Why Purchase Medsups ???

[MatthewC]

Depending on the market, a med supp premium is just too high...like Broward county FL, T65 is about $260/mo for Plan F from UHC or FL Blue plus $104.90 + Drug Plan and your close to $400/mo...

yep - I am in Plam Beach county, same rates.

What boggles my mind is that some insurance administrator decided that Florida should be a price "As Issued" state instead of by age. They were probably thinking it would save seniors money. However, insurance companies then charge the 65 year old the same rate as an 80 year old gets in other states! If the powers that be in Florida thought this would be good for seniors, they didn't run the numbers.

Or....they are trying to support MA / MAPD plans and reduce exposure to Sups.

 

[YouGotMyMoney]

Or....they are trying to support MA / MAPD plans and reduce exposure to Sups.

Prob the case as Med Adv carriers got more $$ to throw around at politicians than med supp companies as a group

 

[SKJ58]

Medicare Advantage plans work great until you have a serious health condition. Unless you are the type of person who believes that all doctors are good then why subject yourself to a network that is limited?

Medicare Advantage plans are a pay as you go type plan, they work great until you use them and have to pay a bunch of stuff out of pocket. Most people on MAPD plans are poor and can't afford premium, how do they afford the OOP? And now more and more of the plans are even adding premium.

I've had prospects that have been scared away from MA by other agents with this "catastrophic health" tactic. I explain to them that there is a max limit OOP for MA, so they are not going to get stuck with $100,000 expenses. I ask them how often they see their doctor. If they are healthy, and only see their doc once or twice per year, then I point out that with a supp, they are GUARANTEED to pay OOP every year of $2,400 - $2,800 (supp + PDP premiums) just to see the doc twice per year. I tell them that if they can afford the supp, but like the MA, just put the $2,800 per year in an account and if they stay healthy for a couple of years, they have their max OOP saved up. If they are healthy for five years, they have a vacation account. I sell both, so it doesn't matter to me which they choose. I just want them to be educated, not scared by some agent who can't sell MA.

 

[MatthewC]

I've had prospects that have been scared away from MA by other agents with this "catastrophic health" tactic. I explain to them that there is a max limit OOP for MA, so they are not going to get stuck with $100,000 expenses. I ask them how often they see their doctor. If they are healthy, and only see their doc once or twice per year, then I point out that with a supp, they are GUARANTEED to pay OOP every year of $2,400 - $2,800 (supp + PDP premiums) just to see the doc twice per year. I tell them that if they can afford the supp, but like the MA, just put the $2,800 per year in an account and if they stay healthy for a couple of years, they have their max OOP saved up. If they are healthy for five years, they have a vacation account. I sell both, so it doesn't matter to me which they choose. I just want them to be educated, not scared by some agent who can't sell MA.

You have some good points and obviously the numbers change by state and county. Some of this is, however, a difference in philosophy of why we buy insurance. If we a person is buying insurance so that if or when they need it they have the quality healthcare of their choosing AND have a maximum financial exposure that will not hinder their quality of life, the Med Sup plan most often satisfies that need better. Even if it is the Plan F-HD and their choice of PD, it can be better during the worst case scenario.

A difference in philosphy does not make a good or bad or right or wrong. The best thing about being independant is that we let the client make the best decision for themesleves.

 

[goillini52]

I've had prospects that have been scared away from MA by other agents with this "catastrophic health" tactic. I explain to them that there is a max limit OOP for MA, so they are not going to get stuck with $100,000 expenses. I ask them how often they see their doctor. If they are healthy, and only see their doc once or twice per year, then I point out that with a supp, they are GUARANTEED to pay OOP every year of $2,400 - $2,800 (supp + PDP premiums) just to see the doc twice per year. I tell them that if they can afford the supp, but like the MA, just put the $2,800 per year in an account and if they stay healthy for a couple of years, they have their max OOP saved up. If they are healthy for five years, they have a vacation account. I sell both, so it doesn't matter to me which they choose. I just want them to be educated, not scared by some agent who can't sell MA.

In other words, you only sell MA. What do you tell when they get a serious...chronic illness and can't qualify to get a Medicare Supplement.

 

[SKJ58]

In other words, you only sell MA. What do you tell when they get a serious...chronic illness and can't qualify to get a Medicare Supplement.

I do sell both, not just MA. I explain everything to them. I explain that if they ever want to switch to a supp, there will be underwriting. In my area, UHC/AARP only has two underwriting questions. Have you been hospitalized in the past 90 days and are there any surgeries requested by your doc that you have not had. If they can answer no to both, it is GI. I point out that if they get into a situation where they need major surgery, they will be turned down for the supp. Then I leave the choice up to them. Some people are very risk averse and elect to go with the supp. I write them up. Some feel they are healthy enough and go for the MA. I write them up. I leave it up to them, but only after I have educated them on both options.

 

[wln417]

I actually think most people would be better off with a High F with a OOP max and a drug plan but then the agents can't make enough to survive just offering High F plans, you have to cross sell and that doesn't always work either.

QUOTE]

I agree. I can offer a $26 HDF coupled with a $17 PDP (or $22 with $0 deductible). Wouldn't hardly make anything, plus for the damn PDP you gotta get an SOA and all that crap.

I think much of the argument is based on what's available where one lives.

In my neck of the woods, there are some very good physician networks that use very good hospitals within many different MAPDs. The MAPDs have $0 premiums, with $5, $10, up to maybe $50 for specialists physician co-pays, and anywhere from $125 to $300 per day inpatient costs, up to the a max of $1,800 out of pocket for any one hospital stay. The MOOP for these plans range from $3,000 to $6,700 ($10,000 for a PPO).

If you are healthy and are OK with a physician from the networks of the plans that offers the lower end MOOPs ($3,000 to $4,000, say), my theory is this: Why pay for a $153 (UHC) monthly premium for the Plan F (plus $22 for the PDP) that will increase every year and that you KNOW will come out of your pocket? Take the $0 premium, and deal with the MOOP should that situation arise. I see no reason for a reasonably healthy person to plan on going into the hospital once a year and having to pay out the max OOP every year. Even if they hit the MOOP once in 3 years – I think that’s not likely but haven’t actually looked up the stats – their OOP would be lower than buying the Plan F. Your experience or reasoning may vary.

An unhealthy person, or a person who is concerned with becoming unhealthy, who has the means to pay the premiums should go with the Plan HD F (or F or G or N, whatever) and the PDP, provided they can get it.

If they are rich enough, just get the F and PDP and don’t worry about it.

 

[sman]

I've had prospects that have been scared away from MA by other agents with this "catastrophic health" tactic. I explain to them that there is a max limit OOP for MA, so they are not going to get stuck with $100,000 expenses. I ask them how often they see their doctor. If they are healthy, and only see their doc once or twice per year, then I point out that with a supp, they are GUARANTEED to pay OOP every year of $2,400 - $2,800 (supp + PDP premiums) just to see the doc twice per year. I tell them that if they can afford the supp, but like the MA, just put the $2,800 per year in an account and if they stay healthy for a couple of years, they have their max OOP saved up. If they are healthy for five years, they have a vacation account. I sell both, so it doesn't matter to me which they choose. I just want them to be educated, not scared by some agent who can't sell MA.

Where are you located? I know Florida has high premiums for Med Supp, but not every state is like Florida. I don't see such high premiums for Med Supps here in Georgia. At least not until they are much older. An 80 year old male can get a Plan G for $157.34 in my area (female $136.74).

I don't disagree with your analysis. A healthy person could definitely save money in a normal year on a Medicare Advantage plan compared to a Med Supp. But there are other factors involved. The biggest one being whether or not their doctor is in the network. Or the hospital they prefer. I find many seniors don't like restrictions of any kind. And some like knowing their worst case scenario is their Med Supp premium.

For the most part, my MA client base consists of those who just can't afford a Med Supp. However, I do have some who have the means but still choose a MA plan. And that's fine too. I will help them either way.

 

[wln417]

Prob the case as Med Adv carriers got more $$ to throw around at politicians than med supp companies as a group

Most of the MAPD carriers here also are Med Supp and PDP carriers. Anthem, Aetna, Blue Shield, HealthNet, Humana, UHC.

 

[vic120]

Most of the MAPD carriers here also are Med Supp and PDP carriers. Anthem, Aetna, Blue Shield, HealthNet, Humana, UHC.

I still find even UHC wants agents to sell MA more then Supp

They probably make a lot more money on it

They even want agents to sell Medi/Medi's More even with the higher cancellation % they want that buis the most

There must be a reason