- 1,953
Another MA article.
- Thread starter Cornelius
- Start date
"often only to be denied care"
lol - yeah, my MA clients hate their plans and beg me to change them back to OM.
"Things that don't happen for $300, Alex"
MA marketing is a perfect storm where numerous parts are in motion at the same time.
Way too much taxpayer money is thrown around like chum.
Almost everyone comes to feed on the dollars and "free" stuff.
Seniors are confused and often leery, especially when almost ever ad viewed, or seminar attended, contains a sales pitch for more free stuff than the other guys are offering.
70% of T65 have never bought health insurance . . . it was always provided by their employer and choices were usually limited to 3 or fewer plans
Even though most EGH plans require premium participation the individual is still working and collecting a paycheck.
Retirement, for most, is viewed as a cliff where cash flow is typically less than their current take home and they are looking for ways to cut expenses . . . a "free lunch" is very attractive
A common pitch is "This is just like your current plan" even though reality doesn't match the presentation
MA networks are almost always small vs EGH and providers they used under EGH sometimes do not participate in MA networks and plans
Those who have enjoyed good health so far view free as "fair" and considering the post-retirement lower cash flow, the no premium plan seems like a good option, especially if changing plans is perceived as risk free
OTOH those who have chronic conditions that require lifetime treatment, or had a serious medical issue, are well aware of how difficult it can be to find a competent provider and care that is affordable.
The constant barrage of sales pitches for free stuff often makes them wonder "Where's the catch?".
OM is rarely mentioned, or explained, which is a good thing for me because I have a captive audience eager to learn how it works without networks, referrals, prior authorization and claim denials
Way too much taxpayer money is thrown around like chum.
Almost everyone comes to feed on the dollars and "free" stuff.
Seniors are confused and often leery, especially when almost ever ad viewed, or seminar attended, contains a sales pitch for more free stuff than the other guys are offering.
70% of T65 have never bought health insurance . . . it was always provided by their employer and choices were usually limited to 3 or fewer plans
Even though most EGH plans require premium participation the individual is still working and collecting a paycheck.
Retirement, for most, is viewed as a cliff where cash flow is typically less than their current take home and they are looking for ways to cut expenses . . . a "free lunch" is very attractive
A common pitch is "This is just like your current plan" even though reality doesn't match the presentation
MA networks are almost always small vs EGH and providers they used under EGH sometimes do not participate in MA networks and plans
Those who have enjoyed good health so far view free as "fair" and considering the post-retirement lower cash flow, the no premium plan seems like a good option, especially if changing plans is perceived as risk free
OTOH those who have chronic conditions that require lifetime treatment, or had a serious medical issue, are well aware of how difficult it can be to find a competent provider and care that is affordable.
The constant barrage of sales pitches for free stuff often makes them wonder "Where's the catch?".
OM is rarely mentioned, or explained, which is a good thing for me because I have a captive audience eager to learn how it works without networks, referrals, prior authorization and claim denials
- 2,114
Is it the free market or just your market. My market is just the opposite.
General observation only . . . not a one size fits all . . . but . . .
As we age the need for more health care, and often more expensive care, increases, not decreases.
Sometimes they are better off keeping their Medigap and paying the premium vs. switching.
I have had a few people drop their Medigap and switch to MAPD because "the Medigap plan never pays anything". They usually say something like "I paid $3,000 in premiums and all the plan paid was $400 for the year. Why am I paying this and getting nothing in return?".
Insurance is not an investment product, it is a risk transfer product. If you are "winning" every year it is because your health is poor.
Losing is a good thing because that means you are healthy.
If you are tired of losing money on your plan every year let me introduce you to folks who incurred $50k . . . $100k or more in medical expenses and only paid $200 or so toward their medical bills.
People are short-sighted and the often don't look at the other side of the balance sheet.
Some of those who switched to save premium dollars called me a few years later wanting to get back on a Medigap plan and I had to tell them no, they would have to keep their $0 premium plan. In retrospect they made the wrong choice.
People turning 65 also ask a similar question . . . should I delay my SSA until FRA or age 70 . . . or take it now?
The answer is simple. When will you need the money? And when will you die?
As we age the need for more health care, and often more expensive care, increases, not decreases.
Sometimes they are better off keeping their Medigap and paying the premium vs. switching.
I have had a few people drop their Medigap and switch to MAPD because "the Medigap plan never pays anything". They usually say something like "I paid $3,000 in premiums and all the plan paid was $400 for the year. Why am I paying this and getting nothing in return?".
Insurance is not an investment product, it is a risk transfer product. If you are "winning" every year it is because your health is poor.
Losing is a good thing because that means you are healthy.
If you are tired of losing money on your plan every year let me introduce you to folks who incurred $50k . . . $100k or more in medical expenses and only paid $200 or so toward their medical bills.
People are short-sighted and the often don't look at the other side of the balance sheet.
Some of those who switched to save premium dollars called me a few years later wanting to get back on a Medigap plan and I had to tell them no, they would have to keep their $0 premium plan. In retrospect they made the wrong choice.
People turning 65 also ask a similar question . . . should I delay my SSA until FRA or age 70 . . . or take it now?
The answer is simple. When will you need the money? And when will you die?
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So the message here is.......mapd is great until or unless you have a bad health condition. Or am I missing something?
No the message here is he’s well off and can afford a Med supp . When somebody’s used to paying zero for claims and can afford it they like it . Ironically his wife had a mapd and had $100k of bills recently . She never said one bad word about it . Question . Would you rather a major med with a $5k deductible or $1 k ? Of course we know the answer . But you get the $5 k because you can’t or don’t want to pay the $1k deductible price . My son just had a kid . He had $4 k deductible. He asked me last week should he drop it to a $1 k . I said it’s to late you had the big bill . Same thing with mapd . Of course when the big claim hits you’d rather have med supp. But you buy what you can afford today .
My good friend who makes $300 k a yr I put in mapd 1 yr ago with hospital plan . He had cancer 5 months ago . The cancer rider gave him a check for $7500 $2 k more than his moop . He had zero issues with pre authorization. He’s extremely happy with his plan .
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