Medicare Supplements Vs. Medicare Advantage

[Jessica Durphy]

Tom Highway, thank you very much for clarifying them!!! I am actually on the NY border... about 15 minutes away from NY. I did want to get my license for NY, but I wanted to get a better knowledge of it all before I go conquering the world! I think, with ya'll, I'm on the right track!!

Policy Doctor...your suggestions are appreciated! I'm one step ahead of you though! I got that idea a few days ago, I was thinking of the different avenues I wanted to take with solicitation... and all of my local Senior Centers have been calling and inviting me to come and speak one time before the Annual Enrollment Period begins. SOOO, I've been preparing a "paper" on what medicare is, what it's all about, how it's changed over the years, what it covers, etc..... I want to make them as informative as I can without going WAY over their heads.... let alone mine (just teasing)

 

[Trmy05]

If they are making only $1000 per month, they would be SLMB or QI-1 and qualify for help on their PDP. It would be a dis-service to put those people into an MAPD. That's the stuff Humana would do.

There are situations where I believe you should put someone who is SLMB or QI -1 in an mapd plan. If someone has a spend down they simply can not meet every month then it would be helpful to them to go into a mapd plan instead of trying to come up with the spend down money on the month they know they have dr appointments and hoping they can scape up the money. At least in a mapd plan they will only have a low co pay that will get applied to their spend down..

 

[Bob_The_Insurance_Guy]

Jessica,

I had to fast forward through much of the posts you received.

Everyone has given you their biased opinions.

Medicare Advantage Plans and Medicare Supplements are like Public Schools and Private Schools - there is a place for both.

You must sell what they are familiar with and comfortable with. If someone is used to a pay as you go system, with a low monthly premium, then Medicare Advantage is the way to go.

If someone like paying a monthly premium, knowing that they will not pay a red cent when they go to the doc or hospital, the Medicare Supplements are the way to go.

If someone has a doc in the network, then Medicare Advantage is the route to take.

If their doc is not in a network, and doesn't know much about Medicare Advantage Plans, then Medicare Supplements are the route to take.

If they have had teeth/gum issues throughout their life, and need some type of Dental coverage, the Medicare Advantage is the preferred way.

If they have never had a tooth pulled, hear perfectly, and have 20/20 vision, Medicare Supplements will do.

If their friend, Estelle, told them not to get a Medicare Advantage, because her butcher's wife's cousin, was roped into one two years ago, then Medicare Supplements will make them happy.

If they heard that Jackie, from across the street got a Medicare Advantage, and they want one that gives them a free membership to a Fitness Center, just like Jackie, then a Medicare Advantage Plan will make them happy.

Regardless of what we agents think, they will be happy with:

• a plan that they know about
• a plan that their doctors accept
• a plan that their friends can vouch for
• a plan that will fit in their budget, without putting a strain on them

Too many agents only care about marketing to seniors from November through March.

Frank and MedSuppPro are the two on this board who market to the market all year round. I agree that you need to educate yourself.

• Read the Medcare and You Book
• Read the Choosing a Medicare Supplement book
• Read the Summary of Benefits for the MA Plans
• Go to the Medicare dot gov website

Hope this helped.

Disclaimer: I don't purchase leads to do telemarketing. All my Medicare business comes from Referrals from Financial Planners, other agents and Family, so many on this board will respond that I don't know what I'm talking about. They have a right to do so, and I have a right to not lose any sleep over what they believe.

 

[jdeasy]

There are situations where I believe you should put someone who is SLMB or QI -1 in an mapd plan. If someone has a spend down they simply can not meet every month then it would be helpful to them to go into a mapd plan instead of trying to come up with the spend down money on the month they know they have dr appointments and hoping they can scape up the money. At least in a mapd plan they will only have a low co pay that will get applied to their spend down..

You should still not put that person into an MAPD unless there is not a good stand alone MA plan available. The spend down has nothing to do with their PDP. If they are 100% LIS they are going to have to pay $0 for their PDP. There are instances where a $0 premium MA only would not be available for that person. That would be the only time to use MAPD. Any other time would be a dis-service to the client.

 

[Chazm]

Not sure if I quite agree with some of these statements

Jessica,

I had to fast forward through much of the posts you received.

Everyone has given you their biased opinions.

Medicare Advantage Plans and Medicare Supplements are like Public Schools and Private Schools - there is a place for both.

You must sell what they are familiar with and comfortable with. If someone is used to a pay as you go system, with a low monthly premium, then Medicare Advantage is the way to go.

If someone like paying a monthly premium, knowing that they will not pay a red cent when they go to the doc or hospital, the Medicare Supplements are the way to go.

If someone has a doc in the network, then Medicare Advantage is the route to take.
Just because their doc is in the network it means you should get a MA???

If their doc is not in a network, and doesn't know much about Medicare Advantage Plans, then Medicare Supplements are the route to take.
Isn't it our job to explain how PPO's and HMO's work?

If they have had teeth/gum issues throughout their life, and need some type of Dental coverage, the Medicare Advantage is the preferred way.
So if you had a client that was financially secure but had gum and teeth problems, you would recommend a MA? Even though you can get a Dental plan for $23?

If they have never had a tooth pulled, hear perfectly, and have 20/20 vision, Medicare Supplements will do.

If their friend, Estelle, told them not to get a Medicare Advantage, because her butcher's wife's cousin, was roped into one two years ago, then Medicare Supplements will make them happy.

If they heard that Jackie, from across the street got a Medicare Advantage, and they want one that gives them a free membership to a Fitness Center, just like Jackie, then a Medicare Advantage Plan will make them happy.

Regardless of what we agents think, they will be happy with:

• a plan that they know about
• a plan that their doctors accept
• a plan that their friends can vouch for
• a plan that will fit in their budget, without putting a strain on them

Too many agents only care about marketing to seniors from November through March.

Frank and MedSuppPro are the two on this board who market to the market all year round. I agree that you need to educate yourself.

• Read the Medcare and You Book
• Read the Choosing a Medicare Supplement book
• Read the Summary of Benefits for the MA Plans
• Go to the Medicare dot gov website

Hope this helped.

Disclaimer: I don't purchase leads to do telemarketing. All my Medicare business comes from Referrals from Financial Planners, other agents and Family, so many on this board will respond that I don't know what I'm talking about. They have a right to do so, and I have a right to not lose any sleep over what they believe.

 

[Bob_The_Insurance_Guy]

I was speaking in generalities, not specifics.

 

[padthaiforlunch]

Looks like generalities have bias.

 

[AJAX]

You should still not put that person into an MAPD unless there is not a good stand alone MA plan available. The spend down has nothing to do with their PDP. If they are 100% LIS they are going to have to pay $0 for their PDP. There are instances where a $0 premium MA only would not be available for that person. That would be the only time to use MAPD. Any other time would be a dis-service to the client.

Stand alone MA's are for people who DO NOT want prescription drug coverage at all. To clarify, an enrollment into a stand alone MA will dis-enroll from a stand alone PDP, or any other coverage: e.g MAPD or Original Medicare.

PFFS (MA) plans + stand alone PDP, are the only separate medicare options that can be combined (besides a Med Supp+PDP, ofcourse).

Otherwise an MA only+PDP enrollment is NOT allowed.

Only PFFS+PDP is allowed.

I'm thinking you guys know this already. But for the casual reader, and those new to MA's and PDP, I'd thought I'd clarify that.

 

[jdeasy]

Stand alone MA's are for people who DO NOT want prescription drug coverage at all. To clarify, an enrollment into a stand alone MA will dis-enroll from a stand alone PDP, or any other coverage: e.g MAPD or Original Medicare.

PFFS (MA) plans + stand alone PDP, are the only separate medicare options that can be combined (besides a Med Supp+PDP, ofcourse).

Otherwise an MA only+PDP enrollment is NOT allowed.

Only PFFS+PDP is allowed.

I'm thinking you guys know this already. But for the casual reader, and those new to MA's and PDP, I'd thought I'd clarify that.

Of course you are correct. All we had here was PFFS, so, it was never the issue of the PPO/HMO. Most of my 800+ MA enrollments are stand alone MA PFFS.

 

[barneyshells]

I'm learning! I love doing this and working with seniors! I'll admit, I'm not the PRO like some of you are, but I intend to be someday. I don't mind doing "homework"...
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I wouldn't go off on you for that!! I have sold about 12 MAPD plans, and so far, EVERYONE is truly happy with them. I've heard NO complaints.

My reasoning for asking is that, as I mentioned, in my area (so far) New Era offers the best price for Med Supps... but for these folks to buy a PDP on top of that, it costs them sometimes double what a MAPD plan is! That's what they look at... ALWAYS before I ever go to an appointment, I try to get as much information from a senior as I can, just by talking to them... I see what their needs are, I can get a feel of what's the most important to them, and then I try to go by that! If they are very concerned about how much is a copay, deductible, what's it going to cost for an ER visit, what if i have to take an ambulance, etc.... I just try to get them into something that will be best for their situation and pocket book...

I have a gentleman that in November he's going to change from his PFFS to New Era, because he gets his prescriptions from the VA or Walmart ($4.00)... so for him to get a Supp is SOOO much better, no copay,no deductible, no more money out of his pocket other than his monthly premium. (to him I hung the moon, he's referred so many folks to me.) I love the idea of a supp... but I just hate that the other portions folks ask me about I have to tell them, no this plan doesn't cover that! BUT with your permissions and signature, I can tell you about this other idea that I may have and it could possibly work for you....

Hey Jessica, How are you getting your leads? Also do you have a good generic flyer / business card you wouldn't mind sharing?