Med Supp Benefits

[Northeast Agent]

I'm working on my yearly AEP letter, and am bracing myself for the angry calls I expect over the Part D premium increases.

What am I omitting here regarding Med Supp benefits?

A Medicare Supplement (Medigap or “Med Supp”) plan allows you the freedom and flexibility to go to any doctor or hospital in the country that accepts Original Medicare. There are no networks, prior authorization isn’t required, the plans don't change yearly like Advantage Plans, there's no 20% co-pay for cancer treatment, no co-pay for hospital stays, PT/OT, you get more time in skilled nursing plus the supplement gives you Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used).

You and your doctors have a lot more control managing your health care decisions with a Med Supp than having an insurance company decide what tests, procedures, etc you can have.

 

[BALDELMO]

Nailed it.

 

[Northeast Agent]

Baldelmo said:

Nailed it.

Thanks. And I just remembered that dialysis costs are covered by a Supp. Trying to see what else.

 

[somarco]

No prior authorization except for DME

Referrals not required

No out of network penalties

Ability to budget your health care

Accepted without restriction by providers who participate in Medicare. (Same applies to Medigap)

No surprise billing

Patient is not responsible for claims denied by Medicare unless they signed a valid ABN form

Med's covered by Part B generally have a lower OOP cost when Medicare is coupled with G plan. (see attachment)

More on Part B drugs
https://www.medicare.gov/coverage/prescription-drugs-outpatient

EDIT
One more benefit . . . no blackout periods like when the MAPD provider contract expires and they will not accept patients until the contract is renegotiated and executed. During that time OM patients can still receive treatment without a challenge

 

[Midlevel]

I'm working on my yearly AEP letter, and am bracing myself for the angry calls I expect over the Part D premium increases.

What am I omitting here regarding Med Supp benefits?

A Medicare Supplement (Medigap or “Med Supp”) plan allows you the freedom and flexibility to go to any doctor or hospital in the country that accepts Original Medicare. There are no networks, prior authorization isn’t required, the plans don't change yearly like Advantage Plans, there's no 20% co-pay for cancer treatment, no co-pay for hospital stays, PT/OT, you get more time in skilled nursing plus the supplement gives you Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used).

You and your doctors have a lot more control managing your health care decisions with a Med Supp than having an insurance company decide what tests, procedures, etc you can have.

Try this:

Medicare supplements are really the only option you should be looking at for your Medicare insurance. There is no reason to look at the other plans that have $0.00 premium, alot better drug plan then I have you on plus dental, vision, OTC, gym, reimbursement for anything related to your fitness activities. Oh, and worst case scenario you would have $3900 max oop for the year. As you can see you are far better off paying $1800/year for your Med Sup and PDP (please ignore that small $545.00 deductible) and then paying all of your own dental, vision, etc. Just because 52% of all eligibles are now on those other plans doesn't mean it will work for you.

Sincerely,

Med Sup only agent

 

[Northeast Agent]

Midlevel said:

Sincerely,

Med Sup only agent

Hey, Midlevel I appreciate your post and feedback. I do sell both MS and MAPD plans, but once someone is on a MS I hate moving them to a MAPD.

I can explain to people 10x the differences, but soon after they switch they're usually griping about co-pays for PT and prior authorizations, etc.

Totally agree with you about the drug costs being better usually on a MAPD than a standalone PDP. I may delete the paragraph about all the MS benefits and just send it to clients who want to swtich as a reminder.

 

[somarco]

Of course there is absolutely NO downside to MAPD . . . .

sincerely

MAPD agent

 

[Midlevel]

Of course there is absolutely NO downside to MAPD . . . .

sincerely

MAPD agent

I haven’t ran into any and have 600 clients on MAPD’s and adding bunches more every year.

MA, Cost Plan and Med Sup agent

 

[T Sparks]

Try this:

Medicare supplements are really the only option you should be looking at for your Medicare insurance. There is no reason to look at the other plans that have $0.00 premium, alot better drug plan then I have you on plus dental, vision, OTC, gym, reimbursement for anything related to your fitness activities. Oh, and worst case scenario you would have $3900 max oop for the year. As you can see you are far better off paying $1800/year for your Med Sup and PDP (please ignore that small $545.00 deductible) and then paying all of your own dental, vision, etc. Just because 52% of all eligibles are now on those other plans doesn't mean it will work for you.

Sincerely,

Med Sup only agent

You forgot that annual deductible for Part B and the usual 10-15% increase on the MedSupp premium each year.

 

[sshafran]

the usual 10-15% increase on the MedSupp premium each year.

Stats to back that up?

I'll grant they go up, but I have several 10+ in who aren't near that pace.