$0 MAPD a Better Plan Than a Med Supp....

[Chazm]

Other than affordability and insurability, please tell us all the ways a MAPD is better than a Med Supp, oh wise one.

Because he lives in FL where it's often true.

 

[goillini52]

Because he lives in FL where it's often true.

I previously conceded that Florida is a different animal.

 

[Chazm]

The other 75% don't all get Medicare Supplements, I believe the national average is around 20%.

I believe in giving my clients a choice of either Medigap or MAPD, particularly in areas such as Florida where a combination of Plan F plus PDP can be $250+ per month.

It's much different to me when Plan F's are in the $150 range, as they are in many states-in those cases I usually recommend a Medigap plan.

There are many metropolitan areas where MAPD penetration is 45% and higher-those areas usually have MAPD plans with better benefits and networks than in more rural areas.

I don't offer Indemnity or Cancer plans (or dental) to my MAPD clients, they would be better off with a Plan K or HDF than spending the money for those

I have no problem with agents who choose to only offer Medigap plans and but wonder why it's so important for some of them to be so critical of those of us who offer both sides. I've personally had MAPD plans for the past 4 years without an issue but recently switched to a low cost (Plan K) Medigap plan because I am spending lots of time in a state where the MAPD travel benefit isn't available.

I just had another example where a client is looking at a Med supp, premium is ~$220/month and a drug plan for roughly $30/month.

I was recommending that but told him he was going to have a huge amount of drug cost, roughly $10k per year.

Out of curiosity, on Medicare.gov, I clicked health plans with drug coverage. 3 of his brand name drugs on Part D only, were tier 2 generics with AETNA PPO in my area. So they are like $5 and to top it off, they are $5 in the donut hole!

There was no way I could recommend the med supp and rx over that.

 

[FLM2]

I just had another example where a client is looking at a Med supp, premium is ~$220/month and a drug plan for roughly $30/month.

I was recommending that but told him he was going to have a huge amount of drug cost, roughly $10k per year.

Out of curiosity, on Medicare.gov, I clicked health plans with drug coverage. 3 of his brand name drugs on Part D only, were tier 2 generics with AETNA PPO in my area. So they are like $5 and to top it off, they are $5 in the donut hole!

There was no way I could recommend the med supp and rx over that.

You did a really good job for your client by taking that extra step...

 

[kgmom219]

The other 75% don't all get Medicare Supplements, I believe the national average is around 20%.

I believe in giving my clients a choice of either Medigap or MAPD, particularly in areas such as Florida where a combination of Plan F plus PDP can be $250+ per month.

It's much different to me when Plan F's are in the $150 range, as they are in many states-in those cases I usually recommend a Medigap plan.

There are many metropolitan areas where MAPD penetration is 45% and higher-those areas usually have MAPD plans with better benefits and networks than in more rural areas.

I don't offer Indemnity or Cancer plans (or dental) to my MAPD clients, they would be better off with a Plan K or HDF than spending the money for those

I have no problem with agents who choose to only offer Medigap plans and but wonder why it's so important for some of them to be so critical of those of us who offer both sides. I've personally had MAPD plans for the past 4 years without an issue but recently switched to a low cost (Plan K) Medigap plan because I am spending lots of time in a state where the MAPD travel benefit isn't available.

We aren't critical of people who offer both.

We are critical of people with a "one size fits all" approach to MAPD or those that make stupid statements like "She never sales MS because a $0 MAPD is a much better deal for the client........."

Is there a place for MAPD? Absolutely. Is it a regional answer? Yes. But under NO circumstance is it a better insurance plan. That's what makes me nutty. But it may be the best plan you can afford.

 

[vic120]

I feel like affordability and insurability are pretty big parts of insurance...but...

Well, I dont know what the illinois market is like. But here in Florida, many parts of the state, it is very strong. I will take one client I have living in Miami county for example. Female, age 66.

She could either pay $286 for a plan F, or $206 for a plan N with AARP (usually the best deal in this state, and no, I'm not gona take the time to look up every medsupp price right now. this is just a rough example.)

Or a $0 MAPD plan that gives back $75/mo with a strong network (as most have around here) and has $0 copays for Doctors, Specialists, Outpatient hospital, Inpatient hospital, and a $50 copay for ER. AND has a MOOP of $3,400 (and this is NOT a medi/medi plan)

Her total estimated cost for insurance (including copays) for the year: $300
if she was on a plan N, it would be: $2,472 (and thats not including copays)

In many cases, MAPD is a better choice. But not always.

I find better to be a subjective word, I have seen the 20/20's where the lady is denied better treatments for back surgery because of preauth denied on MA plan where med supp client have not this Issue. There are other situations too

I find even in area's like in Fl and NY I sell about 70% med supp to MA. in other area's 85 to 90% med supp. I explain the whole of the plus and minus and as a result, I never get the calls about MA not covering what was expected and retention is great, I did get some of those call in my first year before I fully understood the plus vrs minus

 

[LostDollar]

You did a really good job for your client by taking that extra step...

Seems like that might be conditional on whether the medical professionals needed to support the big dollar drugs sign up with plan in question.

 

[FLM2]

We aren't critical of people who offer both.

We are critical of people with a "one size fits all" approach to MAPD or those that make stupid statements like "She never sales MS because a $0 MAPD is a much better deal for the client........."

Is there a place for MAPD? Absolutely. Is it a regional answer? Yes. But under NO circumstance is it a better insurance plan. That's what makes me nutty. But it may be the best plan you can afford.

I said 'some', not 'all' and some are very critical about this regardless of whether you offer both sides or just one.

Those who only offer MAPD are certainly shortsighted and I believe those who only offer Med Supps are fine in doing so but shouldn't bad mouth MAPD in order to sell those plans, it isn't needed because I do fine with both offering a balanced perspective.

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Seems like that might be conditional on whether the medical professionals needed to support the big dollar drugs sign up with plan in question.

The agent clearly understands that or he wouldn't have taken the time to do the search and make the recommendation.

 

[kgmom219]

You did a really good job for your client by taking that extra step...

This is where I disagree. What are the drugs? What's the DX? What's the long term ramifications?

And $10K??? I've got a lot of Part D reviews and I haven't seen anything over $5K yet...

I'm really not trying to argue, but I would love to see the actual info that got you to Aetna MAPD vs Sup/Part D.

 

[LostDollar]

The agent clearly understands that or he wouldn't have taken the time to do the search and make the recommendation.

Ok, thanks. I just commented because I had recently seen another post elsewhere where an agent removed a client from an MA or MAPD because of an unanticipated $10K charge for medical providers. The post above seemed to imply that that decision was made solely on prescription drug costs.
LD