Good News for Medicare Producers

[Brian Anderson]

NAMSA President Ron Iverson just wrote an article for Insurance Forums detailing some positive developments on the Medicare front, including a July CBO report indicating Medicare spending (on a per capita basis) is slowing down; there is progress and hope for a bill to resolve the “admitted” vs. “observational” status of a patient, which impacts whether or not Medicare is paying for the hospital stay; incidences of Alzheimer’s and strokes may be on the decline; and reasons behing nursing homes actually seeing a decline in residents between 2000-2010.

Check out the article here:
Insurance Forums | 3 weeks of solid good news for Medicare-aged people and producers

In your view, what is the best news or most important development for producers who write med supps and MA policies?

 

[houcoogster]

Brian,

You must not have gotten the memo.

Good news is not-allowed on the forum please remove at once!

 

[Midlevel]

To me the best news is the observation vs. admittance to the hospital. A lot of people on MAPD's are getting burned by it being coded observation. Not only does it usually cost more when they pay 20% vs. their daily hospital rate but unless it is 24 or more hours of observation the hospital indemnity plan will not pay either. The 3 day hospital stay doesn't effect the MA plans as much as they do Original Medicare recipients.

 

[MedSuppPro]

"which impacts whether or not Medicare is paying for the hospital stay;"

which impacts how Medicare is paying for the hospital stay;

 

[somarco]

"which impacts whether or not Medicare is paying for the hospital stay;"

which impacts how Medicare is paying for the hospital stay;

Yup.

Admitted as inpatient, Part A.

Admitted for observation, Part B.

 

[Chazm]

I think they mean in regards to whether or not Medicare pays for SNF.
Observation? No Skilled care even when they are staying there for 3-4 days because they were on observation the whole time.

 

[yorkriver1]

Medico says they have HI in some states that covers observation stays. (not mine, sadly) They also have a short term, 360 day max. policy that covers SNF and other residential care with 2 ADL's or cognitive impairment trigger. Pays up to $300/day.
This post makes me consider what to offer clients, especially MAPD with the passage of the law being uncertain, and higher anticipated MOOP's on Medicare Advantage, extra coverage looks attractive.

 

[somarco]

extra coverage looks attractive.

How many add-on policies do you need to offer to cover your butt?

Cancer plans are OK as long as you have cancer (#4 on the list of illness for seniors) but not OK if you have arthritis (#1) or Alzheimers (#2) or coronary conditions (#3).

In the under 65 market agents used to sell high deductible major med plans with a lower premium and then backload an accident plan, hospital indemnity, cancer, heart-stroke, etc

Agents made good money but clients often did not collect for various reasons.

When you write a HIP or cancer on a client that is a paper claim they have to file separately. How many of your 65+ clients will remember they have a plan and remember to file or call you?

I talk to people all the time that have plans deducted from their checking account and they have no idea what the coverage is.

 

[GreenSky]

In the under 65 market agents used to sell high deductible major med plans with a lower premium and then backload an accident plan, hospital indemnity, cancer, heart-stroke, etc

I remember two health insurance "producers" who spent most of their time training agents to sell HSA plus an accident plan. I always thought adding the accident plan was false security. If someone could afford $5K OOP in the event of an illness they could also afford this for a broken leg.

Adding $300-600 a year for an accident plan made no sense then nor now. I do not feel the same way about cancer insurance but that type of insurance is completely separate from a health plan.

Rick

 

[somarco]

There is an interesting thread on MAPD acceptance (or the lack thereof) by cancer centers.

Also comments by Policy Doc about SNF and rehab centers that apparently don't like MA plans.

And yes, I agree that cancer plans are different from accident plans but (some) agents are still trying to plug holes in MA plans (or pad their commissions, or both) with add-on plans. Seems to me like "We have this cheap plan but you really need this, and this and this to cover (some of) the gaps".