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Medicare Advantage saves seniors nearly $2,000 a year compared to fee-for-service Medicare

Insurance Forums Staff

Medicare Advantage beneficiaries report $1,965 less in total annual health spending (out-of-pocket costs and premiums) than those in fee-for-service (FFS) Medicare, according to a new analysis from Better Medicare Alliance.

The study is based on 2019 Medicare Current Beneficiary Survey (MCBS) data, the most recent year available, and comes as new polling from Kaiser Family Foundation shows that addressing seniors’ out-of-pocket costs are among Americans’ top concerns for policymakers.

Findings indicate an increase of $325 in consumer savings compared to last year’s report. The 2021 analysis using 2018 MCBS data found $1,640 lower health spending in Medicare Advantage while an earlier study showed a savings of $1,598.

Chart courtesy Better Medicare Alliance

Researchers found that the average total spending in 2019 per beneficiary was $3,524 in MA compared with $5,489 for those in traditional Medicare.

Further, research shows that consumer savings in Medicare Advantage persist across race and ethnicity. Specifically, Black Medicare Advantage beneficiaries report $1,104 less in total health spending compared to FFS Medicare beneficiaries, while Latino Medicare Advantage beneficiaries see average savings of $1,421.

When considering rates of cost burden, defined as spending 20% or more of one’s income on health coverage, Medicare Advantage has a 35% lower rate of cost burden (13% in Medicare Advantage compared to 20% in FFS Medicare).

“As this study shows, the path to meaningfully addressing Americans’ concerns about out-of-pocket costs and health care affordability and access for our nation’s seniors leads us to Medicare Advantage,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “There is perhaps no more meaningful measurement of a program’s value than its effect on the consumer. In Medicare Advantage, we see that consumers are saving nearly $2,000 a year compared to FFS Medicare – savings that have continued to grow over recent years and are all the more valuable considering that over half of all Medicare Advantage beneficiaries live below 200% of the poverty line. With such robust cost protections across demographic groups, the value of Medicare Advantage for the Medicare dollar has never been clearer.”

“This study proves the worth of Medicare Advantage’s patient-centered approach to meet the clinical needs of underserved populations and lower out-of-pocket medical costs. These equity-enhancing lessons can serve as an example to inform the rest of the US health care system,” said A. Mark Fendrick, MD, Director of the University of Michigan’s Center for Value-Based Insurance Design and Member of Better Medicare Alliance’s Council of Scholars.

Read the full data brief here.

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57 thoughts on “Medicare Advantage saves seniors nearly $2,000 a year compared to fee-for-service Medicare”

  1. Funded by Better Medicare Alliance . . .

    Better Medicare Alliance is the leading voice for Medicare Advantage. As experts in health and advocates for you . . .

    Who funds Better Medicare Alliance?
    The organization is funded by the insurance companies UnitedHealthcare, Aetna, and Humana, and has been criticized as a front group for the health insurance industry.

    Nothing to see here, move along folks . . .

  2. somarco

    Funded by Better Medicare Alliance . . .

    Better Medicare Alliance is the leading voice for Medicare Advantage. As experts in health and advocates for you . . .

    Who funds Better Medicare Alliance?
    The organization is funded by the insurance companies UnitedHealthcare, Aetna, and Humana, and has been criticized as a front group for the health insurance industry.

    Nothing to see here, move along folks . . .

    Have you read the article “A Hamburger is the Healthiest Choice” by Ray Kroc?

  3. Nobody read the article, move along folks. Last thing we need is more agents realizing MAPD's are the real deal and are here to stay. Less competition only helps us agents who do believe in it. No idea why anyone would even consider selling MA plans. Access to care is next to impossible and God forbid you need a specialty hospital such as Mayo, not happening with an MA plan.

  4. I must be dumb, as I find it very difficult to sell a FREE plan to someone, and make a higher commission, to provide higher profits to insurers, and lock my clients into "wide open" limited networks for life.

  5. I must be dumb, as I find it very difficult to sell a FREE plan to someone, and make a higher commission, to provide higher profits to insurers, and lock my clients into "wide open" limited networks for life.

  6. I must be dumb, as I find it very difficult to sell a FREE plan to someone, and make a higher commission, to provide higher profits to insurers, and lock my clients into "wide open" limited networks for life.

  7. somarco

    Funded by Better Medicare Alliance . . .

    Better Medicare Alliance is the leading voice for Medicare Advantage. As experts in health and advocates for you . . .

    Who funds Better Medicare Alliance?
    The organization is funded by the insurance companies UnitedHealthcare, Aetna, and Humana, and has been criticized as a front group for the health insurance industry.

    Nothing to see here, move along folks . . .

    Oh goodness must be the same evil insurance companies that promote buying medicare supplements that guarantee beneficiary's pay a minimum out of pocket in premiums and deductibles of about 3000.00 annual and in return on average will pay out about 350.00 in annual in claims

    I suggest the Senior Forum section of this website be subdivided into two agent groups: Your Dad's Senior Agent Forum and Agents For Today's Medicare Solutions

  8. policywunk

    Oh goodness must be the same evil insurance companies that promote buying medicare supplements that guarantee beneficiary's pay a minimum out of pocket in premiums and deductibles of about 3000.00 annual and in return on average will pay out about 350.00 in annual in claims

    I suggest the Senior Forum section of this website be subdivided into two agent groups: Your Dad's Senior Agent Forum and Agents For Today's Medicare Solutions

    Yes your right!

    I mean all we see is these Med Supplement Commercials bombarding people!

    Clearly they are disproportionally spending more on med supplement commercials and other advertisements because its so much more profitable

    Gee I cant remember the last time I seen a Medicare advantage billboard anywhere

  9. policywunk

    Oh goodness must be the same evil insurance companies that promote buying medicare supplements that guarantee beneficiary's pay a minimum out of pocket in premiums and deductibles of about 3000.00 annual and in return on average will pay out about 350.00 in annual in claims

    That's funny. I must be an exception. :laugh:

  10. vic120

    Yes your right!

    I mean all we see is these Med Supplement Commercials bombarding people!

    Clearly they are disproportionally spending more on med supplement commercials and other advertisements because its so much more profitable

    Gee I cant remember the last time I seen a Medicare advantage billboard anywhere

    I can't remember the last time i got a bonus check or a free trip to Mexico for peddling med supps however I did recently get a nice bonus check for my UHC/AARP med supp production- which is nice.

  11. policywunk

    I can't remember the last time i got a bonus check or a free trip to Mexico for peddling med supps however I did recently get a nice bonus check for my UHC/AARP med supp production- which is nice.

    You do understand the law does not allow such incentives for MA right?

    This also benefits insurance companies

  12. vic120

    You do understand the law does not allow such incentives for MA right?

    This also benefits insurance companies

    Sure do just trying to illustrate that there is a profit motive by insurance companies selling any types of medicare health plans.

  13. policywunk

    Sure do just trying to illustrate that there is a profit motive by insurance companies selling any types of medicare health plans.

    Sure there is a profit motive in everything

    Nothing exist without a motive, No being does anything without a motive

    View attachment 7765

    Otherwise agents would not have stopped selling the plans that went to $0 commission after Obamacare.

    What's being discussed is the disproportionate motive

    The fact is there is much much more motive for insurance companies to sell MA plans which is evident in the disproportionate spending and activity on behalf of the insurance companies

  14. Every Med Sup carrier is offering bonuses now because they know their plan is inferior to MAPD and Cost Plans so have no choice. Just at a meeting with a carrier and are offering up to $700 bonus for 1st 10 apps written. Would take me 5 years to write 10 Med Sups.

  15. Midlevel

    Every Med Sup carrier is offering bonuses now because they know their plan is inferior to MAPD and Cost Plans so have no choice. Just at a meeting with a carrier and are offering up to $700 bonus for 1st 10 apps written. Would take me 5 years to write 10 Med Sups.

    First the lesser known names offered bonus to compete with the larger companies then the larger companies did it because it worked

    The companies that offer both and do bonus for med supp still spend infinitely more on MA advertising

    so not sure what point you are making

  16. Amazing how snide and defensive agents that promote (almost exclusively) MAPD plans based on "lower cost", "can't afford premiums", "don't need unfettered access to health care", "dollars better used to buy cancer, HIP, etc vs paying Medigap premiums" . . . the argument is virtually endless.

    The inability to see, or admit, the holes in MAPD plans seems proportionate to the $$$ earned in FYC vs Medigap. Some even brag about getting double pay for writing MAPD with Oct-Dec effective date and then getting paid again in January (or Feb, Mar) another advance but yet say their motivation is all about their client.

    Such horse hockey.

    Their protestations are so transparent, perhaps it is like politicians that believe the lies they tell.

    FWIW I can see how an MAPD plan is superior to Medigap . . . as long as you are healthy. But for some reason, many of my clients are not healthy when turning 65 and I know they will fare better with a plan that can be budgeted vs surprise billings for large claims. Others start out healthy but quickly turn sour.

    In other words, the MAPD folks fare better as long as they are healthy, not so much so when they are not healthy.

    Problem is, who is going to take a turn for the worse and when will that happen? Will it occur in time for them to switch to Medigap? Probably not.

    Frankly, I don't care which way a prospect (or client) decides to go. The decision is completely up to them. Having handled managed care situations for over 30 years I know the client's problems become mine, and I am trying to make life simple for both of us.

    Nothing simple about MAPD when your health takes a turn for the worse.

  17. somarco

    Amazing how snide and defensive agents that promote (almost exclusively) MAPD plans based on "lower cost", "can't afford premiums", "don't need unfettered access to health care", "dollars better used to buy cancer, HIP, etc vs paying Medigap premiums" . . . the argument is virtually endless.

    The inability to see, or admit, the holes in MAPD plans seems proportionate to the $$$ earned in FYC vs Medigap. Some even brag about getting double pay for writing MAPD with Oct-Dec effective date and then getting paid again in January (or Feb, Mar) another advance but yet say their motivation is all about their client.

    Such horse hockey.

    Their protestations are so transparent, perhaps it is like politicians that believe the lies they tell.

    FWIW I can see how an MAPD plan is superior to Medigap . . . as long as you are healthy. But for some reason, many of my clients are not healthy when turning 65 and I know they will fare better with a plan that can be budgeted vs surprise billings for large claims. Others start out healthy but quickly turn sour.

    In other words, the MAPD folks fare better as long as they are healthy, not so much so when they are not healthy.

    Problem is, who is going to take a turn for the worse and when will that happen? Will it occur in time for them to switch to Medigap? Probably not.

    Frankly, I don't care which way a prospect (or client) decides to go. The decision is completely up to them. Having handled managed care situations for over 30 years I know the client's problems become mine, and I am trying to make life simple for both of us.

    Nothing simple about MAPD when your health takes a turn for the worse.

    Yes selling a med supp is simple.So simple in fact a monkey could do it and the worst thing that happens if the monkey gives bad advice on which med supp carrier to choose is that consumer pays a couple hundred dollars more for a policy .Give bad advice on a mapd and a consumer could be totally screwed.It definitely takes more work and training to correctly explain MAPD vs a med supp .And yes there is definitely a big problem today with agents who don't know or don't care about correctly explaining the in and outs of MA

    Please stop it with the scare tactics.So a consumer who goes through cancer treatment ends of paying 3700 MOOP( florida plans) instead of the minimum out of pocket of 3000.00 (premiums,deductible ) with med supp and part d.Is that the end of the world?The scare tactics may work for consumer facing propaganda like youtube videos but not so much to agents who are fully vested in being an all around medicare health plan agent.Have you sold thousands of Mapd AND med sup plans like I have?No.I have a large book of MA and Med supp and know first hand from client conversations the average cost of out of pocket cost of med supp vs MA. No shit people some people would have been better off on medicare supplement when they go through cancer treatment etc but the vast majority are spending much less on MA than Med supp- especially over their lifetime.

  18. policywunk

    Yes selling a med supp is simple.So simple in fact a monkey could do it and the worst thing that happens if the monkey gives bad advice on which med supp carrier to choose is that consumer pays a couple hundred dollars more for a policy .Give bad advice on a mapd and a consumer could be totally screwed.It definitely takes more work and training to correctly explain MAPD vs a med supp .And yes there is definitely a big problem today with agents who don't know or don't care about correctly explaining the in and outs of MA

    Please stop it with the scare tactics.So a consumer who goes through cancer treatment ends of paying 3700 MOOP( florida plans) instead of the minimum out of pocket of 3000.00 (premiums,deductible ) with med supp and part d.Is that the end of the world?The scare tactics may work for consumer facing propaganda like youtube videos but not so much to agents who are fully vested in being an all around medicare health plan agent.Have you sold thousands of Mapd AND med sup plans like I have?No.I have a large book of MA and Med supp and know first hand from client conversations the average cost of out of pocket cost of med supp vs MA. No shit people some people would have been better off on medicare supplement when they go through cancer treatment etc but the vast majority are spending much less on MA than Med supp- especially over their lifetime.

    LOL

    You know what yes there are good and bad agent who do both or one or the other

    Many (NOT ALL) but many MA only people do so because its easier, Because there is NO UNDERWRITING

    and 2nd I have seen a enough recruiting and training video's on you tube to know many who are killing it in the MA only field (Again not all I know many who don't do this)

    But many in the MA field that watch these videos all the time simple look what plan does someone have IF its AARP then they want to sell another company based on How much is in give back or if they have a give back then they sell one with a flex card

    Its a game whatever the client has then they have something else its for many of these recruits not about putting them in a better situation its about what do they not have so I can create a need and make a sale

    Now again I reiterate this is not all I do know many who do not in fact I sell my fair share of MA myself

    But your comment on it being easier to sell med supp and how responsible one has to be to sell MA is a joke

    And also besides that the monkey is no fool, has more knowledge on placing hard cases then most a good agent knows how to help and place the hard cases

  19. One thing interesting about threads like this is the personal attacks, yet not a single mudslinger has challenged statements about how managed care plans actually work. Some even say I don't know what I am talking about yet no one has ever proved me wrong.

    I probably know more about managed care than most of the folks pushing MA plans. One thing is quite obvious, it is possible to sell a complex product such as an Advantage plan yet still be clueless how it works.

    This point is proven almost daily on this forum.

  20. Pretending like MAPD isn't an easier sale is self-delusion.

    The level of marketing money from Medicare, the insurance company, and the insurance agent basically crams MAPD down people's throats without a balanced discussion of the con's of managed care.

    Seriously, most seniors don't know the in's and out's of Medicare or supported private insurance. They see the shiny 0 premium and a free gym membership and dental and get blindsided with the actual Medical portion of the program.

    In some parts of the country, hands down I would sell the crap out of MAPD because it's really that good (Florida.)

    If you actually take the time to explain the cons of managed care, people with any sort of issues w/ risk tolerance would run for the hills. Most MAPD agents don't do that, because they'd lose a sale. Most seniors don't complain about MAPD because they don't get a balanced version of what's available vs what you offer.

    Instead, they treat the client, and themselves, as a mark and pimp them out for a commission. All while delusionally saying that it's what's "best for the client."

    For people that aren't really expressing the pro's and con's of Medicare Advantage, it's about money. It's about the upwards of 1k that you can make when you add on the MAPD, the VBE, and the Hospital/Cancer plan for someone coming on Medicare.

    It's the relative ease of making a lifetime commission off of the person because they only get a year to walk away, and by the time shit hits the fan, it's game over on getting anything that fits their actual long-term needs. All you have to do is flip them to another MAPD plan next AEP (or keep them where they are… who cares, you get paid either way.)

    I'm not actually against MAPD. I think my job is to assess risk tolerance as the most important prequalification tool. If they're willing to roll the dice they'll never have a chronic or degenerative illness until the day they die, who am I to fight them on that?

    However, if you're just running through the "This is a Medicare Supplement. This is a Medicare Advantage plan." without going in-depth about how each plan actually works OR finding out what's most important for your prospect regardless of losing a sale, you're not doing this right.

  21. Travis Price

    Pretending like MAPD isn't an easier sale is self-delusion.

    The level of marketing money from Medicare, the insurance company, and the insurance agent basically crams MAPD down people's throats without a balanced discussion of the con's of managed care.

    Seriously, most seniors don't know the in's and out's of Medicare or supported private insurance. They see the shiny 0 premium and a free gym membership and dental and get blindsided with the actual Medical portion of the program.

    In some parts of the country, hands down I would sell the crap out of MAPD because it's really that good (Florida.)

    If you actually take the time to explain the cons of managed care, people with any sort of issues w/ risk tolerance would run for the hills. Most MAPD agents don't do that, because they'd lose a sale. Most seniors don't complain about MAPD because they don't get a balanced version of what's available vs what you offer.

    Instead, they treat the client, and themselves, as a mark and pimp them out for a commission. All while delusionally saying that it's what's "best for the client."

    For people that aren't really expressing the pro's and con's of Medicare Advantage, it's about money. It's about the upwards of 1k that you can make when you add on the MAPD, the VBE, and the Hospital/Cancer plan for someone coming on Medicare.

    It's the relative ease of making a lifetime commission off of the person because they only get a year to walk away, and by the time shit hits the fan, it's game over on getting anything that fits their actual long-term needs. All you have to do is flip them to another MAPD plan next AEP (or keep them where they are… who cares, you get paid either way.)

    I'm not actually against MAPD. I think my job is to assess risk tolerance as the most important prequalification tool. If they're willing to roll the dice they'll never have a chronic or degenerative illness until the day they die, who am I to fight them on that?

    However, if you're just running through the "This is a Medicare Supplement. This is a Medicare Advantage plan." without going in-depth about how each plan actually works OR finding out what's most important for your prospect regardless of losing a sale, you're not doing this right.

    Travis of course your clients going to pick the med sup during your “ balanced “ sales presentation . Maybe I should call it “ education” . When you preach the horrors of networks , snf’s and out of pocket costs with mapd of course they choose a med sup .Please emphasize to them is their ms premium will rise 5-7% each and every year . Their pdp plan could double ( the cheaper pdp plans have $480 deductibles and inferior drug tiers ). So with a plan g you must add on about $20 a month for the $233 part b deductible. Also around $30 ish for a 1/2 decent pdp plan . Also in my area any one single making less than $26k can get a charitable right off on hospital bills . That’s why I analyze income in retirement as part of my presentation . What can they afford . We all want to drive a Benz but we can only afford a civic

    It’s nothing do what I or ant agent believe is better for them . The people are speaking by the millions as they move to mapd . Surely you don’t believe all these millions are being manipulated and lied to ? It’s like saying I have a $5k auto deductible as I’m a safe driver . I wanted to save money . Then I get in a big wreck and I have to pay the $5 k . Of course I wish I had bought a $1 k deductible after the fact . Same with a healthy person who bought a Mapd . After they get sick of course they wish they had a med sup . I don’t think anyone’s ever argued on this board which has better coverage . It comes down to what you can afford in retirement.

  22. DonP

    That’s why I analyze income in retirement as part of my presentation . What can they afford . We all want to drive a Benz but we can only afford a civic

    You sell on price, not on the program. I've already refuted your garbage price argument in other posts. Medigap has an option that is BETTER than MOST MAPD plans and adds a standard PDP plan, 37.50$ a month. HDG increases STILL stay manageable throughout the lifetime of the policyholder. I think on the end of the spectrum, it's like 67.50$ a month… 20 years later.

    You're selling on commission because you don't get paid shit for it. Just stop deceiving yourself and your clients. You don't understand Medicare, Medigap, and MAPD well enough to let them make an informed decision.

    You're admitting it as much. "When you tell the prospect the downsides of MAPD, of course they're going to run to Medigap."

    As a professional, I'm actually really sad that you can't make an argument on why MAPD is better than Medigap, except to say "we shouldn't give them all the info" or "they can't afford it." That, in itself, is manipulative.

    DonP

    Surely you don’t believe all these millions are being manipulated and lied to ?

    Actually, I do. When you have an Insurance Agent, Medicare, and the insurance company shoving marketing down people's throats at every turn? Yes, I think it's manipulative. The ends are about money.

    Medicare saves money paying a fixed rate per enrollee.
    The agent makes 2x more year 1, on par for the rest of the clients life with a Medigap plan (which only has a 3-8 year FYC.)
    The insurance company gets more freedom to approve, deny, or alter treatment. They get more freedom to contract and design plans to maintain profitability. Dropping those "extra goodies" because they're no longer cost-effective OR Medicare shoves out more money.

    Poor Ethel and Tom have to navigate a program they know nothing about and probably never had to buy their own insurance policy before. Here comes Delusional Don telling them it's best for them, versus evaluating risk. The deck is stacked against them.

    Wanna know how I know? I've had clients call me where someone like you rolled into their home and SOLD them an MAPD plan because it's "good for them." Only to find out that the enrollee had a condition that was costing them 1k per month for chronic injections, for 6 months until the MooP kicked in.

    Luckily, they were in trial rights, and we could switch them back without underwriting (which would have failed, and they would have been fucked.)

    FFS: Just the other day you asked about moving a dude out of MAPD because he was on dialysis without understanding underwriting, the contract period, SEPs, or C-SNPs. I absolutely feel horrible for your clients, because you don't know what you're talking about and you're too bullheaded to step back and consider a different opinion.

    I make less money selling a Medigap plan over Medicare Advantage. I offer MAPD when the claimant knows all the risks and is willing to accept them. That's making a judgment based on the needs that the clients tell you and your experience based on their situation. Not the assumption that your way is the only way, or they can't afford it.

  23. DonP

    When you preach the horrors of networks , snf’s and out of pocket costs with mapd of course they choose a med sup .Please emphasize to them is their ms premium will rise 5-7% each and every year . .

    Don't you think they have a right to know the negatives of the MAPD's? They don't mention any of the negatives in the commercials and it sounds like a lot of the call centers fail to mention them too.

    I offer MAPD's. There are times when they can't get or afford a MedSupp. There is a place for them, but for me MAPD's are plan B…an inferior product.

    I recommend Med Supps. When told the negatives, most people that can afford a Med Supp won't want a MAPD. I tell people that the only complaint they'll have with their Med Supp is the premium, which will go up every year and we can shop their premium as often as they want until they can't pass underwriting. Even then, they might be able to pass underwriting in a year or 2.

  24. DonP

    When you preach the horrors of networks , snf’s and out of pocket costs with mapd of course they choose a med sup

    You should put this on your business card. It's literally the difference between being an expert (which is what people actually want) and a salesperson (which people hate.)

  25. Ok guys, if you didn't catch it, they are not comparing MA plan's savings against Med Supp savings….it's compared to traditional Medicare only! Not even a good comparison.

    Furthermore, they did the comparisons with people in "facilities".

    This is what it says under Figure 2: Average Total Spending (Out-of-Pocket & Premium) Among Medicare Beneficiaries.
    Analytics limited to community-dwelling Medicare beneficiaries given the unique financial experiences of individuals living in facility settings. Including all beneficiaries (community and facility) would increase total average spending to $4102 and $6415 for Medicare Advantage and FFS Medicare, respectively. Fewer than 3 percent of Medicare beneficiaries reside in a facility.
    2021 Date Brief: Medicare Advantage Outperforms Traditional Medicare on Cost Protections for Low-and Modest-Income Populations.

    So, this just seems like another way to push Medicare Advantage plans with useless comparisons.

  26. Here is an unbiased person trying to figure out if I should buy a Medicare Supplement or an MA plan. I have been an agent for over 20 years so starting out we had the F plan and that was it. No prescription plan so clients just paid themselves or tried to find a discount card. I am 15 years away from Medicare but when clients ask me which I would choose, I tell them I currently pay $300/month for our health insurance and have a $3500 deductible before I even get a prescription or Dr. visit paid for. I am out $7100 guaranteed minimum if I have a bad year. I also know I have over $20000.00 in an HSA so doesn't really concern me if it happens. Plan to keep contributing and hopefully get this over $100000.00 before Medicare.

    Now fast forward to being able to get a MAPD for $0 premium and now I have dental (which I currently pay $500/yr for), gym membership which I currently pay $370/year for, vision which I don't currently have, OTC which I don't currently have, hearing aids which I don't currently have and a hell of a PDP built in for $0 premium and no deductible and all free generics. Now if I have a terrible year and get cancer I may have to pay $3900 out of my pocket. Who gives a s**t when I'm not paying any premium and have all the additional benefits. Also, I can use the HSA if need be.

    I can only speak for the 3 States I am licensed in that I have 0 problems with network, very seldom run into SNF problems and if I do its because the MA plan is actually doing their job and implementing the rules correctly rather then just a free for all like Original Medicare. I have never had anyone go to a specialty hospital like someone keeps bringing up as a huge problem.

    I often hear agents say MAPD's are only for poor people that can't afford a Med Sup. I totally disagree because someone with millions of dollars probably got that way because they have common sense when it comes to their finances and will be able to see they will be far ahead going the MA route. I admit I am very fortunate to have a Cost Plan to fall back on if someone decides they don't like MA after a couple years. So the whole you can't get your plan back doesn't pertain to my area because there are no health questions on Cost Plan and it's benefits are also better then a Med Sup. I can't remember the last time someone chose to go back to paying a premium though. Nice to have the option.

    Anyway, this is only my opinion and I do still show Med Sups to every client turning 65 and let them choose. Most choose MA and some choose Med Sup or Cost Plan. Just my experience and thoughts. Sorry this is so long.

  27. somarco

    One thing interesting about threads like this is the personal attacks, yet not a single mudslinger has challenged statements about how managed care plans actually work. Some even say I don't know what I am talking about yet no one has ever proved me wrong.

    I probably know more about managed care than most of the folks pushing MA plans. One thing is quite obvious, it is possible to sell a complex product such as an Advantage plan yet still be clueless how it works.

    This point is proven almost daily on this forum.

    you have been proven wrong countless time, you just refuse to see it.

  28. Last time I checked, and granted, I'm only relying on 7+ years of Disability reviews and medical records, cancer is almost never a "one-year" issue. It's more like a 3-4 year issue before you go into maintenance mode of 1-2x year appointments and checkups.

    Like most chronic conditions, the initial exacerbation is rarely the last…

    Secondly, no one should make decisions on a medical plan in Medicare based off of extra's that are not protected by Medicare. The vast majority of people never step foot into a gym. OTC will almost always be the first thing to cut, and dental/vision is an insure small that doesn't cover much.

    If there are additional benefits, great!

    Resting your hat on that is a disaster.

  29. Todd King

    Ok guys, if you didn't catch it, they are not comparing MA plan's savings against Med Supp savings….it's compared to traditional Medicare only! Not even a good comparison.

    Furthermore, they did the comparisons with people in "facilities".

    This is what it says under Figure 2: Average Total Spending (Out-of-Pocket & Premium) Among Medicare Beneficiaries.
    Analytics limited to community-dwelling Medicare beneficiaries given the unique financial experiences of individuals living in facility settings. Including all beneficiaries (community and facility) would increase total average spending to $4102 and $6415 for Medicare Advantage and FFS Medicare, respectively. Fewer than 3 percent of Medicare beneficiaries reside in a facility.
    2021 Date Brief: Medicare Advantage Outperforms Traditional Medicare on Cost Protections for Low-and Modest-Income Populations.

    So, this just seems like another way to push Medicare Advantage plans with useless comparisons.

    you don't like MAPD now Todd?

  30. Man, the back and forth here is just ridiculous. If none of you have figured it out by now, you won't change the other person mind. The fact is, there is a place for both Med Supp and MAPD regardless of your personal preference. There is always an argument that a person could spend more money on one or the other. I can make a case both ways.

    There are going to be people who prefer MAPD and others who prefer Med Supp. I just wrote a lady and her husband Med Supps because that's what she said she wanted. She just retired from a rehab facility (SNF) and she said she had seen enough to influence her decision. I wasn't going to argue the merits of a MAPD with her. She'll always be able to change to a MAPD if she wants. But the opposite can't be said for those who start with a MAPD and stay in it for more than a year.

    The clients who I have who are opposed to MAPD are this way mostly because of network. Even when it is explained that their doctors are in the network, they seem to be opposed. I'll sometimes go so far as to say, "these plans are network based (HMO or PPO) just like your current coverage with your employer".

    Ultimately, our job is to educate our clients and let them make an informed decision. We have to remove any bias we have. With that said, if I have a potential client (T65) who has some serious health issues, I 100% advise them to go with a Medicare Supplement. It's their one shot at a Med Supp and I believe they should take advantage of that one opportunity. As the great philosopher Eminem once said:

    "You only get one shot, do not miss your chance to blow
    This opportunity comes once in a lifetime "

  31. axeman462

    you don't like MAPD now Todd?

    I never said that. I do. I think it has its place and so do Med Supps.

    I'm just pointing out the fact that the survey is a crock of hockey! The figures aren't right at all for a direct comparison of Med Adv to Med Supps.

    What really made me go on and read the article is that most Med Supps don't cost near $2000, so that was a red flag right there in the title!

  32. sman

    Man, the back and forth here is just ridiculous. If none of you have figured it out by now, you won't change the other person mind. The fact is, there is a place for both Med Supp and MAPD regardless of your personal preference. There is always an argument that a person could spend more money on one or the other. I can make a case both ways.

    There are going to be people who prefer MAPD and others who prefer Med Supp. I just wrote a lady and her husband Med Supps because that's what she said she wanted. She just retired from a rehab facility (SNF) and she said she had seen enough to influence her decision. I wasn't going to argue the merits of a MAPD with her. She'll always be able to change to a MAPD if she wants. But the opposite can't be said for those who start with a MAPD and stay in it for more than a year.

    The clients who I have who are opposed to MAPD are this way mostly because of network. Even when it is explained that their doctors are in the network, they seem to be opposed. I'll sometimes go so far as to say, "these plans are network based (HMO or PPO) just like your current coverage with your employer".

    Ultimately, our job is to educate our clients and let them make an informed decision. We have to remove any bias we have. With that said, if I have a potential client (T65) who has some serious health issues, I 100% advise them to go with a Medicare Supplement. It's their one shot at a Med Supp and I believe they should take advantage of that one opportunity. As the great philosopher Eminem once said:

    "You only get one shot, do not miss your chance to blow
    This opportunity comes once in a lifetime "

    This is literally my take on the whole situation. My job isn't to influence, it's to offer truthful advice and disclose the pro's and con's of each product. My fear isn't that people want MAPD. It's that agents are concerned that if you "tell people the con's, they won't want to buy what I want to sell."

    That's it.

  33. Todd King

    I never said that. I do. I think it has its place and so do Med Supps.

    I'm just pointing out the fact that the survey is a crock of hockey! The figures aren't right at all for a direct comparison of Med Adv to Med Supps.

    What really made me go on and read the article is that most Med Supps don't cost near $2000, so that was a red flag right there in the title!

    the article doesn't even mention medigap/medsupps (neither does the "data brief pdf" the article links to)….

    also, in Florida, medsupps regularly cost $2,000+

  34. axeman462

    the article doesn't even mention medigap/medsupps (neither does the "data brief pdf" the article links to)….

    also, in Florida, medsupps regularly cost $2,000+

    I know it doesn't mention them…which is my point.

    I did say, "most Med Supps". I know in FL and CA it can easily be over $2000 per year. None of that matters though, as I was saying that the $2000 claim is what caught my eye and made me want to read it.

  35. Todd King

    seems like another way to push Medicare Advantage plans with useless comparisons.

    True . . . what struck me was there was not attempt to appear unbiased. This is a fluff piece funded by carriers with a beneficial interest in the outcome.

  36. Travis Price

    This is literally my take on the whole situation. My job isn't to influence, it's to offer truthful advice and disclose the pro's and con's of each product. My fear isn't that people want MAPD. It's that agents are concerned that if you "tell people the con's, they won't want to buy what I want to sell."

    That's it.

    Nailed it!

  37. Seems like this argument is resurrected yearly. Or maybe it's just been one continuous argument.

    IIRC, a poll was done on here a few years ago, asking agents what they would get for themselves. The consensus was HDF. How many still believe that? How many of them are selling that rather than the F or G or N or MAPD? If not selling HDF (or HDG), why not? United American has overpriced shit, to be sure, but their HDF (or G) are about the lowest, and their commissions continue for life.

  38. wln417

    Seems like this argument is resurrected yearly. Or maybe it's just been one continuous argument.

    IIRC, a poll was done on here a few years ago, asking agents what they would get for themselves. The consensus was HDF. How many still believe that? How many of them are selling that rather than the F or G or N or MAPD? If not selling HDF (or HDG), why not? United American has overpriced shit, to be sure, but their HDF (or G) are about the lowest, and their commissions continue for life.

    😀

    Caveat, not an agent.

    I would be polite and say "continuous disagreement" with rest breaks.

    The MAPD proponents would (probably) say there is still a cost, compared to the "free" plans. (I know, Medicare agents are not supposed to use the "F" word!) I'm not wanting to go hunt up info right now, but I'm guessing I'm paying around $1,100 a year for an HDF and PDP.

    New Era (or their current other company) or BFAC would be my calls for an HDG.

  39. wln417

    Seems like this argument is resurrected yearly. Or maybe it's just been one continuous argument.

    IIRC, a poll was done on here a few years ago, asking agents what they would get for themselves. The consensus was HDF. How many still believe that? How many of them are selling that rather than the F or G or N or MAPD? If not selling HDF (or HDG), why not? United American has overpriced shit, to be sure, but their HDF (or G) are about the lowest, and their commissions continue for life.

    Great point!

    But, you can't make a living on $7/mo commission, so that's one reason agents avoid mentioning it. Plus, the calls regarding pending claims/bills can be a headache, and not worth the $7/mo. Dealing with one client now.

    I only offer the HDF or HDG in Florida where the premium difference covers the OOP vs plan F or G. Or, I offer it as an alternative to going with MAPD plan.

  40. sman

    Man, the back and forth here is just ridiculous. If none of you have figured it out by now, you won't change the other person mind.
    "

    Spot on. It's like trying to convince a liberal democrat to become a conservative republican……….. not gonna happen.

  41. The Government standardized Medicare Supplement plans over 20 years ago to make things easier to understand, and then they came out with Advantage and Part D plans which make their heads spin!

    I think they probable should offer stand-alone Part d coverage with option A, B and C with all carriers.

  42. dandan

    The Government standardized Medicare Supplement plans over 20 years ago to make things easier to understand, and then they came out with Advantage and Part D plans which make their heads spin!

    I think they probable should offer stand-alone Part d coverage with option A, B and C with all carriers.

    Yup, standardized plans are coming to ACA plans in 2023, and it's coming to the MAPD and PDP markets eventually too, get ready for it.

    HHS Notice of Benefit and Payment Parameters for 2023 Final Rule Fact Sheet | CMS

    https://aspe.hhs.gov/sites/default/…ed-Plans-in-Health-Insurance-Marketplaces.pdf

  43. Yagents

    Yup, standardized plans are coming to ACA plans in 2023, and it's coming to the MAPD and PDP markets eventually too, get ready for it.

    HHS Notice of Benefit and Payment Parameters for 2023 Final Rule Fact Sheet | CMS

    https://aspe.hhs.gov/sites/default/…ed-Plans-in-Health-Insurance-Marketplaces.pdf

    How can standardized plans come to mapd when there’s no premium on 90% of them ?Private CO’s assume the risk and get no direct premium like aca applicants get per income . Mapd gives insurers a block of money and they manage it . Aca each individual is subsidized a certain $ amount based on income . Mapd is not subsidized in reality . Their paid on taking risk and can design plans accordingly

  44. DonP

    How can standardized plans come to mapd when there’s no premium on 90% of them ?Private CO’s assume the risk and get no direct premium like aca applicants get per income . Mapd gives insurers a block of money and they manage it . Aca each individual is subsidized a certain $ amount based on income . Mapd is not subsidized in reality . Their paid on taking risk and can design plans accordingly

    Standardized plans have nothing to do with income or premium.

    This about making every carrier offer the same structured medical benefit plans, similar to bronze, silver for aca; and my forecast that it will happen to mapd and pdp also. Govt takeover always happens.

    Similar to Plan G, every insurer is the same. Makes it easier for consumer to compare plans.

    This will get away from the gimmicks and complexity of mapd and pdp plans

  45. Yagents

    Standardized plans have nothing to do with income or premium.

    Not all agents comprehend that.

    Yagents

    Similar to Plan G, every insurer is the same. Makes it easier for consumer to compare plans.

    Medigap is relatively easy to compare .. . as long as you only consider benefits . . . the problem comes with consumers, and agents, assume all that is necessary is to choose the one with the lowest premium.

    If MAPD plans are standardized like Obamacare then all the consumer needs to do is research provider networks, the drug formulary, figure out what MOOP means and how it is calculated . . . easy peasy.

    Consumers will no longer need agents . . . they can buy direct via medicareplans.gov

  46. Yagents

    Standardized plans have nothing to do with income or premium.

    This about making every carrier offer the same structured medical benefit plans, similar to bronze, silver for aca; and my forecast that it will happen to mapd and pdp also. Govt takeover always happens.

    Similar to Plan G, every insurer is the same. Makes it easier for consumer to compare plans.

    This will get away from the gimmicks and complexity of mapd and pdp plans

    Not really that simple ACA though

    I take a look at all the plans each year but end up going the same one a BC HSA with 14K out of pocket max simple

    This past year after going through the plans fund that noe will be as good as the one I had so I quick went through found the BC HSA 14K out of pocket max and signed

    Later few months in found some of the docs were not in network because I am no longer in S network but some other network

    I looked up turned out they have a new HSA just the same as the other HSA in addition to the original one exact same benefits

    the new hsa has a lesser network and is the same cost as the old hsa was and the old hsa is $100 more in premium then it was previously

    I did not expect that and when comparing plans I didn't take a close look at my plan just quick to see the benefits were the same

    Luckily all the kids stuff is still in network only mine and my wife's doc's are not

    Would have been a huge deal if my autistics sons therapies were not in network

  47. somarco

    Not all agents comprehend that.

    Medigap is relatively easy to compare .. . as long as you only consider benefits . . . the problem comes with consumers, and agents, assume all that is necessary is to choose the one with the lowest premium.

    If MAPD plans are standardized like Obamacare then all the consumer needs to do is research provider networks, the drug formulary, figure out what MOOP means and how it is calculated . . . easy peasy.

    Consumers will no longer need agents . . . they can buy direct via

    Just like consumers don’t need agents like you for med sup . A plan g’s a plan g everywhere . Selling mapd 10 times the work over a 5 yr period. Guys like just want to sit back and do no work and collect renewals . Mapd steam roller coming for agents like you .

  48. policywunk

    Oh goodness must be the same evil insurance companies that promote buying medicare supplements that guarantee beneficiary's pay a minimum out of pocket in premiums and deductibles of about 3000.00 annual and in return on average will pay out about 350.00 in annual in claims

    I suggest the Senior Forum section of this website be subdivided into two agent groups: Your Dad's Senior Agent Forum and Agents For Today's Medicare Solutions

    I agree. Some people just can’t accept the fact that Medicare Advantage plans can be very effective and that they work well for millions and millions of Medicare beneficiaries, my mother has been on an MAPD plan for over 20 years. She’s never paid a penny in premiums. She’s a sickly person, has been admitted at least 3 or 4 times in the past 7 years. Her insurance never caused any problems and all her doctors accept her plan. I explain both types of plans to my clients and together we come up with the best choice for each of them. Guys like that YouTuber Chris Westfall are so disingenuous the way they bash Advantage plans. If they weren’t good, there wouldn’t be 20 million plus enrolled in them.

  49. Standardized plans doesn't eliminate the need for an agent.

    Under ACA, clients still need agents for calculating income, aptc clawbacks, elig for SEP, 1095A tax forms, matching doctors to networks, drugs to formulary, HSA funding, correct application submission, income docs, citizenship docs, payment set up, claims help, late payment alert, etc etc

    Just like med supps, clients still need agents to help with part B enrollment, SEP elig, employer separation form, IRMAA, PDP shopping, carrier selection, premium increase history, underwriting, application submission, late pmt alert, pdp problems,, and occasionally claims.

    The need for an agent won't go away, unless we go to universal healthcare

  50. Yagents

    Standardized plans doesn't eliminate the need for an agent.

    My comment about standardized Medicare plans eliminating agents was tongue in cheek.

    On the other hand, some folks are incapable of thinking of health care and health insurance as anything other than dollars and cents. No matter how hard we may try, some will never comprehend the complexity of access to care when a managed care plan is in the middle, calling the shots, and effectively replacing the provider.

  51. selfgen

    She’s a sickly person, has been admitted at least 3 or 4 times in the past 7 years

    She's definitely paid for the insurance over the years, maybe just not in premiums.

    Secondly, the stats don't match your argument about no difficulty with plans.

    Up to 31% of Medicare Advantage claims are denied that shouldn't he based on Medicare claim rules.

    75% of those denied are reversed on appeals.

    1% of people appeal.

    The odds, and stats, are not in your favor.

    I sell MAPD, but if you're not telling your clients the difficulties (based objectively, not acedotal) you are not allowing your clients to make a fair decision.

    As I've said, I don't care if my client wants MAPD. All I care about is that they understand what they're getting.

    I get calls all the time for dental. Usually people are calling because they need it for services. I happen to have a plan that allows for next month coverage w/o waiting periods.

    I'd make 10$ a month, roughly.. as long as they are in the group.

    I still tell people that if it were my dad,, I'd tell him to pass because dental is largely trash in the senior market (ask LD, he has 12 policies to cover his needs ;)) but I'll take their money with the plan I think is "best" for their cost.

    Guess how many people buy dental when you explain why it's trash.

  52. Travis Price

    Up to 31% of Medicare Advantage claims are denied that shouldn't he based on Medicare claim rules.

    75% of those denied are reversed on appeals.

    1% of people appeal.

    The odds, and stats, are not in your favor.

    This is what many dont understand

    they are playing the odds

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