MooP on MAPD

[cedwards]

Funny how things work out. I made this post yesterday and met an agent today at a local meeting that has CIP and hit his $6,700 MooP in March. I believe he's going through cancer treatment. He was someone who always said it never happens and then it happened to him.

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Somarco,

75 year old male

Medicare Supplement - $150.00
Part D - $25.00
Total - $175.00/month

UH MAPD - $0
GTL Hospital Ind -$44.00

Yep, way better off with a Medicare Supplement. Just because you choose to only offer 1 product doesn't mean it's right for everyone.

Does this GTL quote include their lump sum cancer rider? If not how much would it go up?

The only thing I would throw in is a lot of it depends on where the client is at and what their family health history looks like. I know most of the top cancer treatment centers won't allow any MA plans in the door but they will take Medsups all day every day. I use cancer as an example because it runs on both sides of my family and so that would be something if I were turning 65 (I'm a long ways out but it works for my point), I would want to know.

Of course, there isn't one product for every client and I think that is one of the great things about this forum is you're able to get other people's opinions (some more judgmental than others).

 

[somarco]

Midlevel, I don't sell anything. I educate my clients and let them choose. I don't have many that are paying $150/mo. Most are in the $120 range, aomw less than that, and coverage is tailored to their needs and budget.

If you are only going to compare premiums and ignore the coverage differential (OOP) that is a slick sales gimmick.

Advantage + a junk ancillary plan is probably just right for your client base, but mine are a bit more savvy and won't fall for the shell game.

I know most of the top cancer treatment centers won't allow any MA plans in the door

For chuckles and grins I checked MD Anderson and found this.

Some, but not all, cancer treatment is covered under Medicare Part B. Infusion therapy with Medicare + plan G or N means your OOP is mostly limited to the Part B deductible.

I don't peddle hospital indemnity plans so I don't know if they pay for outpatient treatment or not. I suspect not. Regardless, the OOP cost for a hospital stay is usually less than $1500 (Medicare without gap or MA). And most large claims are run up OUTSIDE the hospital, usually after discharge. This means those hospital cash plans mostly go unused.

It all comes down to what the client wants.

I wrote a plan yesterday on a T65 lady who is 4 yrs outside of treatment for breast cancer. She is diabetic (type II) and her friends told her to buy an Advantage plan from BX or AARP/UHC.

BX has 3 plans in her zip, UHC has 2.

2 of the 3 BX plans and both UHC plans are HMO's and her doctor is not in any of them. Her budget is very tight. Can't afford more than $250/mo including the cost of her meds.

Part B, $105.
Plan N, $93
Part D, $20 + $35/mo for Rx copay's.

That's $253 month for everything but the B deductible and $20 OV copay's and she get's to keep her doctors.

Sure, I would make more $$$ peddling $0 MAPD and a hospital indemnity plan but I listen to the needs of my clients and give them what they want. Not what I want to sell them.

 

[jbage007]

Sure, I would make more $$$ peddling $0 MAPD and a hospital indemnity plan but I listen to the needs of my clients and give them what they want. Not what I want to sell them.

I swear I thought you were about to say that you give your clients what they want, not what they need.

 

[Midlevel]

Lump sum cancer would add $18.00/month for $5000 coverage.

Somarco,

I also give them their options and let them choose. Not sure where you are that the supplements are only $120/month. Maybe for a 65 year old female but I have many clients who where stuck on a Med Sup and couldn't qualify to switch so are paying upwards of $200/month plus a PDP. The UH MAPD was still $0/month even if they are 85 years old.
My book is split about 60/40 towards Med Sup so don't think I put everyone on a MAPD. Where I am at they are PFFS plans so don't have to worry about the Dr. not being in network, etc. To each his own I guess.

 

[somarco]

jbad, my clients are smart enough to know what they need. Yours may not be, but mine are.

Lump sum cancer would add $18.00/month for $5000 coverage.

What happens if they live another year?

How much does the plan pay if they have a stroke like one of my friends that has been bedridden and can't speak. He's been like that for 13 years now.

Or my cousin that went into renal failure. Spent 4 years on dialysis, in a nursing home before he finally got tired of living and stopped going to dialysis.

Or my other friend that is in a coma. Been like that for 3 years since her auto accident.

How much do your add-on plans pay for that?



You caught me Midlevel. I just make this sheat up.

There are no plans under $200. There are no HMO's here. No drug plans less than $50.

Please don't assume I am as dumb as your clients may be. I understand the market and my clients needs. I don't approach a prospect with any pre-conceived ideas beyond the belief they really don't know as much about Medicare options as I do.

I do things most agents can't even comprehend, so don't try to second guess me.

 

[Midlevel]

Well Somarco, I guess that settles it. You are a frickin Medicare genius and the rest of us are doing it all wrong. Sounds like your clients are extremely intelligent too unlike the rest of ours. Maybe get off your high horse and try to have a civil conversation on here. 20,000 posts makes me wonder if you even actually have clients or just spend all your time on here.

 

[kstein]

Also if a client is in a Ltc facility, receiving care at home 4+ years, etc it's likely those expenses are out of pocket anyway and medicare doesn't cover them so the supplement won't help.

 

[sman]

Well Somarco, I guess that settles it. You are a frickin Medicare genius and the rest of us are doing it all wrong. Sounds like your clients are extremely intelligent too unlike the rest of ours. Maybe get off your high horse and try to have a civil conversation on here. 20,000 posts makes me wonder if you even actually have clients or just spend all your time on here.

I can attest that Somarco has plenty of clients and is the type of agent I would want to work with if I weren't licensed myself. I've referred prospects to him and wouldn't hesitate to do it again in the future.

For those of us who do the majority of our business over the phone, we are able to spend plenty of time on the web. Especially when from start to finish (beginning of phone conversation to submitted app) it is done in as little as 30 minutes (and that's for someone whom we've never met nor had a conversation with).

Lastly, have you ever considered he has so many clients that his renewals allow him lots of free time?

 

[somarco]

Midlevel, I don't DRIVE to see my clients like a lot of agents here. Glad to have an intelligent conversation with someone who actually understands my market. If you run into such a person, tell them to call me. I'm in the book.

I noticed you dodged my questions about your junk add-on plans and how they would pay for stroke, renal failure, accident.

Guess I stumped you on that one.

Go have yourself a nice day.

 

[Chazm]

Not sure what a stroke or renal failure has to do with it. We're talking about a T65 who would see value in choosing a $0 MAPD (possible $100/month refund too) and add in a $40/month hosp indemnity/cancer plan to help cover cost in a hospital stay or in the event they get cancer. Rather than a $180 med supp plus Rx. If they have a stroke they use their MAPD plan for the hospitalization and the hosp ind plan help pay the copays. Obviously you know all this but you choose to offer your clients one option. No biggie, I like to let my clients decide for themselves and I don't use scare tactics to get them to sign up for what I want. If they prefer the med supp I sell that. If I realize there's no way they can pay $300/month for med supp, part B and part D, I have the option to show them other things.