Is Medicare Advantage the Future?

[Travis Price]

Same thing with agents. You and your ilk, like YouTube’s Chris Westfall, think that ANY agent that sold someone an MAPD plan didn’t explain the benefits, didn’t tell them about network restrictions, didn’t thoroughly go over the benefits, but rather just talked about all the additional benefits, and was just looking to make a quick buck and get out the door.

I whole-heartedly believe you tell people all of the above

I almost guarantee that you don't explain the claims process or give the client a long-term perspective.

mainly because there's no guide to how MAPD resolves claims, because it's not consistent with Medicare claim rules.

Also, pretending that you don't offer MAPD because the commission is higher than HDG/F really hurts your credibility.

Like it or not, when something is free, the user is the product.

The insurance company, agent, and Medicare are selling manage care because it is more profitable than Medigap

It's fine you're selling MAPD. No one is faulting that. It's about uninformed clients, which I promise that if clients are chosing MAPD over Medigap consistently, they are.

 

[LostDollar]

I think there may be some exceptions to the "informed" issue. There are some senior market agents who post that they have chosen, or will choose, MAPD for their own coverage.

 

[Travis Price]

I think there may be some exceptions to the "informed" issue. There are some senior market agents who post that they have chosen, or will choose, MAPD for their own coverage.

Learn about the 80/20 rule. Outlays happen, and that's fine.. it doesn't make it the rule, it makes it the exception.

 

[goillini52]

Oreo cookie?

No woke cookies for me.

 

[selfgen]

As I stated, I sell both MAPD and Medigap. My book of business is probably close to 50/50. And when I’m talking to a prospect, I’m thinking long term; the commission I’m earning doesn’t even cross my mind. Are you kidding me? I’m not thinking about how much I’m going to earn on any one particular sale. Not at all. I’m thinking that I’m adding another client; I’m growing as an agency; I’m thinking about the referrals I may get from this client, etc etc. I’ve been doing this for 25 years. I never look at one individual sale in that manner and let it persuade me to steer a client in one direction or another.

 

[Yagents]

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...

The only constant in this business is CHANGE.

Politicians are constantly making this a moving target.

Right now, ACA changes are on the radar. If ARPA tax credits are not extended, millions will drop coverage or see rates double or triple if above 400% FPL. Could lose some biz.

If ACA changes the family glitch that's on the block, it could add to ACA business, but hurt group plan business.

If politicians in large states like Florida and Texas expand medicaid, a ton of ACA biz will be lost.

If cms implements $2000 OOP on PDP plans, it could make MAPD less attractive.

Democrats hate private insurers making profits in MAPD, and u could see less funding in future years given the large profits.

Congress could decide to pay for part B and supplements for low income, who knows.

Change is a constant, but change has made me more successful over the years, as more govt interaction, creates more complexity and more need for an agent.

ACA doubled my income as more low income could now afford coverage, and the uninsurable could now get coverage. Before ACA, only the healthy higher income were my clients.

 

[AugustaMi]

The only constant in this business is CHANGE.

Politicians are constantly making this a moving target.

Right now, ACA changes are on the radar. If ARPA tax credits are not extended, millions will drop coverage or see rates double or triple if above 400% FPL. Could lose some biz.

If ACA changes the family glitch that's on the block, it could add to ACA business, but hurt group plan business.

If politicians in large states like Florida and Texas expand medicaid, a ton of ACA biz will be lost.

If cms implements $2000 OOP on PDP plans, it could make MAPD less attractive.

Democrats hate private insurers making profits in MAPD, and u could see less funding in future years given the large profits.

Congress could decide to pay for part B and supplements for low income, who knows.

Change is a constant, but change has made me more successful over the years, as more govt interaction, creates more complexity and more need for an agent.

ACA doubled my income as more low income could now afford coverage, and the uninsurable could now get coverage. Before ACA, only the healthy higher income were my clients.

That all sounds right to me.

One thing is constant...change. So true.

As for ACA, I've gotten away from it totally in 2018-ish...I can't stand it. Just a personal preference.

That's awesome though that it worked out for you. These are great things to hear. Last I knew there was just one company in my area that paid a decent commish. Priority. And I am not that interested in doing it. I will help if it's already someone I know or someone already a client or referral, but I am definitely not looking for new clients anymore.

There are about 45 agents built back up in our organization (over the past ten years without me). Most of those DO choose to do ACA, and I'm more than happy to refer out new ACA clients to them.

True on that, most clients in the pre- ACA were at least middle to upper-middle and healthy socioeconomic sphere, and most did buy life, other ancillaries. Only a few of mine were in the super high upper echelon.

Still today I have a nice niche of people on one of my favored plans that's hung in there, for people who do not qualify for subsidies (mostly, but not all, unmarried high earning men--for a reason--with gender difs they tended to get those plans more--please don't cancel culture me for saying that...lol..might be my own bias idk lol). United Health (Golden Rule 100 percent plan that had the decreasing deductible). Also, a good bunch have HSAs. But, over the past few years those premiums started to rise. I've left them there for now, bc the next step wouldn't be more suitable. I have only looked a few times, and very recently due to a big premium hike, and these people are happy for now. Luckily, I have had only a few people complain about the hikes. And those few are very very close to 65 and Medicare. So there's that...

My apologies, I got off-topic, maybe on purpose. I stay away from politicking. That has landed me in hot water in the form of a drunk tank back in 2017. True shameful story. I was out one night on a rare occasion, talking about ACA and Obama with strangers, bellied up at a bar in a casino. Temperatures got heated and heavy. That night went seriously wrong. My fault of course, and it turned out to be a life-changing event. I've since learned to stay away from alcohol and politicking.

Thanks for sharing Yagent, I did take it in and always do...Fyi, back years ago when I never posted on here, I was reading still and remember you being on here many years back...with helpful info.

Time to go to the office and switch gears to my other job....tomr back to this job. I love the variety, actually. Just not ACA. LOL.

 

[Unamanine]

That all sounds right to me.

One thing is constant...change. So true.

As for ACA, I've gotten away from it totally in 2018-ish...I can't stand it. Just a personal preference.

That's awesome though that it worked out for you. These are great things to hear. Last I knew there was just one company in my area that paid a decent commish. Priority. And I am not that interested in doing it. I will help if it's already someone I know or someone already a client or referral, but I am definitely not looking for new clients anymore.

There are about 45 agents built back up in our organization (over the past ten years without me). Most of those DO choose to do ACA, and I'm more than happy to refer out new ACA clients to them.

True on that, most clients in the pre- ACA were at least middle to upper-middle and healthy socioeconomic sphere, and most did buy life, other ancillaries. Only a few of mine were in the super high upper echelon.

Still today I have a nice niche of people on one of my favored plans that's hung in there, for people who do not qualify for subsidies (mostly, but not all, unmarried high earning men--for a reason--with gender difs they tended to get those plans more--please don't cancel culture me for saying that...lol..might be my own bias idk lol). United Health (Golden Rule 100 percent plan that had the decreasing deductible). Also, a good bunch have HSAs. But, over the past few years those premiums started to rise. I've left them there for now, bc the next step wouldn't be more suitable. I have only looked a few times, and very recently due to a big premium hike, and these people are happy for now. Luckily, I have had only a few people complain about the hikes. And those few are very very close to 65 and Medicare. So there's that...

My apologies, I got off-topic, maybe on purpose. I stay away from politicking. That has landed me in hot water in the form of a drunk tank back in 2017. True shameful story. I was out one night on a rare occasion, talking about ACA and Obama with strangers, bellied up at a bar in a casino. Temperatures got heated and heavy. That night went seriously wrong. My fault of course, and it turned out to be a life-changing event. I've since learned to stay away from alcohol and politicking.

Thanks for sharing Yagent, I did take it in and always do...Fyi, back years ago when I never posted on here, I was reading still and remember you being on here many years back...with helpful info.

Time to go to the office and switch gears to my other job....tomr back to this job. I love the variety, actually. Just not ACA. LOL.

Your experience highlights an important aspect of any profession: finding what you are passionate about and aligning your work with those interests can bring greater satisfaction and success

 

[BALDELMO]

[EXTERNAL LINK] - Opinion | ‘What’s My Life Worth?’ The Big Business of Denying Medical Care

 

[rmhaire]

[EXTERNAL LINK] - Opinion | ‘What’s My Life Worth?’ The Big Business of Denying Medical Care

You've done it now. The mao's are going to be on the war path. If you need a place to hide out for a few days let me know.