As I See It: Understanding Medicare Advantage

[sshafran]

So you re-wrote her med supp?

That's what I was thinking! I wrote (and got approved) 3 new business Plan Fs this AEP and several more Gs. Have an appt tomorrow for another G, off a referral from a lady who had G paying 244/mo that I got way lower last AEP.

All of them - "Ok, you have G. You pay "X". Are you wanting that same type of coverage or were you calling because you are interested in one of those advantage plans?

Same type of coverage? Cool.

Let me run the numbers....

 

[Fisher]

Same type of coverage? Cool.

Let me run the numbers....

Word.

 

[LostDollar]

Eat that shit up LD. You have the worst option you could possibly pick but yet you know more then the agents.

That would be ??????

 

[LostDollar]

OH Shit...I have an MAPD

I better go get me a Med Supp and make it a plan F Please.

Prepare to be carded.

 

[InsuranceGuy29]

And then, according to other posts on the site, she has a chance of dying sooner than she might have had she kept the medigap plan, because of lower quality treatment accessible with the MAPD and/or MAPD restrictions on her care.

And other past posts suggest for many cancer treatment situations, an MAPD plan holder can expect to pay the MAPD moop two years running.

I've had at least 20 clients get cancer and there were no restrictions on care. Even paying a MOOP for infinity and beyond is still cheaper than most of the premiums around here. It's not an issue.

Would the agents each have 76,000 MAPD clients who have had cancer?

That appears to be the study base for research published in the Journal of Clincal Oncology.

Anecdotal of course, but I’ve been in this business for 8 years, and have had roughly 14 or 15 clients come down with cancer.

I was always with them every step of the way and asked if there were any problems or issues.

Literally never had even one complaint and got nothing but praise for helping them by most of them. Take that for what it’s worth.

In that study, there’s also some poor control mechanisms, a lot of assumptions made, and too many X variables that either weren’t mentioned or simply weren’t accounted for.

It just struck me as a study where they already had the message they wanted to propagate, in their heads, and just made a “study” to “prove” it.

If I've seen one thing in this business, it's this.....the agendas are everywhere. I've heard first-hand from some facilities that they don't like Medicare Advantage plans for one simple reason, because they can't make as much money off of them, depending on how their deals/care model was setup.

 

[sshafran]

Prepare to be carded.

occasionally LD has a good zinger.

 

[dandan]

I always go over both Medicare advantage and Medicare Supplement options and let them choose, how can an agent make the decision for them?

A couple of years ago I presented both options to two buddies that were turning 65 a few weeks apart, one was a semi-retired group health agent and the other is a lawyer, before I got through with my presentation one chose Advantage and his buddy chose Med Supp.

Today they both have stayed on their original plan and are as happy as can be.

 

[Travis Price]

I always go over both Medicare advantage and Medicare Supplement options and let them choose, how can an agent make the decision for them?

A couple of years ago I presented both options to two buddies that were turning 65 a few weeks apart, one was a semi-retired group health agent and the other is a lawyer, before I got through with my presentation one chose Advantage and his buddy chose Med Supp.

Today they both have stayed on their original plan and are as happy as can be.

I don't do the same.

Here's the thing, 99% of the difference between MAPD and Medigap to the client is risk tolerance.

My question is, "Would you rather pay more up front and very little when you use it OR less up front and pay as you go?"

I don't explain MAPD if the risk tolerance leans to Medigap or vice versa.

I'm the worst salesperson in the world. I literally don't care what they chose, if they sign up with me, I refuse to dive into dental (I hate it.)

I could do better with apps if I was more aggressive, but I do pretty good for my part time schedule.

I just invest everything I make in insurance while I keep my job.

 

[LostDollar]

If there is an article then it has to be correct. Obviously cancer can overlap years but doing the math in his example they will still be far better off over the long run. Don’t believe everything you read. Sometimes agents with hundreds of MAPD clients have more experience then some beat writer.

Just curious,
How does your MA book split between the special Cost plans not accessible to agents and consumers in many other markets, and the more normal MAPD plans with wider availability?

 

[somarco]

More than nine out of 10 cancers are diagnosed in people 45 and older. Seniors older than 74 make up almost 28% of all new cancer cases.
[EXTERNAL LINK] - Cancer Incidence by Age

Breast cancer is one of the most common cancers in people over 60 years of age.

Over 285,000 women were diagnosed with breast cancer in 2020, and over 44,000 thousand women died of the illness

Prostate cancer is a common diagnosis in men over the age of 65.

Almost 250,000 men were diagnosed with prostate cancer in 2020, and more than 34,000 men lost their lives to it.

More than half of the people who get lung cancer are over 70 years old.

There have been many advances in treating lung cancer, but it remains one of the deadliest cancers. The 5-year survival rate is only 21%.
[EXTERNAL LINK] - The Most Common Cancers in Older Adults



And then there is this from another thread

Those covered by Medicare Advantage were 1.5 times more likely to die within a month after having their stomach or liver removed, and twice as likely if they had cancer surgery of the pancreas, according to findings published Nov. 21 in the Journal of Clinical Oncology.
https://consumer.healthday.com/cancer-treatment-2658727750.html

If they die within a month they really don't have time to complain . . .