Part C

dandan · 10-24-2007, 03:02 PM

Am I the only one that thinks Medicare Advantage plans are a bad deal? I know people say that many people can't afford to pay med supp premiums, but wouldn't they be the very same people that could not afford the out of pocket expenses that could hit them with a advantage plan?

2112Greg · 10-24-2007, 03:39 PM

No, you're not the only one...but all too often, agents will place them in an MA plan before a regular supp. only to find out their client cannot get the care they had before, Medicare has been replaced and they are pissed off. Agent makes a bundle, though. Bad deal for the client...so I don't deal with them. In fact, I do the opposite...I get them OFF these plans and back to original Medicare and a good Part D.

See my post in this forum about the FBI raiding Wellcare...these things are about to explode, IMO.

dandan · 10-24-2007, 04:04 PM

Greg, I am new to the forum, I am a old time med supp guy. I have seen so much abuse with the advantage plans and much confusion on all parts. Thanks for your response, I was beginning to think I was not seeing the forest for the trees.

*midwestbroker* · 10-24-2007, 04:15 PM

Part C can be a bad deal, all depending on where you live.

If you are not in a major metro area, Medicare Advantage plans are probably still new. Here in Kansas City, they are old news.

Humana has been in KC with some type of Medicare Advantage plan since 1991. Coventry since 1999. They were standardized in 1997 by Clinton (called Medicare + Choice) and then expanded by Bush in the Medicare Modernization act in 2003. Now they are Part C.

So, they are a good thing, pending on the benefits. I should mention that I only sell HMO/PPO plans, and I do not mess with the PFFS side.

MAPDagent · 10-24-2007, 04:41 PM

I sell Medicare Advantage PFFS plans almost exclusively, and I think Medicare Advantage is great, and so do my clients. Although I also sell med supps, I think they are just insurance for insurance (which is kind of silly IMO). A minute fraction of people out there on MA plans ever even approach the MOOP on an MA plan, most of them paying maybe $1000 in a year. Many more pay much less than that. I'm not making this up either, because I have seen the statistics.

I know it's cliche, but if people would put their med supp premium in a self-made health savings account instead of a med supp company, they would find that they could potentially save many, many thousands of dollars over their lifetime. Believe it or not, I actually have quite a few clients who do just that.

It really just comes down to choice and how an individual wants to handle their health insurance expenses and risk. Some folks prefer to just pay a monthly bill and forget about it...others would prefer to pay as they go. It doesn't really matter to me, but I feel it's my fiduciary duty to let people know what their options are, and then let them decide.

dandan · 10-24-2007, 04:59 PM

The older each of us get the more medical expenses we tend to experience, for example home health care, oxygen, skilled nursing home etc. These are very real and expensive benefits.

It seems like the very people that can't afford these expenses are the very people that are targeted by the advantage plans.

I can maybe see the plans being a good fit for the 65-70 crowd that are on the wealthy side and are willing to take the risk of the potential MOOP.

I guess I need a lot of convincing, and the regulations if done correctly if I'm understanding it.

1.You have to have an appointment 2.you must give a complete presentation 3. you cannot compare a competitors plan 4. If it is not a good fit you cannot pull a med supp app out and write it you must make another appointment a go back! 5. and as a salesman you are not selling or aloud to sell but you help them enroll.

*midwestbroker* · 10-24-2007, 05:18 PM

Those CMS rules are inplace to prevent people from showing up for one thing and selling another (bait and switch). If you are doing your job properly, then you should not have any problems.

You make a good point that people who cannot afford DME and other expenses are targeted by MA carriers, but they are the ones who could benefit from it as well. They are typically the ones who do not have a supplement and are only on Medicare alone.

What I have seen in the market place is the wealthy or well off keep the supplement because the premium is not effecting their lifestyle. The ones who are struggling to pay bills and supplement premiums or have lost their supp due to rising premiums are the ones enrolling in MA plans.

MedSuppPro · 10-25-2007, 12:20 AM

MA plans can be good, bad, and ugly. I've seen many go over their MOoP . And I've yet to hear an agent or company trainer warn the consumer "and don't get ESRD (Renal Disease)". What about the Zero premium MA member who later develops ESRD. Can they move from MA plan to MA plans or are they stuck with a bad marriage.

But, you have got to stay competitive in the marketplace. There are good MA's that work. And that market will change year to year and county by county. The Zero mentality is out their across all economic boundaries. It is OK to favor MedSupp's. After all, your the pro.

scottfree · 10-25-2007, 10:53 AM

Quote:

Originally Posted by 2112Greg

No, you're not the only one...but all too often, agents will place them in an MA plan before a regular supp. only to find out their client cannot get the care they had before, Medicare has been replaced and they are pissed off. Agent makes a bundle, though. Bad deal for the client...so I don't deal with them. In fact, I do the opposite...I get them OFF these plans and back to original Medicare and a good Part D.

See my post in this forum about the FBI raiding Wellcare...these things are about to explode, IMO.

Quote:

Originally Posted by midwestbroker

Part C can be a bad deal, all depending on where you live.

If you are not in a major metro area, Medicare Advantage plans are probably still new. Here in Kansas City, they are old news.

Humana has been in KC with some type of Medicare Advantage plan since 1991. Coventry since 1999. They were standardized in 1997 by Clinton (called Medicare + Choice) and then expanded by Bush in the Medicare Modernization act in 2003. Now they are Part C.

So, they are a good thing, pending on the benefits. I should mention that I only sell HMO/PPO plans, and I do not mess with the PFFS side.

Quote:

Originally Posted by MAPDagent

I sell Medicare Advantage PFFS plans almost exclusively, and I think Medicare Advantage is great, and so do my clients. Although I also sell med supps, I think they are just insurance for insurance (which is kind of silly IMO). A minute fraction of people out there on MA plans ever even approach the MOOP on an MA plan, most of them paying maybe $1000 in a year. Many more pay much less than that. I'm not making this up either, because I have seen the statistics.

I know it's cliche, but if people would put their med supp premium in a self-made health savings account instead of a med supp company, they would find that they could potentially save many, many thousands of dollars over their lifetime. Believe it or not, I actually have quite a few clients who do just that.

It really just comes down to choice and how an individual wants to handle their health insurance expenses and risk. Some folks prefer to just pay a monthly bill and forget about it...others would prefer to pay as they go. It doesn't really matter to me, but I feel it's my fiduciary duty to let people know what their options are, and then let them decide.

I am not going to add much to this right now, but MA plans can be both bad and good. I believe mostly that they are good. I love to hear how agents that sell MA plans are doing it for the big bucks. I think it is just the reverse if you want to do the math. MA's give good first year commission(250-400 for the most part) then the next year most pay in the area of $100 and the years after that they fall off even more. Med sups commission is 15% to 22% of premium, so a $1800 yearly premium is say $300 and you get a bit a a reduced amount for that for usually 10 years and then it is reduced. Who's making more money???

I do sell MA plans mostly and also offer can offer some of the least expensive sup plans out their there. BCBS plan J is $109 a month.

90% of my clients have MA's and 95% of them are happy.

Let the MA bashing continue..................

retread · 10-25-2007, 11:52 AM

Scottfree:

How do you contract with BC/BS to sell Med Sups? Here in Kansas and Missouri, BCBS has no agents. They only sell directly to beneficiaries and that's why they say they offer the lowest cost plans. Indeed, their plans are the lowest across the board. I can sell BCBS individual health plans, but not Medicare plans. I assumed this was the same for other states as well.

Anyone else out there have info about BCBS Med Sups, please chime in.

dandan · 10-25-2007, 12:02 PM

I'm sorry if you feel I'm bashing MA plans, I am more trying to understand them.

I mentioned a few of my concerns is all and just wanted your educated opinions.

I also went through certification with a company and was told Doctors may accept you as a patient with a PFFS, and if you go back a week later he can decide not to accept you, they said they can accept or not accept you at will.

A couple other Questions.
If you go on an appointment with hmm lets say BCBS and after doing the needs analysis you find Humana is a better fit what do you do?

If you have a client that only wants PDP and they don't offer to tell you what meds they take what do you do?

dandan · 10-25-2007, 04:13 PM

? anybody

arnguy · 10-25-2007, 04:49 PM

In the Philadelphia 5-County Metropolitan Area, MA plans have been around for many years and enjoy wide popularity. This is where US Healthcare started in business selling HMO's before they were sold to Aetna. Today there is heavy competition between Aetna and Blue Cross in the Part C arena. There are a few other players within the city limits of Philly. Most MA subscribers I know are happy with them. I understand that Blue Cross will be adding a PFFS Plan for 2008.

*midwestbroker* · 10-25-2007, 10:14 PM

Retread - You can contract with BCBS of Kansas City, but you have to go through a blue chip brokerage, like Financial Associates in Overland Park (that is who I have my contract through).

Dandan -

If you find that another plan is a better fit, then you should tell the client just that. I know agents who sell each MA plan here and will kick it to them, as they do the same.

With PDP, if they do not offer to tell you their drugs, just hand them the formulary and tell them they can find how they are tiered in there.

I have had only a couple of people that would not give me any info about themselves (like they were in a stand off). All you can do is review the benefits, tell them how to enroll and ask if that is what they want.

senior-advisor-indiana · 10-25-2007, 10:44 PM

If they won't tell you thier meds then tell them to kiss off. Its not worth the money to talk to them. They don't trust you anyway if they won't tell you that. I have never had anyone keep thier meds from me though.

GreenSky · 10-26-2007, 02:12 AM

Quote:

Originally Posted by senior-advisor-indiana

If they won't tell you thier meds then tell them to kiss off. Its not worth the money to talk to them. They don't trust you anyway if they won't tell you that. I have never had anyone keep thier meds from me though.

Agreed. I've never met a senior who wasn't proud of all their medication!

By the way, you spell it "their". Just being helpful until the spell check is on line.

Rick