Why Purchase Medsups ???

[russelltw]

SKJ,
I also educate clients on both the pros and cons of each. However it really depends on the clients needs and situation. I recommend meds supps if the client can afford it. MA plans have taken a hit in NC. Just worked with a client who had an MA in FL and moved to NC. She was very disappointed in what her carrier in FL was offering in NC. Very different plan. In rural areas in NC, there are very few MA plans. Most cherry pick the counties they participate in due to re-reimbursement rates. Rates have increased to a point that several MA plans are not worth the few dollars a client saves over a Plan G. That was different a couple years ago.

In my opinion, MA plans have too many moving parts. Networks can change, copays/costays can change, MOOP change, premiums change, etc. every year.

I enjoy reading this to get other opinions. I can see why MAs are so popular in FL. Referrals I pick up from NY, FL, and TX have complained about how poor the coverages are on the MA options here in NC as compared to what they had in their prior state.

 

[vic120]

Plan N is my go to in Fl

Also don't underestimate the restrictive MA networks and pre-authorization

I have a couple in Fl where the wife understood and got the supp and the Husb was die hard MA $0 prem

The wife had an accident and needed a surgery

the husb needed a stint

while he had to wait for pre-authorization and could not go to where he was recommended the wife had no issues in and out

he was sorry he didn't go supp luckily in fl underwriting is not tough

They will never switch back to MA

----------



If it's Part B med, it's Medicare covered. If it's Medicare covered, MA has to cover it.

Yes, unexpected things can happen. I spend time with prospects to make sure they understand that. It is not up to me to scare, or force them to take the plan that I think they should take. It is my job to explain everything, then leave the decision up to them. I don't sell in NY, I sell in Florida, so I tell them how it works in Florida. Could one of my clients get cancer and be told that the only place to get treatment is the Mayo clinic up north? Of course they could. I tell them that, but also ask if they are worried about that scenario. As I said in one of my previous posts, some people are very risk averse. When I get one of those, that is healthy, only sees the doc once per year, is 65, but is very worried about the worst happening, I tell them that they are better off with a supp. Just for their peace of mind.

Who said anything about scaring or forcing?

----------

Legitimate / serious question:

Considering the above quote concerning MA's have to cover Part B. That I know. But Part B only covers 80% of Medicare charged costs.

Doesn't that leave the client vulnerable to the other 20%? AND Don't MA plans have their own price schedule that may not be identical to Medicare Assignment?

I've seen couple out if pocket a large amount, 1 I believe wasnt covered at all
with supp even plan N $0 out of pocket

All I am saying is there is a lot more then meets the eye with MA plan
there are more things to consider then a doctor copay or even an out of pocket max

When I present I present both side's , I end up with somewhere between 70% or 80 % supplements,

of coarse I sell in a dozen state's and probably end up with 40% ma IN Fl ( by far my highest MA state)
and I am marketing less and less in FL & CA

 

[yogooglethis]

Legitimate / serious question:

Considering the above quote concerning MA's have to cover Part B. That I know. But Part B only covers 80% of Medicare charged costs.

Doesn't that leave the client vulnerable to the other 20%? AND Don't MA plans have their own price schedule that may not be identical to Medicare Assignment?

if it's a network provider the rates that carriers negotiate for medicare covered services is never higher then original medicare rates and usually lower then the already ridiculously low medicare allowable rates.i.e the 20% for an MRI under the original Medicare is usually about 125.00 whereas the 20% on MA plans is usually around 90.00


I have to laugh some time when I come across someone who is very healthy but want to enroll in a med supp vs an MA plan strictly based on the fact that they plan on getting cataract surgery soon and they want to make sure they are fully covered.The cataract surgery 20 % on an MA plan is usually about 150.00 but they feel it's better to pay a 200.00 premium so the carrier can then pay 150.00 to the provider to cover the 20%.

after the insured sees how well the first claim was paid the policyholder is hooked and convinced the med supp pre payment system is the best - until one day they actually look at their EOB's and realize their med supp typically pays out very little for part B services compared to how pay they pay each month in premium.

 

[goillini52]

Who said anything about scaring or forcing?

----------

I've seen couple out if pocket a large amount, 1 I believe wasnt covered at all
with supp even plan N $0 out of pocket

All I am saying is there is a lot more then meets the eye with MA plan
there are more things to consider then a doctor copay or even an out of pocket max

When I present I present both side's , I end up with somewhere between 70% or 80 % supplements,

of coarse I sell in a dozen state's and probably end up with 40% ma IN Fl ( by far my highest MA state)
and I am marketing less and less in FL & CA

Thank you Vic for adding another word that has more than one spelling and is often used improperly. Don't see that one much.

Course...coarse. There...their...they're. Your...you're, etc.

 

[wln417]

I still find even UHC wants agents to sell MA more then Supp

They probably make a lot more money on it

They even want agents to sell Medi/Medi's More even with the higher cancellation % they want that buis the most

There must be a reason

No one from any of those companies has ever suggested I sell one over the other.

How do you sell in so many states? Doesn't MAPD have to be face to face, or in a call center run by the company itself? Humana won't even let me sell PDP over the phone, much less a MAPD.

 

[somarco]

My impression of those who push MA plans is they really don't have enough experience in the health insurance side to truly understand what can happen on the claim side.

The MA is not anything at all like what most people have been accustomed to (copay's, deductibles, networks). Not even close.

Of course you don't have to hit your OOP to make the MA plan more expensive than a gap plan.

What I really loathe in MA peddlers are the ones that sell the $0 premium plans and then come back and load up their client with hospital indemnity, cancer, heart-stroke plans, etc.

I replace a few of those each year, usually with plan N. Would replace more than that if the people could pass underwriting.

That's usually when they call. They have an MA plan they can't afford any more.

I know the tricks the MA peddlers use. See them every day. But they think folks who sell Medigap are the only ones that lie about what could happen.

Oh, and SKJ, don't presume you know me or what I know about this industry, because you will be dead wrong.

 

[vic120]

No one from any of those companies has ever suggested I sell one over the other.

How do you sell in so many states? Doesn't MAPD have to be face to face, or in a call center run by the company itself? Humana won't even let me sell PDP over the phone, much less a MAPD.

MA does not have to be face to face or in call center

Humana has issues its a depends who you talk to and when or whats involved

But all the other companies no issues like that

In fact no scope needed

However Prospect needs to initiate contact leads must be complaint

 

[GreenSky]

My impression of those who push MA plans is they really don't have enough experience in the health insurance side to truly understand what can happen on the claim side.

That's not always the case. I write plenty of MA plans when it's the option the client wants. Many of them are medi-medi and actually have better choices of doctors/hospitals in MA.

And Los Angeles is 40% MA. If someone wants a zero premium, zero copay I'll take care of it. The max OOP is only $2,200 so it's hard to argue they should spend more than that on a supplement.

The networks are great here but I also give them the option. And present it as "if your wife had breast cancer, where would you like the treatment?" No matter what the answer I tell them that in an HMO it's not going to be UCLA, Stanford or Mayo. If they still want the MA I then say "sign here."

Rick

 

[senior-advisor-indiana]

That's not always the case. I write plenty of MA plans when it's the option the client wants. Many of them are medi-medi and actually have better choices of doctors/hospitals in MA.

And Los Angeles is 40% MA. If someone wants a zero premium, zero copay I'll take care of it. The max OOP is only $2,200 so it's hard to argue they should spend more than that on a supplement.

The networks are great here but I also give them the option. And present it as "if your wife had breast cancer, where would you like the treatment?" No matter what the answer I tell them that in an HMO it's not going to be UCLA, Stanford or Mayo. If they still want the MA I then say "sign here."

Rick

I don't believe that you said that to all 3 of your clients. Nice story though...

 

[GreenSky]

I don't believe that you said that to all 3 of your clients. Nice story though...

Ok, you got me.

Rick