 19 years I have sold medicare plans

Caveat, not an agent.

If you intend that to mean ALL seniors, you have made a false statement.

not following-
yes, I am an agent-19 years selling medicare plans
second-none of MY clients want to pay deductibles-good grief the feedback I get from the cost of their drugs is enough

Caveat, not an agent.

"seniors don't want to add yet another deductible". This is a generic statement which is incorrect.

I am a senior non-agent consumer. I have an HD Medigap plan. From reading posts on the site over a period of several years, I know of two agents who have HD Medigap plans.

From reading posts on the site over a period of years I know a number of agents have sold a few HD F and G plans.

From reading posts on the site over a period of years, I know that some of those sales have come from consumers specifically requesting HD Medigap coverage from the agent. From reading posts on the site over a period of years I know that some Plan N and some HD F&G sales have been a compromise between F and G or going to an MAPD.

People bring their differences as people and their differences in finances to the process of buying Medicare health coverage. Some WILL find the HD Medigap plan to be a valid solution for their situation.

 

[LostDollar]

Lasso was the only MSA I was aware of, and they went bye bye.

I found a 2019 article by Phillip Moeller talking about the Lasso plan. He said there were 2 other MSA's in Wisconsin and 1 in New York at that time.

I found a post on q1Medicare that said the only MSA in 2024 is 1 in Wisconsin. The q1Medicare post also mentioned 1 in Vermont in 2022.

So there have been a few others around, but Lasso was the carrier trying to make the MSA more of a mainstream product.

 

[LostDollar]

MSA plans have an account associated with them that is funded right from the start and the money can be used to cover health related expenses. It is prorated the first year, based on when you start, but if you start in January, it's $3K. If you don't use it, it rolls over to the next year, just like an HSA.

If you have an HSA when you begin Medicare, and were in reasonably good health, you would conceivably never have any out of pocket expense. If I were Medicare age and an MSA was available in my area, I wouldn't hesitate to join one.

You may want to read the SOB for an MSA Plan. If you choose the lower deductible plan, your Max oop is limited to the deductible $5k - $2K that is deposited into your account. So, $3K max out of pocket is not going to kill two years of hsa savings. They are making this deposit annually. Additionally, MSA funds can be used for Rx. This imeo is absolutely better than paying for a HD G plan.

I didn't say it was for "everybody", but there are a lot of people that could really benefit from these plans, if they understood them. It's not a real winner for most agents to market them, because you have to have a "reasonably intelligent" audience, and of course, that's not most people.

I lost track of how long Lasso had been selling MSA's.

I first looked at the Lasso plan for 2019. I don't know for sure without doing a lot of checking, but I think my HDF premiums have fluctuated in the $55 to $60 per month range from then to now. I am going use a round number of $700 for my annual HDF premium.

At one point, an agent had discussed a Kansas issue age plan G with me. Now, I don't know what the premium was for that plan in 2019. In 2021, in round numbers, it was $2300 per year.

I was getting my most expensive medication through Canadian pharmacies or ProgressiveRX, so "being able to use MSA funds for medications" was of limited value to me.

in 2019, The net maximum member responsibility under a Lasso plan was $5180. The HDF plan cost me $700 and had a deductible of $2300.

In 2020, that number was $5160. The HDF plan cost me $700 and had a deductible of 2340.

Given those two numbers, In 2021, the second year I looked at a Lasso plan, I would likely have chosen the "high" option so my maximum member responsibility would have been $5,000, with a maximum OOP of $8,000 and a contribution of $3000. The HDF plan cost me $700 and had a deductible of $2370.

In 2022 the Lasso would again have had a contribution of $3000, a maximum OOP of $8000 and a net maximum responsibility of $5000. The HDF plan cost me $700 and had a deductible of $2490.

In 2022 I had $20K of Medicare approved expenses. 2 1/2 times the Lasso OOP. And approximately 2 1/2 times the annual MSA contribution. My HDF deductible was only $2490 (approximately half the Lasso maximum member responsibility). HAVING an HSA was not useful, because the AMOUNT OF FUNDS and the PLANNED USE OF THOSE FUNDS were not useful for this situation.

Jim Handlan of Lasso said one should have a plan. I could never come up with a plan for the potential Lasso liabilities. I set up a savings account for the HDF deductible and had the money for the necessary payments in 2022.

Personally, I found staying in the Original Medicare world and using an HDF plan to be a better solution than going to the Medicare Advantage world and taking a Lasso MSA.

 

[dandan]

I sat down with a client last week, he had done all of his homework and knew what he wanted. I usually go over Med Supp coverage first and then Medicare Advantage and answer questions along the way, I don't intentionally sway anyone to either option but try to inform them so they can make an educated decision, as soon as I went over Plan G he pulled out a piece of notebook paper and he said tell me why I would give this money away?

Dental $2000
Eye glasses $250
GYM (his) $660
Fitness Allowance $600
Foreign Travel $250,000
Over the counter and healthy foods $720
$4230.00 not including travel bene

Maximum out of pocket if I max out $5500.

 

[GoPokes]

not following-
yes, I am an agent-19 years selling medicare plans
second-none of MY clients want to pay deductibles-good grief the feedback I get from the cost of their drugs is enough

I still miss the old Silverscript pdp... $30/month and no deductible. Such simpler times

Caveat, not an agent.

"seniors don't want to add yet another deductible". This is a generic statement which is incorrect.

I am a senior non-agent consumer. I have an HD Medigap plan. From reading posts on the site over a period of several years, I know of two agents who have HD Medigap plans.

From reading posts on the site over a period of years I know a number of agents have sold a few HD F and G plans.

From reading posts on the site over a period of years, I know that some of those sales have come from consumers specifically requesting HD Medigap coverage from the agent. From reading posts on the site over a period of years I know that some Plan N and some HD F&G sales have been a compromise between F and G or going to an MAPD.

People bring their differences as people and their differences in finances to the process of buying Medicare health coverage. Some WILL find the HD Medigap plan to be a valid solution for their situation.

He was most certainly speaking in generalities, but I think you might agree that you dont "want" another deductible, however you likely dont mind a "reasonable" deductible. In the line of sales work, a salesmen must eventually realize we dont sell what we want, but rather what the consumer wants.

It's my perception that you are on top of your plan LD, much more than the average consumers. There are still a lot like you, but I dont think it is the majority.

Given a choice, I think consumers would "want" less deductibles, if Plan F was still available to new enrollees, it would likely be well received.

I still have a handful of Plan G members who are billed above and beyond the $240 deductible. They are not supposed to pay these bills, but they do, and some will question it and reach out to me, but usually it's after the fact.

At some point in life, saving money seems to become less appealing. The prospects/clients I talk to in their 90's tend to not get too excited about saving some premiums for a lower cost plan, or more deductibles. However, some people arrive at this outlook earlier.

 

[GoPokes]

I sat down with a client last week, he had done all of his homework and knew what he wanted. I usually go over Med Supp coverage first and then Medicare Advantage and answer questions along the way, I don't intentionally sway anyone to either option but try to inform them so they can make an educated decision, as soon as I went over Plan G he pulled out a piece of notebook paper and he said tell me why I would give this money away?

Dental $2000
Eye glasses $250
GYM (his) $660
Fitness Allowance $600
Foreign Travel $250,000
Over the counter and healthy foods $720
$4230.00 not including travel bene

Maximum out of pocket if I max out $5500.

On the other side of the fence, I spoke with a couple recently who have 2,000 per month income, and both have Plan G. His premium is $400 and hers is $300. Both tobacco, age 83 and 74. He has taken memory meds in the past, and doesnt go to the doctor.

What do you do for someone like that. They scrape by to pay medigap premiums....

 

[Chazm]

I sat down with a client last week, he had done all of his homework and knew what he wanted. I usually go over Med Supp coverage first and then Medicare Advantage and answer questions along the way, I don't intentionally sway anyone to either option but try to inform them so they can make an educated decision, as soon as I went over Plan G he pulled out a piece of notebook paper and he said tell me why I would give this money away?

Dental $2000
Eye glasses $250
GYM (his) $660
Fitness Allowance $600
Foreign Travel $250,000
Over the counter and healthy foods $720
$4230.00 not including travel bene

Maximum out of pocket if I max out $5500.

If someone said that to me I say, simple. Access to care and prior authorizations. Those are two things that my MAPD clients might complain about.
After I explain it and if they still don't care, I say, here's two MAPDs I recommend

 

[dandan]

My business is about 70% med supp and 30% Med Advantage, it seems like most of the aging in are choosing Med Advantage, they are used to co-pays and prior authorizations and networks.

 

[Midlevel]

My business is about 70% med supp and 30% Med Advantage, it seems like most of the aging in are choosing Med Advantage, they are used to co-pays and prior authorizations and networks.

dandandandandandan, you about to get the wrath of Mhaire and the MSO's. Sounds like a made up name for a band but they are actually a real group of MA haters. No way anyone that has been paying deductibles, copays, and has had to follow a network or have a test pre approved would ever want to continue doing that. It's OK for 64.999 years of their life but not a day more.

 

[straightnochaser]

My business is about 70% med supp and 30% Med Advantage, it seems like most of the aging in are choosing Med Advantage, they are used to co-pays and prior authorizations and networks.

My experience too, I recently wrote my ex-partners parents, both very wealthy, both scoffed at the idea of a Plan G (which I recommended due to health issues).