Medicare Advantage Plans Accused of Denying Care and Overcharging

[Travis Price]

They don't qualify for medicaid but cant afford the HIGH FIXED monthly cost of a supp in SoFl. So

I would challenge this.. Medigap comes in multiple price tiers. The difference is YOU don't get paid as much. I'm not saying don't enroll your client in MAPD if that's what they want. I'm just saying that people don't always get all the information because agents look at pay and they think it's a waste of time.

HDG is actuarially the same as most MAPD medical with lower MOOP and open availability to care and claims process at a third of the price of a traditional Medigap plan.

 

[Todd King]

I would challenge this.. Medigap comes in multiple price tiers. The difference is YOU don't get paid as much. I'm not saying don't enroll your client in MAPD if that's what they want. I'm just saying that people don't always get all the information because agents look at pay and they think it's a waste of time.

HDG is actuarially the same as most MAPD medical with lower MOOP and open availability to care and claims process at a third of the price of a traditional Medigap plan.

Isn't it funny how the majority of people were able to afford a Med Supp before MA's came around? Now, it seems as though hardly anyone can "afford" it. Sometimes it's that agent that gets sold.

 

[Travis Price]

Isn't it funny how the majority of people were able to afford a Med Supp before MA's came around? Now, it seems as though hardly anyone can "afford" it. Sometimes it's that agent that gets sold.

Tbf, most of these people have never been in a pre MAPD world.. I mean, when I started MAPD was a big Shiney that got abused by agents and that's why we have all this fuckery today.

 

[LostDollar]

My plan G at age 77 is $3700 per year. The 0 premium MA plans in my area all have $6700 OOP. That means I am saving $3000 per year plus have access ro any provider without referrals or approvals.

I would challenge this.. Medigap comes in multiple price tiers. The difference is YOU don't get paid as much. I'm not saying don't enroll your client in MAPD if that's what they want. I'm just saying that people don't always get all the information because agents look at pay and they think it's a waste of time.

HDG is actuarially the same as most MAPD medical with lower MOOP and open availability to care and claims process at a third of the price of a traditional Medigap plan.

(Caveat, not an agent)

Age 77 KS. Closed book, Issue age, HDF, M, NT, $52 per mo, $624 per year.

$624, plus 2022 maximum high deductible ded $2490, = $3,114 for the year.

Rousemark $3,700
LD $3,114
Mrs R $1,320

 

[somarco]

Tbf, most of these people have never been in a pre MAPD world.. I mean, when I started MAPD was a big Shiney that got abused by agents and that's why we have all this fuckery today.

I wasn't involved in the Medicare market at the time but I do recall being heavily recruited by carriers and local GA's to sell the product . . . seems like that was 2006 or so.

It was like the wild west . . . just need to be licensed for health insurance . . . almost everyone who wanted to jump in was appointed . . . training was a 30 minute presentation + Q&A . . . I don't recall the $0 premium plans (they may have come along later. You could cold call, door knock, DM (nothing had to be approved).

I got contracted with a few carriers. One fellow supposedly had a connection with the Atlanta city employees credit union and "hired" me to sit in a room at the credit union and take orders. He was going to promote the product and all I had to do was write the apps.

First day not a single person showed up . . . including the guy who recruited me.

Some agents were door knocking and writing 6 . . . 8 . . . 10 apps a day. I think the comp was $500 or so per app. No open enrollment . . . you could take apps any time of the year.

I never really pursued it because I knew it would blow up . . . and eventually did. That's why we supposedly have all these rules that prevent churning

In some ways, not much has changed and "celebrities" are pitching free everything . . . operators are standing by

 

[Travis Price]

In some ways, not much has changed and "celebrities" are pitching free everything . . . operators are standing by

Which is why they're cracking down again.

However you have all these guys saying it's so much of a pita.

Seriously though, it's really a bare minimum bar to sell MAPD.

 

[Travis Price]

Rousemark $3,700
LD $3,114
Mrs R $1,320

BUT that's maximum exposure and Louis is on G I believe.

 

[rousemark]

BUT that's maximum exposure and Louis is on G I believe.

Yes, what i posted is the premiums i pay. Mine is SILAC. Charlotte is with Manhattan.

 

[LostDollar]

BUT that's maximum exposure and Louis is on G I believe.

what I should have said for the 2022 comparison:

Rousemark $3,700 premium
$233 part b deductible
Total for 2022 $3,933

LD 2022 HDF premium $624
2022 High Deductible $2,490
Total for 2022 $3,114

If you want a lower number, My plan is for the 10 year period 2021-2030, to have an average annual cost that does not exceed Premium + an average expenditure of $1,200 per year. That leaves my Actual Premium, my Actual Expenses, the inflation of expenses, and the Actual Annual High Deductible for future years as unknowns that can be hypothetically adjusted to support either side's point of view in an argument about HDG/HDF vs regular G/regular F.

(For what it is worth, I think my 2021 actual costs were probably less lthan Mrs Rousemark's. I am starting to accumulate enough future specialist obligations that I don't know that I can repeat that performance in any future year.)

 

[goillini52]

Yes, what i posted is the premiums i pay. Mine is SILAC. Charlotte is with Manhattan.

I really liked Equitable before they sold.