MEDICARE ADVANTAGE: Growth Projections Are Stunning.

[AllenChicago]

Based on this eye-opening news article today, UnitedHealth, Humana May See Surge in Medicare Advantage - Bloomberg I'm now going to get certified to sell Medicare Advantage plans with 2, or perhaps 3, good carriers.

I looked at one from Humana last year for my dad in Michigan, but the out-of-pocket expenditures for medical care were stunningly high, compared to Standard Medicare mated with a Plan "F" MedSupp.

But if Medicare Advantage participation is going to grow a whopping 50% over the next 10 years, I'd be a fool not to at least have it in my portfolio of offerings.

Who's driving the growth of these Medicare Advantage plans the most.. Is it Well-To-Do Seniors who don't mind paying the high out-of-pocket costs? Or is it Seniors on very limited income who are attracted by the lower overall premium cost? Other some other demographic?

-Allen

 

[anonymous1]

Here In iowa I let them choose with an out of pocket in most counties are 3300-4000 New retirees like that as most of their group insurances premiums are 300 mth per person with company's. they get the choice to pay as you go (ma) or pre pay (plan f). New retirees are use to ppo HMO major meds so it's not a far stretch for them to choose the ma

 

[AllenChicago]

Thanks for the helpful feedback, Anonymous1. You're right..for new retirees and business owners, the $3k-$4k OOP probably isn't a big deal for them. This will help when suggesting the appropriate route for them.

My dad is 94 years old and lost my mother's state of Michigan retiree group coverage when she died last year. He chose the "security" of a $2,000 maximum out-of-pocket High-Deductible Plan "F" for $108 a month, which is all his modest income would allow. The Medicare Advantage plan was only (I think) $52 a month, but the $4,000 OOP freaked him out. But he has the $2,000 socked away in case he needs to use it, but thankfully his health thus far is good.
-ac

 

[G.Gordon]

Thanks for the helpful feedback, Anonymous1. You're right..for new retirees and business owners, the $3k-$4k OOP probably isn't a big deal for them. This will help when suggesting the appropriate route for them.

My dad is 94 years old and lost my mother's state of Michigan retiree group coverage when she died last year. He chose the "security" of a $2,000 maximum out-of-pocket High-Deductible Plan "F" for $108 a month, which is all his modest income would allow. The Medicare Advantage plan was only (I think) $52 a month, but the $4,000 OOP freaked him out. But he has the $2,000 socked away in case he needs to use it, but thankfully his health thus far is good.
-ac

That's a simple close. $2000 deductible hF, $1296 in premium, his worst year is $3296 OOP. currently. Now, present it as only $700 net amount at risk if he was on the MA plan and was one of the 1% of the MA members that hit the MOOP.

I too see more and more new beneficiaries making MA their choice. High employer plan premiums, higher deductibles and out of pocket expenses, or if on individual they have HSA type plans with $2500-10000 deductibles and premiums in the $300-700/mo range. Transitioning to the MA mind set when presented side by side with the best value available for Medigap/part D combination is pretty simple to conceive.

 

[russelltw]

I explain all the differences also. I find that people love MA plans until they have claims....Those OOP expenses are okay in theory, but not so fun when they are actually getting them.

MA's have so many moving parts. Benefits change, networks change (had a client's doctor sell his practice mid year and new practice would not take the MA plan he was taking, client had to change doctor), MOOP changes, etc...

 

[anonymous1]

Every area network is different and depending on how inclusive the networks are will make a big difference on your options Here we have a surgery center that is out of network. But the surgery center that is literally 3 miles away across the river is in network and almost all the doctors are the same Just have to know your territory and what is viable as solutions

 

[Chazm]

$52 for a MA plan? If they cost money here I probably wouldn't offer it much at all either.

When I can give someone a plan that cost $0, refunds $99.90 of their part b premium, has a MOOP of $3200, and bundle it with a hosp. Indemnity plan with cancer coverage for under $40. It's a no brainer.

 

[JimmyUt]

Most of what we have out here are $0 premium plans with an in network MOOP of under $4,000. While I believe that a med supp is a better option, the networks here are decent and include most hospitals and major medical groups. The big question I always ask folks is if they will be traveling a lot, or want the freedom a med supp provides. With that being said, It is hard to argue with coverage that is similar to these folks former employer plans at much less cost. I would take an MA any day over the crap coverage I have, at least for the money.

 

[openmindedone]

More than anything sales and marketing are driving growth.

Now if your able to offer a dynamite plan like Chazm that pays the client a hundred bucks a month to take the darn thing, that would be very easy to market and sell. In most of my service area only one MAPD plan is offered. It costs $75 a month with a $6700 max oop! And a ton of people take this plan at ahem...wal mart.

Do you know what a scope of appointment form is? Do you realize you cannot make any unsolicited contact for an MA plan? These are two awful reasons to sell MA.

Last year I had an insurer stop offering one plan and then start offering a new plan in the same county. If I don't get out and see every one of those people, during the same narrow window i have to get new people, then I lose them. Every year I have some block of MA business on the chopping block. Constant turmoil.

 

[rvgiles]

When selling MA or MAPD, the OOP of any plan needs to always be compared to the total cost of annualized premium for the competing MedSup. Of course, there are additional considerations....