40% rate increase in IL

[DonP]

While Medigap has more exposure than MA, and does so without the benefit of taxpayer subsidies, they are also secondary payers to Medicare and only have to absorb 20% of the spillover Part B claims.

Medicare pays most of the Part A claim, everything but the $1676 deductible.

Most, but not all, T65's I talk to are healthy, but I would not expect someone who only pushes MA plans to know that. And if those same agents focus on low income folks with unhealthy lifestyles it would seem that folks gravitating to MA plans are looking for plans without a premium and low copays.

As long as they remain healthy, no question the MA plan is a good choice . . . but not so much when their health goes south and especially if they can't afford to pay the OOP.

It's a bit of a damned if you do, damned if you don't mess.

That's what you've never understood in all these yrs . Most people until the last few that bought mapd were mostly lower middle income to low income people . Many never pay the hospital co pays . But a good agent like myself will show them a good hospital indemnity plan to cover the bigger out of pocket bills for $50-$75 a month . I show Medicare sup to all t-65's and few want them . Now if there already sick I'll highly recommend a sup . I think you have this reversed . I show a supp and mapd . You ONLY show supps . You're the biased one . I won't relist all the reasons why the med sup premium pool is in trouble Premiums will be a problem for many in the next 2 yrs .

 

[sshafran]

In essence:

The better quality MAs from circa 2018-2023 led to more MA enrollment and it "hurt" the Medigap pool.

Healthy Sandra chose $0 with some extra benefits that she would actually use and took the risk on the OOP. Now PlanG/N won't get her 5 years of premium with almost $0 claims. That hurts.

If MAs take a tank again 2026 with high MOOPs (which might happen) I can see the Medigap market pick back up - even with "healthy" people. But carriers might want to open new blocks. That might be exactly what they're doing.

The worst scenario for the agent is having a great MA or set of MAs with good benefits and network and low max - and it's not commissionable.

The agent commission is a drop in the bucket but these carriers are on razor thin margins.

 

[sshafran]

In essence:

The better quality MAs from circa 2018-2023 led to more MA enrollment and it "hurt" the Medigap pool.

Healthy Sandra chose $0 with some extra benefits that she would actually use and took the risk on the OOP. Now PlanG/N won't get her 5 years of premium with almost $0 claims. That hurts.

If MAs take a tank again 2026 with high MOOPs (which might happen) I can see the Medigap market pick back up - even with "healthy" people. But carriers might want to open new blocks. That might be exactly what they're doing.

The worst scenario for the agent is having a great MA or set of MAs with good benefits and network and low max - and it's not commissionable.

The agent commission is a drop in the bucket but these carriers are on razor thin margins.

It was probably mentioned here but Anthem just added a barrier around MA enrollments by requiring agents to hire a Sherpa from Uzbekistan to hand deliver an enrollment form in person to a committee at the home office after the applicant signed in blood with DNA verification. It'll be a lot but the better agent will figure it out.

 

[DonP]

It was probably mentioned here but Anthem just added a barrier around MA enrollments by requiring agents to hire a Sherpa from Uzbekistan to hand deliver an enrollment form in person to a committee at the home office after the applicant signed in blood with DNA verification. It'll be a lot but the better agent will figure it out.

I'm wondering if that Anthem news was a mistake . I saw also you can no longer order more paper booklets so how do you get part apps.But your're a fool to sell any anthem going forward rest of yr as those products have a high likelihood of being termed . The real concern is how heavy united the biggest of the big terms plans and areas . United doesn't play and is focused only on profit margins and stock price . If they term 10-15% of their huge book it could cause Chaos in the mapd mkt . Think about the flood of termed plans moving to other carriers . You'll have a wave of plans and carriers coming out the 2nd week of aep going to commission suppression . Also thank how many sick mapd people with termed plans move to med supps GI . The increase cms gave to mapd carriers of 5% just covered medical inflation in 2026 . Also the fights coming between hospitals and carriers will be brutal in the next 2 yrs . The bottom line both mapd and med supps in a tough spot. The question is will agents be caught in the middle with reduced or no comp. I read $6 billion in commissions ,overrides and marketing money is paid out to agents yearly . Thats a lot of money to be cut with carriers with tiny margins and looking for cuts

 

[rmhaire]

I'm wondering if that Anthem news was a mistake . I saw also you can no longer order more paper booklets so how do you get part apps.But your're a fool to sell any anthem going forward rest of yr as those products have a high likelihood of being termed . The real concern is how heavy united the biggest of the big terms plans and areas . United doesn't play and is focused only on profit margins and stock price . If they term 10-15% of their huge book it could cause Chaos in the mapd mkt . Think about the flood of termed plans moving to other carriers . You'll have a wave of plans and carriers coming out the 2nd week of aep going to commission suppression . Also thank how many sick mapd people with termed plans move to med supps GI . The increase cms gave to mapd carriers of 5% just covered medical inflation in 2026 . Also the fights coming between hospitals and carriers will be brutal in the next 2 yrs . The bottom line both mapd and med supps in a tough spot. The question is will agents be caught in the middle with reduced or no comp. I read $6 billion in commissions ,overrides and marketing money is paid out to agents yearly . Thats a lot of money to be cut with carriers with tiny margins and looking for cuts

And while you're trying to figure all this bs out, me and @somarco are over here selling our little supplements.

Ain't so dumb after all are we?

 

[somarco]

Many T65's look at their personal medical history as well as people they know (relatives and friends) who have had health issues. They often factor this information into their MA or Medigap choice.

If their knowledge base indicates problems / dissatisfaction with a specific carrier they ASSUME they will have difficulty with that carrier when they crossover to Medicare.

If this comes up in discussion I ask questions. Where did the problem come up? Was it claims, premiums or general customer service.

Most of the time it was a claim concern under their EGH plan. If this is the case, I let them know carrier X will NOT be adjudicating their claims. I also explain how OM is not managed care so prior authorization, case management, continued stay review does not come into play for medically necessary procedures.

Asking questions, listening to the response, and educating the prospect usually allays their concerns allowing them to make informed choices.

Educating a prospect goes a long way in helping them decide.

 

[DonP]

And while you're trying to figure all this bs out, me and @somarco are over here selling our little supplements.

Ain't so dumb after all are we?

I'm figuring nothing out . I'm still selling 30-40 mapd a month . All the sup guys will be hustling moving people around just like the mapd guys . Plus pdp's will be rocketing . Everyone's in the same boat . Only difference is mapd still zero premium

 

[Newby]

You would think these politicians if they really want to help seniors would allow them to go from MAPD to Med Sup guaranteed issue on their birthday each year.
That would really tank the Med Sups even quicker.

 

[sshafran]

You would think these politicians if they really want to help seniors would allow them to go from MAPD to Med Sup guaranteed issue on their birthday each year.
That would really tank the Med Sups even quicker.

In states that allow it, how do they get out of the MA mid year? Is there a SEP for a PDP?

Example: July birthday

 

[annon123]

You would think these politicians if they really want to help seniors would allow them to go from MAPD to Med Sup guaranteed issue on their birthday each year.
That would really tank the Med Sups even quicker.

Some people don't want supps to tank. They NEED and WANT the unlimited networks so they can be seen in and out of state anywhere that accepts medicare. In areas that have fantastic health care that probably isn't an issue but in many rural areas and smaller cities or states with really crappy health care that issue becomes much more important.