Should You Ditch Your Medicare Advantage Plan?

[sman]

I am so curious about this! So he could potentially help them with an Advantage but refers them out? Why?

You should ask him.

 

[sman]

He doesn't sound like an insurance advisor. He sounds like a Medigap salesman.

I'm willing to bet his clients are well educated by the time they enroll in a plan. I know Bob personally, not just as a faceless member of the forum. I can assure you he is more of an advisor than many on this forum.

 

[somarco]

@MedicareWAA & @Medicare bro my business model has been the same for as long as I have been in the industry. It has served me, and my clients well. My closing ratio is in the high 90's and never any pressure to buy. Everything is on a take it or leave it basis. Likewise, client retention is in the high 90's. I guess someone likes what I offer even if other disagree.

Offer accurate, honest & impartial advice . . . the kind I would want as a consumer. Never any pressure to buy . . . anything. Never offer coverage that I would not buy personally. Suggest plans with comprehensive coverage, unfettered access to care and limited OOP exposure.

Most people hate to be sold but they love to buy.

YMMV

 

[annon123]

You should ask him.

One guess I would make is that MA clients change plans far more often than OM supp clients and so you'd have to work harder to hang on to your AP clients. If you are happy with your income already why add that extra work? Sure you get more for AP enrollments but money isn't everything if you are already making enough to meet your needs and have other priorities in your life you'd like time for.

Also if your client base is middle class and above income + assets wise they can afford the premiums up front (and aren't in the bind of can't afford premiums and also can't afford the MA MOOP).

I, personally, believe that OM results in better medical care in many areas of the country due to the need to travel for good medical care when there isn't much locally. OM is far better suited for that along with no referral issues, changing network issues (which are a problem if locally, like here, there are few choices to begin with), etc. And yes I sell both as my volunteer work gets me a lot of dual eligible clients and other lower income clients.

I hate having to counsel the ones who can't afford premiums and can't afford copays but aren't eligible for mediciad to use the only system here that won't sue them for not paying their bills (and if they have to have a specialist apt elsewhere prioritize paying that copay due to the consequences of not doing so). I struggle with knowing they won't pay their copays and telling them who to rip off as that is, in my opinion, unethical but they'd have care cut off outside of that one system not doing that.

With care locally you need to cross systems for decent care depending on what is wrong with you and what specialists you need (I personally use 3 systems here). Almost all doctors here are employees of one of the systems which complicates the situation. As a newer agent I need all the clients I can get.

 

[somarco]

I struggle with knowing they won't pay their copays and telling them who rip off as that is, in my opinion, unethical but they'd have care cut off outside of that one system not doing that.

That has been one of my main beefs for a long time . . . and it started before sky high Obamacare premiums coupled with high OOP.

If someone cannot afford the premium for GOOD coverage they probably cannot afford to get sick either.

Which is worse? Paying ~ $200/month (about $6 - $7 per day) and have unrestricted access to care + nominal OOP . . . or paying $0 and unable to pay for care?

I have clients where family members chip in to help pay premiums so mom, dad, can have a good insurance plan. Seems easier to get small change from family for premiums than trying to raise hundreds or thousands to pay medical bills.

 

[MedicareWAA]

And your point is . . .?

I cannot help you learn how to read.

 

[somarco]

I cannot help you learn how to read.

And I can't help you overcome your inability to form complete thoughts and express yourself.

Have a nice day.

 

[MedicareWAA]

And I can't help you overcome your inability to form complete thoughts and express yourself.

Have a nice day.

Did you read my posts? Go back and read them. If you still can't comprehend what I'm saying and the points I'm making, it just supports my sense that you should have retired a generation ago.

 

[sshafran]

Once again, this is not accurate in all parts of the country. There are tons of densely populated areas with MAPDs having $2,500 - $3,200 MOOPs. Sometimes lower.

Whether or not an Advantage plan makes sense for someone depends on their individual needs and preferences, but it is a myth that MA out of pocket costs are meaningfully higher than a supplement. That's true in some markets, but it's not true in many other markets. In many markets, it's the opposite. What a supplement gives you is maximum freedom and very predictable costs.

Out of pocket costs = plan premium plus cost share

@MedicareWAA - there were exactly (let me count again) - Zero things that I said that were inaccurate.

You simply brough up irrelavent data. I'm well aware that some areas of the country have low Max. For now, at least....


My story was about Jim. Let me paint this a bit better and give you more details.....

Nov 2018 - he called me - T65 June 2019

Showed him G & N - he was in wheelchair @ the time. He wanted to pay as little as possible. Showed him MA options - he wanted giveback, cost of Medicare would be "difficult." (no, he didn't qualify for assistance).

Sold him MA effective June 2019 w/ Giveback

Each year he gets my letter - sometimes he calls in, sometimes he doesn't - each time he just wants to keep whatever is cheapest (so, Part B giveback plan)

January 10 2024 he calls me, "suddenly," they're going to need to amputate his leg, then he'll need SNF. Wow - that's a big blow - and he has an idea of combined cost, they said about $8,000 - he asked for "Plan G."

[His Max OOP in 2024 on his giveback plan is $8,000.]

Thankfully, it's January. I use OEP and move him to a lower Max OOP - for 2024 we had a $2,900 Max OOP. That starts 2/1/24.

He maxes it out, of course in 2024. I saved him $5,000....

Fast forward to AEP - his $2,900 Max OOP plan will be terminating SAR - I think - this is great, Jim can GI into a med supp. I'll make $3.23 and a gift card for the dollar tree in commissions but - hey, it'll be good for Jim.

I call Jim and explain. Guess what he wants to do?

No - not going to pay for Plan F GI. He "wants the cheapest" again. I explain - Jim - sure, we can - but just so you know, you likely won't have this option come up again.

Jim's stubborn and it worked out OK last time so he just thinks all his medical is past so he wants the "giveback" plan again.

Sure, jim, here it is.

He currently for 2025 has a $9,350 MOOP and if he dares complain about out-of-pocket I'll remind him again, I explained Plan G late 2024 and you could have had it no health questions.

So.... not sure what was inaccurate.

Also, I don't think Jim is my brightest client. It's literally baffling to me that he wants to again open up that risk but it's his decision.

 

[Millwood]

There are some clients that will always make the worst decision. You bail them out and they immediately get themselves back into a bad situtuation.
It's just who they are.
Doesn't matter if it's insurance, buying a car, or choosing a partner .
Momma said you can't fix stupid. She was correct