Why buy a plan "J"

[toc3]

I talked to a med supp lead last night. She has been shopping around and asked me about plan J. I don't have a company that writes plan J in Arkansas. What is the best way to guide her over to Plan F? Before anybody says anything, my plan F is less than the part B deductible difference per yr compared to plan D. Thats why I like Plan F here.
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Also is having preventitive care NOT covered by medicare worth having when buying a supplement. I cannot find a definition of what that actually involves.

 

[patch36]

You have to do the math. Depending on the companies in your zip and state, G, D or C generally beat F. If they don't then Plan F is great. They all beat J in most cases though I have seen J priced low with some companies, but that is probably a teaser rate that will be raised in a year. The lack of coverage for the Part B deductible of $135 is usually more than made up in the lessor expense of the G or D and the Part B excess is hardly ever an issue, but...if it isn't I can't disagree with your logic. It is simply an issue of doing the math. Just my opinion.

 

[Dave020]

I've never understood the value of D and G, but will get to that in a minute.

J offers only two benefits greater than F, at-home recovery and preventative care. However, if you check with your carriers, you may find (as is the case in CA) that the at-home is maxed at $1600 per year and the preventative at $120 per year. It is a bit difficult to justify the extra 20-30 or more per month for J for those little benefits. J was great when it had Rx, once that changed it became the slightly bigger F plan.

I read a lot here about D and G plans and can't understand what I am missing here. F covers all Part B including excess charges at 100% while D & G do not cover those. D has no Part B coverage at all and G does not cover the deductible nor the excess above 80%. Can someone explain to me why that is a good deal?????

 

[GreenSky]

From what I understand, Plan J is going bye-bye shortly, along with a couple of other plans. But for now...

If Plan J is cheaper than F, go with it. There is little difference. The preventative care benefit is really not needed because Medicare covers so many tests anyway, and at-home is almost never used.

Why Plan D/G vs. F? At age 70, it may cost a person $300 a year (or more) to choose F over G. The Part B deductible is $135. That means it costs $165 a year more than the benefit. Even when a doc does not accept assignment (maybe 1-2% of the time), the cost rarely will exceed $165 a year.

I recommend Plan F for T-65 because it is a better deal than D or G. Once they turn 70, I suggest the opposite. It's all math.

Dave, give me a call and I'll go over the figures using companies other than Blue Cross/Shield. I'll learn ya good!

Rick

 

[insurance0707]

They usually want Plan J because they have health issues and when they look at the chart, they see Plan J has the most benefits and must be the best plan or else a Bankers Life agent is pushing the Plan J because not too many carriers offer Plan J, but unfortunately, Bankers Life does and they really seem to push that plan.

Rick, AARP should offer Plan J. When you explain to them that they are only getting 2 additional benefits vs Plan F and when you explain the benefits that they are getting, they usually realize the Plan F is a better option. I've been doing this for close to 20 years and I wrote a ton o f the plan D's. I have never seen the at home recovery benefit used. I think Medicare is eliminating it. Most preventative care is covered by Medicare. If the doctor doesn't code the office visit correctly and puts down physical, then the Plan J might pay the 120 for the physical, but most doctors know to code the preventative care service as "mammogram", PSA test, etc. things that Medicare does approve. They usually won't code it as a physical

 

[GreenSky]

They usually want Plan J because they have health issues and when they look at the chart, they see Plan J has the most benefits and must be the best plan or else a Bankers Life agent is pushing the Plan J because not too many carriers offer Plan J, but unfortunately, Bankers Life does and they really seem to push that plan.

Rick, AARP should offer Plan J. When you explain to them that they are only getting 2 additional benefits vs Plan F and when you explain the benefits that they are getting, they usually realize the Plan F is a better option. I've been doing this for close to 20 years and I wrote a ton o f the plan D's. I have never seen the at home recovery benefit used. I think Medicare is eliminating it. Most preventative care is covered by Medicare. If the doctor doesn't code the office visit correctly and puts down physical, then the Plan J might pay the 120 for the physical, but most doctors know to code the preventative care service as "mammogram", PSA test, etc. things that Medicare does approve. They usually won't code it as a physical

Exactly! Brilliant minds think alike.

Rick

 

[Frank Stastny]

Rick and Patch are spot on.

Virtually all doctors in Missouri accept assignment. I recommend Plan D 100% of the time. Even if Plan J was a couple of dollars cheaper I would still recommend a Plan D. It has the best "history" of all the plans in Missouri.

J's rates are going to soar in a year or two and probably going to go away totally. The "preventative care" benefit is smoke and mirrors. I have never had one client go in for a "check up" and been told that Medicare denied the claim.

Regarding the "preventative care" benefit. As of 2008 it is pretty much of a mute issue. Medicare has initiated a new program to not only enable doctors to make more money but to insure that his/her patients with specific health problems are constantly being monitored on a regular basis. The list of covered conditions is huge.

It was part of the Tax Relief and Health Care Act of 2006 (TRHCA) that was signed by the President on Dec 20, 2006. The part of the act that provides incentives for doctors who comply is called the "Physicians Quality Reporting Initiative" (PQRI) It was enacted Dec 29, 2007.

If the physician will follow the routine checks and tests in the new Medicare directive the doctor will receive an extra 1.5% of their total allowed charges for that patient for covered Medicare Physician Fee schedule services.

If the doctor also e-prescribes the medication they will receive an additional 1%.

Right now this is voluntary for the doctors, they don't have to follow the guide lines but they will not receive the extra 1.5%. In the near future, around 2010, it is going to be mandatory for the doctor to comply with Medicare's directive or the doctors will not receive any payment when treating patients who have any of the lengthy list of illnesses listed.

In my opinion this is a huge reason why Med Supps are still the best option for my clients. Some doctors are beginning to shy away from Medicare patients because they don't feel they receiving enough income when treating them.

I believe that it is doubtful that any of the MA plans are either going to approve the additional testing and visits or give the doctors the additional increased payments. When doctors treat patients with traditional Medicare they will make a total of 2.5% more on claims filed with Medicare.

Medicare is giving them the "green light" to see their patients more often and to order additional tests and specific examinations for patients with those related health problems.

 

[The Rabbi]

In Floriduh, AARP plan J is over $1 LESS than F.

Should I not offer it?

 

[insurance0707]

If Plan J is a buck less than Plan F offer them it....it's usually the other way around, Plan J is more expensive than Plan F and it's not worth the extra cost. Plan J being less then Plan F tells you how much those extra benefits get used.

 

[Frank Stastny]

In Floriduh, AARP plan J is over $1 LESS than F.

Should I not offer it?

I have been told that, like Missouri, the vast majority of doctors in "Floriduh" <grin> Accept Assignment. If that is incorrect I would appreciate that information.

If as in Missouri "all" doctors Accept Assignment then there is no logical reason to put clients with either a J or an F.

That being said and with the information posted in the posts above if I were selling Med Supps in Florida I would do the exact same thing I do in Missouri. Sell Plan D.

Plan F is traditionally the one that gets the highest increases. Plan J is going to get very healthy, no pun intended, increases. Plan D has been one of the most stable Med Supps at least in Missouri.

I refuse to "chase my clients" each year when a new company blows into Missouri with slightly cheaper rates. In the fifteen years I have been selling Med Supps I have not seen one of those "new kids on the block" be competitive after about three years.

United World barged into Missouri a couple of years ago with cheap rates. Now we have United of Omaha because United World got too high.

I explain this to my clients and for the most part they understand and agree with my recommendations. It is only because I recommend and sell Plan D that I have been able to do this. At least that is what I think, right or wrong. It's working so far.
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They usually want Plan J because they have health issues and when they look at the chart, they see Plan J has the most benefits and must be the best plan or else a Bankers Life agent is pushing the Plan J because not too many carriers offer Plan J, but unfortunately, Bankers Life does and they really seem to push that plan.

This is exactly why seniors need to consult with a knowledgeable Med Supp agent before making a decision.

I've talked to you, you are very good at what you do. Explain what we are talking about to your prospects using logic and factual information and you can blow Bankers agents out of their kitchen.

I do it all the time especially with someone who has a Plan F. (I'm talking about selling in Missouri.) If my prospect has a Plan F I know that 90% of the time or better I am going to walk out the door with a signed app and a check. In most cases they have saved a lot of money and I have made a couple of bucks.

In my experience and in Missouri Bankers agents use scare tactics and play on the prospects emotions. Use logic and facts and you will make them look like commission hungry fools.

Selling Med Supps can get kind of boring especially after the second appointment of the day. Making agents, in Missouri, who sell Plan F look like crooks sure helps make the day more interesting.

Don't you guys in other states where Plan F is a great deal jump all over me. If F is the best then sell it, it isn't in Missouri.