Medicare Part B Giveback

Yeah for MAPD plans you can't just make your own marketing material and mail it out. We have a few giveback plans in FL and even if I were allowed to market it on my own, most T65's would either A) have no idea what it means or B) not believe it.
I use it as a last ditch effort if someone can't qualify for MSP and is considering dropping part B. Or if it's someone like my dad who is stubborn and T65 this coming Jan and only wants a giveback plan.
 
What are some best practices to market a Part B giveback Medicare Advantage product?

The only give back MAPD I know of ($50 Medicare B refund) is designed to appeal to very healthy T65's, or beyond, who aren't interested in how their non-existent current health issues or prescriptions can best be covered. They would like to have a plan that is low current cost, with a maximum out of pocket for catastrophic health events.

I can see that the carrier would like to diversify their members over the spectrum of morbidity. They also offer an HMO with a built in health center benefit, including 3 kinds of special needs HMO's.

I have a 68 YO family member in finance who has a generous emergency fund, is a saver, and doesn't see the benefit of spending $2k a year in anticipation of needing a low to no deductible medical plan, i.e., Medicare supplement. He has at least $24K in the bank for that. Isn't worried about networks, or any of the typical MAPD concerns for those with chronic health conditions.

So there is a demographic for such a plan. Thrifty sorts who have been on group insurance, and are used to plan out of pocket costs, and aren't particularly low income. I have just such a client who, even with some health concerns, can't see spending the month in/month out costs for more first dollar coverage. No rebate plan in that client's zip code, but if there was....
 
One of the "horror stories" I see discussed in MA threads is the idea of catching cancer in the last quarter of the year which leads to back to back, winter and spring oop charges for chemotherapy. How far does $24K go in a situation like that?

It seems to me like anyone with a financial base below a minimum of $1M-$3M is risking some serious financial loss with an MA plan.
 
Last edited:
One of the "horror stories" I see discussed in MA threads is the idea of catching cancer in the last quarter of the year which leads to back to back, winter and spring oop charges for chemotherapy. How far does $24K go in a situation like that?

It seems to me like anyone with a financial base below a minimum of $1M-$3M is risking some serious financial loss with an MA plan.

Just signed up someone today with a $3,100 MOOP. You sure about your statement?
 
One of the "horror stories" I see discussed in MA threads is the idea of catching cancer in the last quarter of the year which leads to back to back, winter and spring oop charges for chemotherapy. How far does $24K go in a situation like that?

It seems to me like anyone with a financial base below a minimum of $1M-$3M is risking some serious financial loss with an MA plan.

I prefer MS to MA but max out of pocket is $6700, often less. 2 years of MOOP still leaves him around half his savings. Not ideal, but doable.
 
He's just here passing time. Ignore what he posts. I've done that and it's much easier than trying to teach him.

Rick

Chazm has said many, many, many times that FL is different than the rest of the US. So my questions below relate to outside of FL.

In states other than Florida, once one has contracted cancer, is it possible to shift back from an MA plan to a Med Supp plan?

If the answer is yes, then my post above is based on an invalid assumption. If the answer is no, then the next question is-What amount of money does someone stuck on a high annual oop MA plan need for deductibles and out of network costs for the rest of their Medicare covered life span of 20-30 years?

My numbers above may be high for a minimum figure, but I would be pretty sure a $24K reserve is not going to cover 15-20 years of MA oop's and out of network costs.

And (again outside of FL) What kind of exposure does the MA plan leave the patient for potential out of network costs for things like heart conditions, diabetes, joint replacements, eye surgeries, cancer and whatever other kinds of medical conditions the senior body incurs that may have complications requiring going outside the specific MA network?

Also, are MA plans more restrictive on drugs than PDP plans? That is something I don't remember seeing any discussion about.

Then when you get to the MA part B kickback plans which were the subject of the thread, do they become even more restrictive in regard to network providers and covered drug costs?
 
Chazm has said many, many, many times that FL is different than the rest of the US. So my questions below relate to outside of FL.

In states other than Florida, once one has contracted cancer, is it possible to shift back from an MA plan to a Med Supp plan?

If the answer is yes, then my post above is based on an invalid assumption. If the answer is no, then the next question is-What amount of money does someone stuck on a high annual oop MA plan need for deductibles and out of network costs for the rest of their Medicare covered life span of 20-30 years?

My numbers above may be high for a minimum figure, but I would be pretty sure a $24K reserve is not going to cover 15-20 years of MA oop's and out of network costs.

And (again outside of FL) What kind of exposure does the MA plan leave the patient for potential out of network costs for things like heart conditions, diabetes, joint replacements, eye surgeries, cancer and whatever other kinds of medical conditions the senior body incurs that may have complications requiring going outside the specific MA network?

Also, are MA plans more restrictive on drugs than PDP plans? That is something I don't remember seeing any discussion about.

Then when you get to the MA part B kickback plans which were the subject of the thread, do they become even more restrictive in regard to network providers and covered drug costs?

Can it be done? Yes. Read up on Medicare SEP

Will most experienced agents tell somebody how to do? Excluding helping out a family or friend, I'd venture to say no because it isn't practical most of the time. To each their own, but I wouldn't target that market.

Your last question sounds like an excel spreadsheet in the making. At a minimum, I hope those people have life insurance. Possibly cancer insurance too if they can swing the extra $20-$40 a month in addition to their lovely MA plan.
 
Back
Top