Seniors With Medicare Advantage May Pay More

EckoRomeo said:
Again... you confuse your personal experience with a universal one. Also, you aren't including all costs. You are excluding the Part B deductible, higher RX premiums and copays, and dental and visions premiums. The difference in Rx costs between an PDP and an MAPD can often exceed $1,000/year.

You also fail to recognize that a premium is a guaranteed cost. You WILL pay $2,640 this year. NO MATTER WHAT. The vast majority of MAPD enrollees won't have OOP costs anywhere near that. Even in your market, the risk between a Supp and the best MAPD is only $560/yr based on your own admission. So, worst case, a beneficiary would be OOP $560 more on that MAPD, while they could be OOP $2,640 more on your supplement than someone on that MAPD.

The benefit of an OM + Med Supp, is rarely the costs savings. It's the freedom from networks and reauthorizations. To some people, that isn't worth the cost. Your preference may be different. But its just that, YOUR preference.
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You missed the "in network". If I need to go out of network the MOOP skyrocket. Do you tell your MA prospects that? Do you tell them that they probably will not be able to go to places like the Mayo Clinic with their MA? With OM there are no networks. Use any providor I want.

I have said MA is a better deal on a cost basis for healthy people but we buy insurance to protect against the catastrophic situations.

But, there is more do it than costs. What about MA requirements for pre-approval? Do you how many requests are denied. And even if approved on appeal, it can drag on for days and even weeks. In my case, the denied to approve the recertification for home health even though the Dr. and home health agency said I needed it and it would be beneficial. I never had that problem with OM. I could on about the disadvantages of MA but it is a waste of time because you will not acc re pt any of it. You are afraid you would actually have to start selling for a living.
 
rousemark said:
Even if that be the case, the Med Supp preoum would be far less than the MA MOOP.

MA is a great buy if you are reasonably healthy but if you have a serious illness many times that is not the case. I have spoken with lots of folks that are happy with their MA plans but they are mostly those that are reasonably healthy. Some that are having a lot of expenses are satisfied until they learn that a med supp combined with medicare would be paying almost 100% of their expenses. Add that to the difference in being able to get services pre-approved and their dissatisfaction increases. Most tell me the agent that sold them their MA never explained the difference in what a supp paid and what a MA paid. But why would they? MA pays larger commissions and it is easier to "sell" a zero premium plan.
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I have a client (water and utility company in South Georgia) who pays for their retirees Medicare Supplement and PDP. The HR person typically sends me a completed Medicare Supp app for the retiree and a list of medications. I run the comparison and we get them enrolled in the PDP plan as well. The HR person died last year and the new person is still learning the ropes.

I said all that to say, one got through the cracks and he enrolled in a MAPD. Luckily we're still within the time to get him enrolled in a Med Supp and a PDP. When we spoke he said the agent who enrolled him never told him he had a MOOP of $7,999 for in-network and $12,999 for OON. He was unaware of the hospital copay and most other copays other than his RX copays.
 
rousemark said:
You missed the "in network". If I need to go out of network the MOOP skyrocket. Do you tell your MA prospects that? Do you tell them that they probably will not be able to go to places like the Mayo Clinic with their MA? With OM there are no networks. Use any providor I want.
Click to expand...

So, you value the ability to go OON. Not everyone does. See how that works? And, believe it or not, there are some people who have no intention of stepping foot in an Mayo or MD Anderson. I'm not aware of any of my supplement clients who have gone to those facilities either.

rousemark said:
I have said MA is a better deal on a cost basis for healthy people but we buy insurance to protect against the catastrophic situations.
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It's a better deal for the vast majority of people on a cost basis. The math is irrefutable.

rousemark said:
In my case
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I fixed your post…

rousemark said:
You are afraid you would actually have to start selling for a living.
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lol… yeah because Med Sups are hard to sell, right?
 
sman said:
I have a client (water and utility company in South Georgia) who pays for their retirees Medicare Supplement and PDP.
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lol… every beneficiary is in his exact situation and has their supplement paid for by the former employer.

You MSO nazis predominately sell to upper middle class retirees and assume what's suitable for them should be suitable for everyone else. Y'all don't have clients who receive only $1450 in Soc Sec and have $600 monthly rent. You think that person prioritizes be able to go to the effing MAYO clinic SOMEDAY is more important than putting food on the damn table?

Anyone who believes there is only one suitable product for everyone isn't as smart they think they are.
 
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