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Assume you take 3 or 4 prescriptions which is about the norm. Do you see Medicare Advantage PFFS plans doing better than the HMOs did ...


View Poll Results: What would you do if you were on Medicare?
Enroll in a Medigap plan only 0 0%
Enroll in a Medigap plan and purchase a separate drug plan 2 15.38%
Enroll in a Medicare Advantage plan with prescriptions 5 38.46%
Enroll in a Medicare Advantage plan w/o prescriptions, purchase separate drug plan 6 46.15%
Do nothing, just stay with original medicare only 0 0%
Voters: 13. You may not vote on this poll

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Old 12-22-2006, 08:03 AM   #1
Kyle Henson
 
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Assume you take 3 or 4 prescriptions which is about the norm.

Do you see Medicare Advantage PFFS plans doing better than the HMOs did in the 90s?
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Old 12-22-2006, 12:57 PM   #2
al3
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There are some very nice MA plans out there. In CA Blue Cross has a zero premium plan with a good drug forumulary built in which is popular. It's not as good as a J plan but it's close(er) and obviously less expensive.

Al
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Old 12-24-2006, 03:40 AM   #3
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Originally Posted by al3
There are some very nice MA plans out there. In CA Blue Cross has a zero premium plan with a good drug forumulary built in which is popular. It's not as good as a J plan but it's close(er) and obviously less expensive.

Al
Al, do you sell BC MA plan? Which others do you sell?
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Old 12-28-2006, 11:33 AM   #4
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The PFFS vs. the HMO/PPO really boils down to network. If all your Docs are in the HMO network, the hospital is in netowrk, and you do not travel, why pay more (if the PFFS is more).

We sell mostly HMO and PPO here in KC for that reason.
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Old 12-29-2006, 01:10 AM   #5
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Originally Posted by fla2cali
Originally Posted by al3
There are some very nice MA plans out there. In CA Blue Cross has a zero premium plan with a good drug forumulary built in which is popular. It's not as good as a J plan but it's close(er) and obviously less expensive.

Al
Al, do you sell BC MA plan? Which others do you sell?
I write for BC, BS (they compete in CA), Aetna, and Assurant. These are the major players in the Sacramento area. Of these, only Blue Cross (Freedom Blue PPO) has an MA plan in this area... and it is quite good for zero premium.) I know United Healthcare has one and I believe Humana has one too, but I'm not appointed with UH and no one on the planet can figure out how to get appointed with Humana. It's a some kind of state secret which is not on their website. :-)

Blue Shield has a good MA plan, but they don't sell it in Sacramento county for some reason.

Al
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Old 12-29-2006, 10:20 AM   #6
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Humana (in the Kansas City market) lets brokers sell the PFFS plans. The captive agents are the ones who sell the HMO's and PPO's. They did in this market let a select few independent agents sell the HMO and PPO since there was a shorter time period.

They do have a referral bonus program where you can refer a client to a captive agent and then get paid when they get a MA.
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Old 12-29-2006, 10:34 AM   #7
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I am appointed with Humana, American Progressive, GTL, Wellcare, Unicare for Medicare products only. I mainly write Unicare, AmerProg MA plans and GTL Medigap. Humana Gold plan in Delaware is $199/mo! Don't anticipate doing much of that.
 

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Old 01-02-2007, 02:10 PM   #8
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$199 a month! That is over the top, unless everything else out there is just as expensive.

Have you done any GTL products? I am assuming that is the tie-in plan for inpatient co-pay.
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Old 01-02-2007, 03:44 PM   #9
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$199 is quite insulting to the agent and the client. I'll bet they do not sell a single one here.

I have done a lot of GTL Medigap business, and will probably does some Advantage Plus plans with them this year too.
 

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Old 01-02-2007, 06:10 PM   #10
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Originally Posted by perfectchoice
$199 is quite insulting to the agent and the client. I'll bet they do not sell a single one here.

I have done a lot of GTL Medigap business, and will probably does some Advantage Plus plans with them this year too.
All of those who sell Medicare Supplement coverage with GTL, do you have the rates for Georgia? If so, what's a plan F run for male and female age 65? Also, do they medically underwrite if outside the guarantee issue time frame?

Thanks.
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Old 01-02-2007, 06:34 PM   #11
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If you have Plan F, you do not need the GTL plan, as that is designed to go with Medicare Advantage plans. But they do underwrite after the guarantee period. Basically a one year look back and pull the MIB.
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Old 01-02-2007, 07:07 PM   #12
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Originally Posted by midwestbroker
If you have Plan F, you do not need the GTL plan, as that is designed to go with Medicare Advantage plans. But they do underwrite after the guarantee period. Basically a one year look back and pull the MIB.
So GTL doesn't write a Med Supp? Perfect choice stated he did a lot of GTL Medigap business. I just assumed he was referring to Medicare Supplements. What benefits does the plan you are speaking of provide? I'm assuming it helps with some of the out of pocket expenses associated with MA plans. What's the cost?
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Old 01-02-2007, 07:43 PM   #13
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Oh, my bad. I was talking about the GTL hospital supplement plans that tie-in with the Medicare Advantage plans.

I think that they do write supps, most state insurance websites let you price all the available supps. I would try that.
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Old 01-02-2007, 07:46 PM   #14
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Originally Posted by midwestbroker
most state insurance websites let you price all the available supps. I would try that.
Unfortunately our states website isn't accurate/up to date on any of the med supp rates. That's why I was asking here. Just trying to see how competitive GTL's rates and underwriting is compared to the other carriers here.
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Old 01-03-2007, 09:55 AM   #15
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GTL medigap premiums have increased a lot over the past year. I have one couple paying almost $400/mo for a plan D. Granted they are 86 yrs old. I am going to switch them to a Wellcare Duet plan with $0 premium and maybe add the GTL advantage plus for roughly $40/mo premium. That will help them out tremendously since they can no longer afford their medigap.
It will also pay me pretty nicely at $1200 commish
 

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Old 01-03-2007, 03:22 PM   #16
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A lot of supps went up.

Mutual of Omaha had a 17% increase in MO

BCBS of KC had a 7.6% increase

That is why people are starting to look more twords the MAPD plans rather then the traditional supplement. I have seen a lot of group people looking at these plans since their premiums have also gone up quite a bit.

If Medicare goes 75/25, supps will really jump.
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