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I sold MSA plans 8-10 years ago. Clients loved them. The "risk" at that time was in the mid $2,000 range, not the much higher mid $4,000 range that I have seen suggested for my market this time around. That's going to be a tougher sell to risk-adverse senior citizens. Another thing, the way MA plans have been handling skilled nursing facilities has caused some seniors to come back to traditional supplement plans; not sure if this will impact MSA plans, as I can no longer honestly tell people that MA plans provide the same benefits that Medicare does, just packaged a little different.
I would love to know if MSA plans will be using the MA model to deny benefits. (Medicare itself is an almost automatic approval of a skilled nursing facility following a hospital stay, easily in the 90% approval range; MA plans are quick to deny coverage, using virtually any excuse on the planet).
Risk aversion is tough. One way to think about it is to consider a 2 year time horizon. Assume 10% of the members spend through deductible (costs $4,000) and 90% spend=deposit (cost $0).
Here is the % chance of going through the deductible over 2 years:
0 times inpatient: 81% chance you spend $0
1 time inpatient: 18% chance you spend $4,000
2 times inpatient: 1% chance you spend $8,000
Assuming your alternative is to buy a plan F for $2,000/year, there is a 100% chance you will spend $4,000. So, compared to a Plan F, here are the outcomes:
81% chance $4,000 better off
18% chance same outcome
1% chance $4,000 worse off
This is kind of a simple way to look at it since there are tons of possible outcomes, but maybe this helps. . .