How Do You Present Med Supp Value Over MA and $0 Premium?

[case1]

Husband and wife have been supp clients of mine for 2- 3 years and now they have decided to go with their neighbors UHC Medicare agent and a $0 premium.

He says I've never even talked with him about Medicare Advantage. I always go over both options but I think at this point he feels I've been ripping him off the past couple of years being on supplements.

I presented some of the differences between the two options again as well as the value of supps over MA. His words:

"I don't give a shiz."

 

[GreenSky]

Perhaps you should be offering MA products as well. It's a bit of a snob syndrome to believe what you sell is always the right choice,.

Rick

 

[Midlevel]

Case,

I can't tell by your post if you do sell both Med Sups and MA plans. I do both and it is so nice when you sit down with a T-65 or even someone older who has a Med Sup premium going up to be able to show both options. Go over A,B,C and D of Medicare and how each works with them and then let them choose. That way there is no pressure on them and they don't feel like there are other options you aren't telling them about. They often ask me which way I think they should go, I tell them every person is different and have to make their own decision. I also many times tell them they don't both have to go on the same plan if one is more comfortable the other way. It seems to work well and btw I always run GTL quotes to cover hospital copay so they know about that option too for MAPD's.

 

[senior-advisor-indiana]

Have you educated them on Plan N and HDF and the network restrictions of the MAPD? I have had a few clients reach their MOOP this year on MA plans and my MA book is small, around 40-50 clients. There may have been more that hit it but those are the 2 that called me complaining. They are pretty easy to sell against here. Maybe not in your area.

 

[Monkeyonabicycle]

Not ALL doctors or even Hospitals accept MA. Need to check whats up where you live. Here where we are, its not a good option.

 

[medsuptage]

Med supps have a ton of value over MA. It's obvious what the perks of a supp are, freedom to dictate your healthcare, 100% coverage or very close to it.

I think the biggest kicker between the two is that MA is great while you're healthy but when people develop medical conditions and they're spending large sums of money on out of pocket costs, and/or fighting with their company for approvals of treatments or having to get referrals ect. At that point there's a really good chance they can never go back to Medicare supplement because they can't qualify.

A lot less people would pick MA over a supp if they knew once things get serious, they can't change back to a supplement without passing underwriting. It's really alarming how many people don't know this. Most don't find this out until after it's too late.

In my opinion there are a few states where MA actually makes sense. GA is not one of them.

 

[yaknow1]

It's easy here since the plans are weak, 80/20 on chemo with high OOP limits.

I tell a lot of people about my grandmother's experience with cancer. She was treated in 3 states by over 20 providers. Not once did we worry about cost, or if the physicians would be in network. She even consulted one of the top pancreas surgeons in the world. We didn't have to hassle with getting approvals and referrals or OON charges. Ultimately she didn't have surgery or chemo, that would have only been more of on ordeal with MAPD. She did have a few hospital admissions.

Medical costs are generally highest in the last years of life. Pay now or pay later. The process of dying is hard enough, why encumber yourself with playing games with insurance companies to save $150 a month?

Another example, one company only has one contracted SNF in this county. Most people wouldn't send the dog there. Sure, the county owned hospital and all of the doctors are in network, but if you need SNF, do you want to be locked into that place? Maybe you will get lucky and have to stay in the hospital a few extra days while waiting for the SNF to have some beds become available.

Many Humana plans here have a $50 copay for labs drawn at the hospital. Never saw as many pissed off seniors until they got their bills for bloodwork.

 

[somarco]

I talked to a husband and wife today that were looking at Cigna-Healthspring MAPD $0 premium. A friend had recommended it to them.

They were still unsure. Husband has hip replacement scheduled for January, the month he goes on Medicare. Wife is type II and her Medicare starts Feb 1.

He talked to the lady at Cigna (HO rep) that said he would be in the hospital 2 days @ $250 per day. His out of pocket would be $500.

So it was my turn to talk.

The Cigna plan is an HMO. His PCP and surgeon are in network, as is the hospital.

OK, but what about the assistant surgeon? Or the anesthesiologist? Are they in network?

Did the Cigna lady mention how much you would pay for follow up visits and PT?

Did she explain how OON charges can add up, especially for elective surgery?

Let me tell you how plan N works ..........

Premiums for N are $87 for him and $80 for his wife.

No networks. No hassles. OOP is $0 for the hospital, $147 for outpt follow up then $20 for each OV.

I took both applications today.

The real story on MAPD vs Medigap may lie in the Rx benefit. I ran comparisons for a type II last week on a PDP and the drug benefit for the MAPD he wanted.

The PDP will result in $3000 OOP for his meds.

The MAPD he wanted is almost $9000 OOP.

It's not always about the network.

 

[case1]

Perhaps you should be offering MA products as well. It's a bit of a snob syndrome to believe what you sell is always the right choice,.

Rick

I do offer MAPD, thanks for playing.

 

[steveadlman]

Med supps have a ton of value over MA. It's obvious what the perks of a supp are, freedom to dictate your healthcare, 100% coverage or very close to it.

I think the biggest kicker between the two is that MA is great while you're healthy but when people develop medical conditions and they're spending large sums of money on out of pocket costs, and/or fighting with their company for approvals of treatments or having to get referrals ect. At that point there's a really good chance they can never go back to Medicare supplement because they can't qualify.

A lot less people would pick MA over a supp if they knew once things get serious, they can't change back to a supplement without passing underwriting. It's really alarming how many people don't know this. Most don't find this out until after it's too late.

In my opinion there are a few states where MA actually makes sense. GA is not one of them.

You make some very good points and that is exactly what I tell my prospects that are considering a MAPD.