• Do you have any victories you'd like to share for the month of May? Help us celebrate others by posting here.

MA vs Supps

Crabcake Johnny

5000 Post Club
Well my parents came over yesterday and we talked about their supp vs the MA plan through Bravo and we went through the brochure.

Right now they both have plan F for $340 a month combined - not person, through AARP. They have zero OOP expenses; no deductibles, no copays, no nothing. Their care is "free."

A MA through Bravo would be $130.50 a piece or $261 for a savings of $79 per month or $948 per year.

However, then everything would be a copay and deductibles. They'd have to pay their Part B deductible, office copays for everything, hospital copays, ER copays, ect...

They'd also have to stay in network and as it stands now they pretty much go anywhere for care. I'm not getting into my parent's health here but safe to say for people in their mid-70's they are unbelievably healthy yet still have some issues.

My father immediately, as soon as he saw the HMO part and copays/deductibles blurted out "not a shot in hell." It took him 30 seconds to show how they'd have more OOP over the $900 savings per year and more general frustration.

We left with "So who falls for this crap?" Enough said for me.
Yeah but who in their right mind would pay $130.50 for a MA HMO plan?? What plan is that? I would never consider an MA unless the premium is under $50 a month with rx coverage or under $35 without rx coverage. $130.50? no way.
The MA plans serve a useful purpose. Naturally, I show them the Supp. Plan F. They still have to pay their part B of Medicare which is automatically deducted from their check, no getting around that. But, if they feel that they can afford that plan and know exactly what they will be paying for a year, then that is fine. If they cannot affort the Supp and only have Medicare, then I do show them the MA and explain the co-pays and deductibles. They feel they can affort that, then that is what I write. I can either write them a MAPD or a MA with a stand alone PDP. Before I actually write them though, I do a comparison with what they are going through right now with their health and they can see if this is good for them or not. The final choice is always the clients. I understand that our new MA for 2008 will now have a $0 premium.:policeman:
John, your parents are in a fortunate position to be able to afford their supplement.

Most of the people who inquire about MA plans are the ones who are having to stretch their budgets too far to be able to afford their supplement.

Mind you, the MA plan that you have is not a significant savings. Now, show them a $0 premium MAPD plan and that is a difference of $4080 per year.

Is it worth the savings? That is where a quality needs analysis comes into play.

Supplement Pros -
Any Medicare approved provider
No Co-pays
No out of pocket costs (pending on plan)

Cons -
Health prior to enrolling if not in a guaranteed issue period

MA pros and cons really depend on the plan that you have and the network available.
MA and MAPD plans vary greatly by geographic area and that Bravo plan doesn't look so good to me. Go to Medicare.gov - The Official U.S. Government Site for People with Medicare scroll down to search tools and click on compare health plans to see all the options available to folks in your parent's county. Remember though plans will be changing for 2008 and I wouldn't recommend they make any change until the new open enrollment beginning Nov 15.

PS to everyone. Watch for the new Medicare Medical Savings Account programs in 2008. I think they are going to make a lot of sense for many.

Going to a traing and certification for the new MA and to learn about the new MSA. I had not heard of them before and the carrier noticed me about them. Going to find out how and if they will work for me. Most of the clients I deal with are under $20K a year income and the MA's are their choice. However, I do run into those that are on the "fixed income" of $5k a month....haha
MSAs are going to be good for the higher income folks...not medicaid (they cant enroll) nor those who can not afford a supplement. It will be a smart alternative for those who like to stay in control of their health care costs.
SAI...what are the new benefits for Todays Options? They had been strong in some areas and weak in others...anything for preventive??
SAI...what are the new benefits for Todays Options? They had been strong in some areas and weak in others...anything for preventive??
The benefits for the Premier Plan are essentially the same except $10/$25 to see docs and $195 for hopsital. However, they now have 6 premium levels depending on county. Have not seen a grid of which counties have what price. Current maximum price is $72, for 2008 it's $90.

There are 2 lower level plans with ok benefits/costs but the negative with both are the hospital costs are on a per-day basis, not a one-time cost as the plan above.

Plans can add the PDP for $35 additional.