Medicare Advantage Future

gordon112

Guru
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1,374
Florida
It appears that the Advantage plans eventually will be limited to lower incomes where it will be based on people on medicaid or dual eligible. It simply can't go to the way of having one area in the country offer it and not in others. Can this be unconstitutional?


Insert from the congress blog:The candidates' positions on Medicare Advantage - The Hill's Congress Blog
"Medicare Advantage plans are paid based on a legislative formula, and any payments they receive above what is necessary to provide the basic Medicare benefit must be provided to the beneficiaries of the plans in the form of expanded benefits, such as lower deductibles and copayments for services. Once the election is over and the artificial and temporary bump-up in payments is terminated, as it inevitably will be, the Medicare Advantage plans will be forced to pare back benefits, and enrollment in the plans will drop."

"This should not be surprising. The traditional Medicare fee-for-service insurance is an extremely inefficient model. There is no incentive for either the providers or the enrollees (most of whom have supplemental coverage beyond Medicare) to control the use of services. Thus, the volume and intensity of service use rises dramatically each year. Moreover, there is no coordination among those providing medical services to the patients, which leads to fragmented and low-quality care in too many instances."

Since traditional med sups are considered inefficient in controlling costs and the fact the president wants to cut spending on advantage plans it leaves a big gap of uncertainty of which way we go with medicare. I would hope we get rid of the political animal and try to come up with the most efficient way to run medicare for future generations to come as the country ages.

What is your take?
 
The fact that MA carriers keep buying up med supp companies would indicate they agree as well. It's telling when the primary carriers in a market begin to diversify because they know there is about to be a shift in the marketplace.

Agents need to make sure they can offer both products because even if the government doesn't eliminate MA the gap between med supp and MA will continue to decrease and it will eventually become a choice between network (PPO,HMO, HMO-POS etc, Med Select) vs, no network (med supps)

The next few years will be both interesting and challenging for agents who operate in the Medicare space. With the decreasing volume of new agents into the business and the number of existing agents dropping due to retirement and industry changes making it more challenging to keep pace.

At the end of it all the worst part is that it doesn't bode well for the Senior who needs guidance from professional agents... fewer agents, less choice and increasing costs...
 
Wouldn't that bode well for us if the pool of agents is relatively small and a significant portion are retiring?
 
I am in the camp of scrapping the caddy scenario vs continuing on a path of destruction. Will it happen, probably not, the country chooses to be divided on everything and ultimately leads to more destruction. I believe there needs to be a system of controlling costs while offering quality service. Right now there is too much confusion for seniors. We have a cadilac that runs on dirty gasoline, and too much confusion with doctors getting out of the plans while patients are stuck with changing doctors or having to change plans all the time. If we could come up with a quality universal med sup that helps control costs and gives the patients the right to choose doctors while giving doctors and hospitals the proper pay and incentive we might have a solution....and I am not sure that exists.
 
Aksarben68022 said:
The fact that MA carriers keep buying up med supp companies would indicate they agree as well. It's telling when the primary carriers in a market begin to diversify because they know there is about to be a shift in the marketplace.

Agents need to make sure they can offer both products because even if the government doesn't eliminate MA the gap between med supp and MA will continue to decrease and it will eventually become a choice between network (PPO,HMO, HMO-POS etc, Med Select) vs, no network (med supps)

The next few years will be both interesting and challenging for agents who operate in the Medicare space. With the decreasing volume of new agents into the business and the number of existing agents dropping due to retirement and industry changes making it more challenging to keep pace.

At the end of it all the worst part is that it doesn't bode well for the Senior who needs guidance from professional agents... fewer agents, less choice and increasing costs...

Where do you get your info in the decreasing number if agents?
 
I did an educational seminar to other senior professionals (case managers, social workers, etc) and a couple of agents showed up. One of the questions I asked was "How long have MA plans been around?" One agent who I know from running into here and there said 1996. She is a manager for a local carrier.

Seems to me that no one is looking back far enough. MA plans have been around since the 70's. The survived at 95% for a long time. Their market share will go down, but they will not go away. That is unless of course AARP does not get paid for MA plans anymore...
 
The fact that MA carriers keep buying up med supp companies would indicate they agree as well. It's telling when the primary carriers in a market begin to diversify because they know there is about to be a shift in the marketplace.

Agents need to make sure they can offer both products because even if the government doesn't eliminate MA the gap between med supp and MA will continue to decrease and it will eventually become a choice between network (PPO,HMO, HMO-POS etc, Med Select) vs, no network (med supps)

The next few years will be both interesting and challenging for agents who operate in the Medicare space. With the decreasing volume of new agents into the business and the number of existing agents dropping due to retirement and industry changes making it more challenging to keep pace.

At the end of it all the worst part is that it doesn't bode well for the Senior who needs guidance from professional agents... fewer agents, less choice and increasing costs...

I agree with many of your points, most importantly that the agent that offers both med supp and MA will be best positioned to help his/her clients now and in the future. We don't know for sure what will happen to either. In my area, it's more difficult than every before to find docs that will see patients on original medicare. We now have 3 very large medical groups who won't even continue to see existing patients who transition to original Medicare. Most practices are refusing new Medicare patients. While at the same time, the MA networks are becoming increasingly unstable (hospitals and medical groups dropping out mid year even).

On the flip side, there was Universal American that decided earlier this year to get out of the med supp business all together and they're only offering MAs. That was the biggest signal to me that the MAs indeed are not going away.

For now, I believe that med supp is still the better option for most. However, that could change in a few years. We'll just have to see how it all unfolds.
 
On the flip side, there was Universal American that decided earlier this year to get out of the med supp business all together and they're only offering MAs. That was the biggest signal to me that the MAs indeed are not going away.


[FONT=Verdana","sans-serif]You’re giving Universal American way too much credit. It could be they don’t have a clue. If they had half a brain they would have sold their MedSupp business instead of closing their doors. :goofy: [/FONT]
 
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