- 2,370
I think most carriers are required to have prospects sign a form stating they understand this is not a medicare supplement policy and such. The statement sounds like just a different way of phrasing it.
Cancer & HI Plan Sales Prohibitions
- Thread starter WCMason
- Start date
I wrote up a lady last month that bought the $0 Piedmont/Wellstar HMO plan plus a GTL "Advantage Plus" for an extra $121 per month.
She travels a lot, especially out of state to see her grandkids and hopes she doesn't have a repeat of last year where she was admitted to the hospital via the ER.
For $121 she got the MAPD and plus that could still leave her several hundred, or even thousands OOP unless she just happened to be treated for something covered by the GTL plan.
The Piedmont/Wellstar plan has $3900 OOP for in network approved charges.
After a 40 minute phone conversation she decided she would be better off with plan N for $87 and have better coverage than her HMO MAPD and overpriced GTL plan.
She travels a lot, especially out of state to see her grandkids and hopes she doesn't have a repeat of last year where she was admitted to the hospital via the ER.
For $121 she got the MAPD and plus that could still leave her several hundred, or even thousands OOP unless she just happened to be treated for something covered by the GTL plan.
The Piedmont/Wellstar plan has $3900 OOP for in network approved charges.
After a 40 minute phone conversation she decided she would be better off with plan N for $87 and have better coverage than her HMO MAPD and overpriced GTL plan.
I might sell I GTL when the Supp option is like $150 plus drug
and they just don't want to pay that
and the MAPD is $0 and the GTL is less then $50
someone selling a $100 GTL when a N plan is less then $100
is just a thief
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In fact where that happened a lot is in FL mostly
GTL is not in FL anymore
So I have not sold a GTL in a while
I had a guy who was a tobacco user and was paying $190 for a Medicare Supplement and $36 for a PDP. I signed him up for a UH PFFS for $0 premium and a GTL hospital indemnity plan for $37.00/month.
He was saving $2256/year on premiums. He ended up in the hospital because he fell and got a terrible concussion. He had every imaginable scan and test known to man kind. He was in the hospital for 21 days. His copay on his UH was $1580 for the 21 day stay. Luckily he had his $400/day GTL hospital plan and received a nice check in the mail for $4000. He took his wife and kids on a nice vacation with the extra $2420 he received from GTL.
He is now telling all his friends about his coverage and I foresee lots of referrals come October 15th from people who are overpaying for a Med Sup and separate PDP.
He was saving $2256/year on premiums. He ended up in the hospital because he fell and got a terrible concussion. He had every imaginable scan and test known to man kind. He was in the hospital for 21 days. His copay on his UH was $1580 for the 21 day stay. Luckily he had his $400/day GTL hospital plan and received a nice check in the mail for $4000. He took his wife and kids on a nice vacation with the extra $2420 he received from GTL.
He is now telling all his friends about his coverage and I foresee lots of referrals come October 15th from people who are overpaying for a Med Sup and separate PDP.
Well that's just dumb not to do a plan N there. I've never seen a GTL plan that high and a plan N that low but I would have easily done the same as you
- 1,199
I sold some GTL in Fl mostly to G.I T65 especially if client was a claim ready to happen and they didn't see they value in stretching their budget a little to pay the premiums for a med supp/pdp combo or if they were were healthy and the biggest obstacle to the MA was a 200.00 a day IP co pay .I rarely sold a plan where premiums was more than 30% of a med supp because most care received under Medicare/MA plan are outpatient based services and the value vs a med supp was not there.
I was shocked too. Tried to recreate it but couldn't. Figured there had to be an additional GTL plan (accident?) that was bundled.
Taking advantage of seniors like this is criminal. When I encounter situations like this and ask a few questions, it seems obvious the agent never bothered to consider the needs of their client. Just grab the money and run.
Most consumers fear the hospital stay as a bank account buster but that hasn't been the case in years. Close to 60% of the dollar value of large claims (xs of $50k) are incurred OUTSIDE the hospital.
Almost 80% of all claims do not involve a hospital stay.
- 2,370
I am a fan of offering MA clients HI plans. Give your client 3 choices:
1. MAPD plan
2. MAPD with HIP
3. MAPD with HIP + Cancer rider
This way the client has the ability to choose what level of coverage they are most comfortable with. Of course, in the example above, if a Plan N is only a few dollars more, then offer that as an alternative. However, most of my MAPD + HIP offers have hovered around the $40 per month range. Add Cancer and you are looking around $55 per month ($5K benefit).
1. MAPD plan
2. MAPD with HIP
3. MAPD with HIP + Cancer rider
This way the client has the ability to choose what level of coverage they are most comfortable with. Of course, in the example above, if a Plan N is only a few dollars more, then offer that as an alternative. However, most of my MAPD + HIP offers have hovered around the $40 per month range. Add Cancer and you are looking around $55 per month ($5K benefit).
