Is Medicare Advantage the Future?

[somarco]

present the facts, let the potential client choose what best suits their needs

That's the way I approach it.

However, I find it disturbing that some prospects either forgot, or failed to understand how MAPD plans really work. One of the more common ones I run into is the belief they can use their PPO plan with ANY provider with impunity.

That is not always the case, and even if/when a non-par provider agrees to see you, the patients OOP costs may be higher vs using a par provider. A retired home office individual argued that I was wrong on a public forum. Even when presented with verbiage from (what he claimed to be his plan) he continued to say "That is not what it says. I have gone to non-par providers and NEVER been charged more.".

Of course that settles it.

I suggested he contact his carrier and tell them to change the SOB wording . . . which I am certain he did.

 

[T Sparks]

However, I find it disturbing that some prospects either forgot, or failed to understand how MAPD plans really work. One of the more common ones I run into is the belief they can use their PPO plan with ANY provider with impunity.

I find it disturbing when someone insinuates that an agent who OFFERS a MA-PD plan is a "peddler" or soon to be used car sales man.

Look...after doing this for numerous yrs. since 1986 to be exact.
It is not disturbing to me when I get that call from a client that ask me to explain how their part A , B and part G works and or why that 86 yr old calls and takes zero medications wants to know why they are paying close to $400.00 a month for their medicare supplement and why they need a seperate drug plan. I get it.

I use to be ALL in on the Med. Supp. game but NO more. You have to give these folk the option for both or someone else will.

By all means this is in no way a perfect system...you just have to educate yourself stick to the basics and do your best for the people.

 

[somarco]

Some are peddlers and tin men, some are not.

I never said ALL agents who offer MAPD plans are uninformed, or fail to fully explain and present the complexities of managed care plans.

Learn to read with comprehension.

However, if the shoe fits . . .

 

[Travis Price]

Tom @goillini52 the article you linked is from 2020 . . . the "Trump" model which has since been scrapped in favor of the Biden model . . . at least for now. Seems the Biden model has detractors that are casting stones.

Which will be replaced by the next administration's "great ideas."

Unfortunately, government "helps" you to death. I don't think it's like "Let's screw over these people.." instead of "This is a better way in my opinion, and I have the authority to enforce it."

 

[T Sparks]

Some are peddlers and tin men, some are not.

I never said ALL agents who offer MAPD plans are uninformed, or fail to fully explain and present the complexities of managed care plans.

Learn to read with comprehension.

However, if the shoe fits . . .

Ok Mister professor...you missed your calling!

Seems as though you choose not to offer complex managed care plans due to your limitations of intellect

 

[Jeffrey_G]

Possibly, my personal opinion is different, but others disagree. From a retiree's perspective the pitch is attractive . . . even though the presentation is rarely (if ever) accurate and mostly misleading.

If MA is the "wave of the future" is it a good business model for the agent?
MAPD is moving in the same direction. DTC advertising comes from CMS and the carriers. Frankly, I am surprised agents are still in the game. While some agents produce a fair amount of business (mostly because of artificial incentives) a number of agents create headaches for the carriers. It has always been that way in the health insurance side. Agents who know how to sell but have no idea what they are selling or how the product works, create problems, and losses, for carriers.

How long before the MAPD market is no longer a profitable business model for agents? Change, is good . . . or is it?

Started writing med supps in 1988. I utterly despise what has become of the marketplace these days. MA is the scourge of modern times in this business, primarily because the plans are so heavily protected by disenrollment periods, have no real underwriting and are dirt cheap.

Misinformation is rife... I have even seen misleading statements made on the avalanche of constant daytime commercials on TV.

But it seems they are here for the duration, and if you cant beat em... join em. I have become much more of a LTC, life and annuity guy these days, but I still rely on the med supp market to find such clients.

Wont be much longer before trad med supps are in the minority. I am in the process of adapting before I turn into a dinosaur.

 

[aheff]

Started writing med supps in 1988. I utterly despise what has become of the marketplace these days. MA is the scourge of modern times in this business, primarily because the plans are so heavily protected by disenrollment periods, have no real underwriting and are dirt cheap.

Misinformation is rife... I have even seen misleading statements made on the avalanche of constant daytime commercials on TV.

But it seems they are here for the duration, and if you cant beat em... join em. I have become much more of a LTC, life and annuity guy these days, but I still rely on the med supp market to find such clients.

Wont be much longer before trad med supps are in the minority. I am in the process of adapting before I turn into a dinosaur.

Gosh golly

Started writing med supps in 1988. I utterly despise what has become of the marketplace these days. MA is the scourge of modern times in this business, primarily because the plans are so heavily protected by disenrollment periods, have no real underwriting and are dirt cheap.

Misinformation is rife... I have even seen misleading statements made on the avalanche of constant daytime commercials on TV.

But it seems they are here for the duration, and if you cant beat em... join em. I have become much more of a LTC, life and annuity guy these days, but I still rely on the med supp market to find such clients.

Wont be much longer before trad med supps are in the minority. I am in the process of adapting before I turn into a dinosaur.

I utterly LOVE what has become of the Medicare business. As a salesperson and producer that writes both MA and MS for sometime, it's been a great business to be in. We are our own bosses. We own our business. We work as hard or as little as we want to. And that renewal income stream... So, what exactly are you complaining about?

 

[UKTX]

This is America. Eventually, someone is coming to stop the party. Its not a case of are they, its a case of when are they.

It could be 5 years, 15 years or 25 years from now. No one knows. At 43 I might make it to retirement age (55-60 ish) before anything happens.

I have learnt that when things are going good for a agent, someone, somewhere is looking to bring you down. Whether thats shaving your commissions, altering your contract, tweaking the product, or having the feds step in to act as guardian and savior :(

What they did to under 65/major med show us what the future looks like for a Medicare agent, and they did that quick as well. 2009 I was selling a major med for 35% commission, 9 month advance........by 2011 it was over.

They view commissions as the evil monster....eventually they will reduce/remove them to force consumers to go direct or to a single payor, with very limited options.

 

[AugustaMi]

Possibly, my personal opinion is different, but others disagree. From a retiree's perspective the pitch is attractive . . . even though the presentation is rarely (if ever) accurate and mostly misleading.

If MA is the "wave of the future" is it a good business model for the agent?

For years DC has pushed the single payer system for health insurance and it never got off the ground. Then a charming young fellow came on the scene, connected with the younger crowd, women and minorities, and swept the political landscape with a Gordon Gecko style catchphrase . . . "Change, is good".

People bought the pitch. Some thought everything would be free an no one would have to pay for anything.

Of course they were wrong . . .

Now we have ACA, a fascist creation where government tells private enterprise what they can and cannot do. This change did not lower premiums but did create a massive subsidy program making the monthly cost affordable (after rebate) to low income individuals . . . everyone else is screwed in that regard.

It also promised to bend the health care cost curve downward. Never happened. Health care is more expensive than ever.

Insurance carriers and agents cheered the change . . . then envisioned a world where everyone would be required to buy their product and all those on the supply side would get wealthy.

Didn't happen.

Most health insurance carriers bailed on the market . . . same for agents. Consumers, for the most part, must go to a government site to shop, price and purchase health insurance. Agent commissions are lower and mostly restricted to open enrollment and SEP. The overall number of agents and carriers in the under 65 health insurance market fell off a cliff shortly after ACA was implemented.

The few carriers that remained in the market don't need (or want) agents, plus the government handle most of the DTC advertising. Carriers are bootlicker's and lapdogs for the government.

MAPD is moving in the same direction. DTC advertising comes from CMS and the carriers. Frankly, I am surprised agents are still in the game. While some agents produce a fair amount of business (mostly because of artificial incentives) a number of agents create headaches for the carriers. It has always been that way in the health insurance side. Agents who know how to sell but have no idea what they are selling or how the product works, create problems, and losses, for carriers.

How long before the MAPD market is no longer a profitable business model for agents? Change, is good . . . or is it?

Caveat, I didn't read all the posts here. The ACA talk always gets my temperature rising...by the time things got very bad, we were losing Assurant, World, American Community, etc....I loved the U65 world.

I lived through that and was doing very well when we started to know ACA was coming down the pipeline, around 2009. I remember the day someone came in spouting off about Market Place Exchanges, probably 7 or 8 yrs before the exchanges actually came to fruition. My initial thought was wtf is she talking about? Turns out she was right. We all heard it was coming but remained in relative denial/disbelief. Then it happened. It was a "slow death" is what it felt like to me. We had time to prepare but many did not.

Looking back, I wish I had prepared better. But it turned out well for me, although I had to add another basket for my eggs. I chose property management. Luckily I had my 3 kids all but out the door into adulthood. Back then, Assurant was my bread and butter, with a high GA contract, that supported the family as a single mother of three. Also sold tons of Life, Ancillaries (mostly Assurity but others as well).

At that time, we had about 40 agents. Most scattered to varying other careers. A few chose to jump into Medicare. I wish I had went to Medicare, but again, things turned out fine for me in another area.

As it stands now, and because of the past experience, one of those agents did manage to get me back thinking about Medicare recently. I am doing it and doing ok with it. However, I will never do this business without other baskets for all my eggs

Is Advantage the future? I really doubt it. These things change so fast based on politics. But I do feel like its at least here for awhile. While I was getting started, just back in August, to start right at AEP 2021, I was very skeptical. Took my time with learning all the ins and outs (gap, MA, MAPD, PDP, varying carriers) to be prepared for all things that may come my way out in the field.

So far, most do not want Supps anymore. I have presented and offered and client picks MAPD. Little caveat here too, is that mostly I am seeing people who were already established MAPD people. As someone else pointed out here though is that I too am coming across many with JUST A and B. Those people are presented all options. So far they have chosen MAPD.

I've been wanting to sell a certain Supp, esp bc there's bonuses and its a good option, but people aren't biting.

One thing I do know is that in the beginning my thoughts were "ok, wow, he was right this is a great thing so far...easier than U65 (the biz I used to cherish), and I thought maybe I should quit my day job and focus soley on this. Then My temperature rose again thinking about the ACA f'n mess, and quickly went back to my "Do Not Put All My Eggs In One Basket" theory.

Short answer is that I am very very skeptical of Medicare Advantage being the future. I'm here now though and people seem to like it from my pov. Many of these clients were already used to high deductibles BC of ACA and many even prior to that....So, the MOOPs are not a problem for them. I add the GTL when I can...same as I used to with Assurity CI....they like that and there's another purpose of that...it keeps my clients with me (studies show more policies in a household more likely they stay long term, less likely to jump ship next phone call they get...imo and experience I have seen this in past U65 life).

After getting through the ACA issues, I will say this....I trust NOT A WHOLE LOT in this biz, and I understand fully that I need to be ready to roll with the changes....and of course, have more baskets for the eggs. I have seen the rug pulled out in a crazy and slow way, and I do think there's a high likelihood it could happen with MAPD, but it's here now, and quite alright for me. If the rug is pulled, I doubt it will be fast and abrupt. We have to roll with the changes, as do our clients.

Just my opinions, and I might be new to this whole MAPD scene, but I am no longer naive after ACA. Hell, just thinking about that still makes my temp rise. I loved that biz back in the day and thank God I had it to raise my kids, but damn...for me that was a wicked bittersweet learning experience....stronger today bc of it though...

 

[sman]

Is Advantage the future? I really doubt it. These things change so fast based on politics. But I do feel like its at least here for awhile.

Short answer is that I am very very skeptical of Medicare Advantage being the future.

Well, the MAPD market is 28 million strong and growing each year. That's a very large voting block to piss off. While ACA really destroyed the health insurance market, it was really marketed more to the individual purchaser and not the group insurance market (although it greatly impacted that market as well).

My point is, I believe MAPD is here to stay unless we go completely nuts and move to single payer with a max out of pocket cap on Medicare. It certainly could happen, but I believe MAPD is here for a long, long time.