MSAs Poised for Popularity? -- Lasso focused article

[Millwood]

Can anyone give us some insight on what happens if these plans get loaded up with AKF patients?
There are 3 legs to patient cost liabilities.
1. Plan premiums which must always be $0 per CMS.
2. MSA contribution. COULD IT be significantly reduced in future if plan gets upside down with claims?
3. Who and what would allow deductible to be changed in the future ? Are their any maxes for deductible?
I can already see every single AFK patient in the country going on it and AFK covering the $3000 gap.
We saw a similar situation with Mutual of Omaha plan N.

 

[LostDollar]

I can already see every single AFK patient in the country going on it and AFK covering the $3000 gap..

MSA's are Medicare Advantage plans. Are ESRD patients allowed to join Medicare Advantage plans?

. MSA contribution. COULD IT be significantly reduced in future if plan gets upside down with claims?

It's a Medicare Advantage plan so I suspect the answer is yes.

. 3. Who and what would allow deductible to be changed in the future ? Are their any maxes for deductible?

It's a Medicare Advantage plan so I suspect those figures are subject to carrier decision. A recent (preview) post indicates there will be some significant Lasso deductible changes coming in 2021. No reason to think other changes wouldn't happen in farther out future years.

For example, The sense I have from reading forum posts is that the government is throwing a lot of money at Medicare Advantage carriers right now. Would you expect that to continue, and if the government chooses to cut back, would you expect carriers to continue with their current Medicare Advantage commission and benefit structures? (I have my not-an-agent answer to that question.)

 

[LostDollar]

ESRD,
See page 3 of this document:

https://lassohealthcare.com/documents/H1924_2020SB6_M.pdf

 

[LostDollar]

Caveat, not an agent.

Bolding is my modification to text.

What are my costs? Each year, plans set the amounts they charge for premiums, deductibles, and services. The plan (rather than Medicare) decides how much you pay for the covered services you get. What you pay the plan may change only once a year, on January 1.

Page 10:
https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf

 

[TwoCents]

ESRD,
See page 3 of this document:

https://lassohealthcare.com/documents/H1924_2020SB6_M.pdf

ESRD restriction is going the way of the dodo for 2021.

 

[vic120]

MSA's are Medicare Advantage plans. Are ESRD patients allowed to join Medicare Advantage plans?

Got to take the ahip every year to keep up with the changes

 

[Millwood]

MSA Medicare Advantage products have some specific rules and regulations that are peculiar to only them.

That's why I'm trying to identify future what ifs that could affect someone dropping a supplement who will never have the ability to go back.
I never wrote MO plan N for that reason. GLAD I didn't. Many agents did and didn't give a crap what happened.

Just trying to figure out the future bogie man's with this product. So far haven't been able to find the answers needed.
I would think if LASSO actuaries have an idea this can get turned upside down with tons of bad risks they would show their hand to discourage that. Mutual of Omaha was arrogant when I tried asking these same questions and how did that turn out?

 

[Millwood]

American Kidney Fund just made known there will be no NEW recipients insurance premiums paid. That will dramatically push new ERSD patients to MA. Specifically this plan because of every provider being elgible & max $3000 exposure which would equate to a $250 mo underage supplement premium.

 

[LostDollar]

Got to take the ahip every year to keep up with the changes

I'm pretty booked. How much study time am I going to need in addition to the 7 hours to take the test?

 

[somarco]

American Kidney Fund just made known there will be no NEW recipients insurance premiums paid. That will dramatically push new ERSD patients to MA. Specifically this plan because of every provider being elgible & max $3000 exposure which would equate to a $250 mo underage supplement premium.

U65 Medigap plans in most states have a "defensive wall" against ESRD clients. It is called ultra high premiums. Plan G U65 in Georgia start north of $600 per month for most carriers.

TransAm in the $290 range but aren't they pulling out of the Medigap business?

Reserve National was the low price leader in the $250 range but recently tripled their rates for new entrants.

That leaves State Farm @ $360 for now. I wonder how many SF agents even know what ESRD means?

Wonder what MA plans will do when they have to take ESRD? Can they design a plan ONLY FOR ESRD or would CMS hammer than on that?

Or maybe that plan won't be available for agents to write. Or they can write but $0 commission.