We’re cancer doctors. Here’s why Medicare Advantage fails America’s elderly.

[rmhaire]

Most of the argument focuses on premium and ignores everything else.

What other argument does a mao have other than premium?

Obviously they can't argue that MA offers superior coverage. As soon as we sell one, we turn around and sell them a hip and a cancer plan.

If it's so great, why do we have to put band aides on it?

 

[renee15]

Yes, the same maximum-out-of-pocket that is $2,150 on most plans I write. Which happens to be lower than many stand-alone supplement premiums that are guaranteed to insurance companies every year.

On other plans, it hover around $3,600 in my area. On the off-chance someone does get cancer, hitting a $2,150-$3,600 MOOP is literally a non-issue when you factor all costs associated with supplements into account, as well as all the other bonus money in extra benefits they receive.

Supplement-only agents that love to pretend like this is the end of the world do crack me up though.

There are people that aren't 65, like me, that would damn-near kill to have a $0 insurance plan with a low MOOP. Oh no, the "horror." My deductible alone on my plan is $8,000, and I pay tons of money for it every single month.

It's as if people forget you are literally paying nothing for the plan every single month. Zero, zip, zilch, nada. Do you have any idea how insanely great that is?

Plus there's no deductible.

That's because in your mind.....you think you have $$. When you retire and the spigot turns off, and you live off of your assets and SS, you approach all spending differently. MAPD plans in my state have OOP at $4500-$8000

 

[renee15]

There is no MOOP even remotely close to that around here. Here is what the situation is here: (Ignoring dual eligible, which are MAP and MAAP, and which are HMO, HMO-POS, PPO, and regional only):

View attachment 19017

Ignoring the network issues, this kind of major difference really affects the costs for people.

Here is G for a t65 female not tobacco user

View attachment 19018

Of course adding in vision, dental and hearing would raise that a bit but many of the people I talk with aren't interested in those except periodically, especially since you can get, for $50 added on the vision exam (so you pay) for glasses added to the annual B wellness check for vision. Glasses/contacts out of pocket are often less than vision. Plenty of places here you can get glasses frames and progressive lenses which are the most expensive (or contacts) for $200-300 total. Dental is another issue but the dental school is $78/cleaning and $208 for a filling.

As a result this dramatically changes what is the cheapest when you add it all up. Please remember that when some of us talk about supplements vs MA's. Your area has completely different comparison financials than mine (and I'd suspect at least some of the rest of us).

after cataract surgery-there is no need for a vision plan as you kissed those glasses goodbye

 

[annon123]

after cataract surgery-there is no need for a vision plan as you kissed those glasses goodbye

Yes my mom was thrilled about that. After surgery she was also surprised that a shirt she had bought had some yellow in it. She thought it was just blue and white. LOL

 

[rousemark]

after cataract surgery-there is no need for a vision plan as you kissed those glasses goodbye

Not true. My wife and I both have glasses even though we had cataract surgery.

 

[Winters Ins Agcy]

There is no MOOP even remotely close to that around here. Here is what the situation is here: (Ignoring dual eligible, which are MAP and MAAP, and which are HMO, HMO-POS, PPO, and regional only):

View attachment 19017

Ignoring the network issues, this kind of major difference really affects the costs for people.

Here is G for a t65 female not tobacco user

View attachment 19018

Of course adding in vision, dental and hearing would raise that a bit but many of the people I talk with aren't interested in those except periodically, especially since you can get, for $50 added on the vision exam (so you pay) for glasses added to the annual B wellness check for vision. Glasses/contacts out of pocket are often less than vision. Plenty of places here you can get glasses frames and progressive lenses which are the most expensive (or contacts) for $200-300 total. Dental is another issue but the dental school is $78/cleaning and $208 for a filling.

As a result this dramatically changes what is the cheapest when you add it all up. Please remember that when some of us talk about supplements vs MA's. Your area has completely different comparison financials than mine (and I'd suspect at least some of the rest of us).

Those annual premiums cannot be accurate for a standard G.

 

[Millwood]

Those have to be a high deductible plan G.

 

[annon123]

Those annual premiums cannot be accurate for a standard G.

I literally took them off of medicare.gov since that was fastest. They were for t65 female non smoker in this area.

 

[renee15]

Not true. My wife and I both have glasses even though we had cataract surgery.

not sure why...Cataract lens replacement- essentially a contact lens that permanently restores vision. Mono vision can provide near in one eye, and distance vision in the other eye. 3 relatives all followed me and are eyeglasses free. OR you can pay additional money and get a lens that can switch from near to far vision.

 

[rmhaire]

not sure why...Cataract lens replacement- essentially a contact lens that permanently restores vision. Mono vision can provide near in one eye, and distance vision in the other eye. 3 relatives all followed me and are eyeglasses free. OR you can pay additional money and get a lens that can switch from near to far vision.

Has a lot to do with what Medicare will pay for. The basic lens is usually fully covered and the more advanced lens has a larger co-pay.

Most Seniors don't see the need for x-ray vision and even the basic lens will keep you from looking like Mr. Magoo.