What May Happen with Medicare Advantage 2017 & Beyond?

[TDS551]

Back to the original question.

MAPD is growing every yr, UNH earnings and growth rely heavily on it, just read their last earnings report.

My experience is that even though out of pocket costs are rising, as these plan proliferate, new to medicare types in urban areas are having a harder time listening, or understanding that mapd are a derivative of medicare and not the standard.

probably all the marketing, bad info from friends and even providers.

 

[Ronnie Carter]

Back to the original question.

MAPD is growing every yr, UNH earnings and growth rely heavily on it, just read their last earnings report.

My experience is that even though out of pocket costs are rising, as these plan proliferate, new to medicare types in urban areas are having a harder time listening, or understanding that mapd are a derivative of medicare and not the standard.

probably all the marketing, bad info from friends and even providers.

Very likely dumb question, but what does UNH stand for? Thanks.

 

[sman]

Very likely dumb question, but what does UNH stand for? Thanks.

United Healthcare I would assume.

 

[Key2Success]

Very likely dumb question, but what does UNH stand for? Thanks.

University of New Hampshire

 

[Ronnie Carter]

United Healthcare I would assume.

Ahhhh, thanks. Makes sense, although UHC (or even UH) would've been a little less ambiguous.

Too many abbreviations on these threads!

 

[FLM2]

Regardless of what anyone on these forums thinks, MAPD plans are not going away because enrollments are growing, not declining.

According to Kaiser, 70% of all Medicare beneficiaries have either MAPD, Medicaid, or retiree benefits and only 20% have Medigap plans: Officials Looking To Cut Federal Spending Eye Medigap Policies | Kaiser Health News

This data is several years old-if anything the 70% has increased since then.

You can't make the assumption that everyone on Medicare cares enough about their health or which doctors or hospitals they use to purchase a Medigap plan with 100% coverage nor can you make the assumption that everyone should be able to afford it as well. Florida Medigap rates are really high, it's tough to tell someone entering Medicare with $30K in annual income that 15% of their income will now go towards healthcare premiums if they get a Plan F and a Part D plan along with their Part B premium.

MAPD has its place and everyone's situation is different. I entered Medicare in 2012 and, by having an MAPD plan, have already saved well over $10,000 in premiums; I have married friends whose savings are twice that in the same time. I also have many Medigap clients who either have ongoing medical needs or have enough income where the premiums don't matter.

It's just personal preference, just as it's personal preference for agents to decide whether they want to offer both sides or just one.

 

[midwestbroker]

Ever since the MMA (Medicare Modernization Act of 2003) came out, every couple years MA plans are in the cross hairs, especially when there are elections involved.

If you look at the history of the plans:

1972 there was an amendment to the Social Security Act which allowed Medicare to sign at-risk contracts to HMO's

The Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 created the ACR (adjusted community rate), which basically paid the HMO 95% of the ACR (capitation rate)

The Balance Budget Act of 97 changed things up (created Medicare + Choice) looking to save some money by shifting more of the cost to beneficiaries, plus they wanted managed care plans to expand to more rural markets

Then the MMA struck making Medicare C and D and expanded the managed care plan footprint across the country

The point of all this? Medicare managed care plans have been on the market for 44 years. They are not going anywhere. Remember the insurance carriers have one heck of a lobbying team in Washington. Even if they do scale back (as someone said, watch the $), as long as the carrier is making a profit, there will be MA plans.

 

[Brian F 11]

Short answer: It will be around for at least the next 2-5 years, if not forever.

Long answer, read on....


MAPD is out there for those who can't afford, can't qualify for, or can't justify the cost of Med Supp. Imagine, we sell something that people need, they want, and can easily afford, especially when it's free in most cases. It is increasingly popular, however, ACA has caused some providers to walk away from it, networks seem to be shrinking.

Politicians have not been able to ruin it because seniors actually get out and vote. Any politician who has tried or tries to sell it out violates the 1st or 2nd rule of politics.

The only real threat to MAPD is if the wrong politician gets in the white house and wants to leave a legacy or make a bigger name for themselves. Uncle Bernie wants to go to single payer. If he succeeds, we are probably looking at the end of 2018, beginning of 2019 before it's completely wiped out along with the rest of our health care system. At that point, the carriers will move to government contracts to process claims and provide ASO.

Some super smart guy with deep pockets and powerful friends will start some kind of sub-health insurance market with the top providers on the books, serve some needs locally or build an international network of providers that are tops in their respective field, catering to those who can afford super high premiums. Basically start an insurance carrier outside of the single payer system, as we have seen with ACA and temporary insurance.

Hilary has mentioned something about replacing ACA with a Medicare buy-in program. If that happens I want my Ferrari to be white like Don Johnson's too. Joking.

What will Trump do if he gets in? He wants to kill ACA, and replace it with what? While he's at it, reform Medicare too, why not, could be HUGE.

The other possibility (and this one is much more likely to happen) is that insurance carriers and their lobbyists will bribe CMS to look the other way while they cut or completely eliminate commissions. Since they already have gotten away with murder before, cutting out 2/3 of MAPD and ACA completely, they will do it again, or at least try. Anyone notice there are already some plans on carriers commission schedules that are 'not commissionable'? Notice there were only 1 or 2 of those plans out there from each carrier a couple of years ago and now there are a handful? Wonder how many there will be in the 2017 plan year?

I would bank on the current MAPD lasting for a few more years then changing in some way. We all know agent comp is not protected from greedy pockets, so don't make it the foundation of your business. In reality nothing ever stays the same.

Always wise to diversify.

Sent from my iPhone using InsForums

 

[enyce]

I guess the politics this year would unfortunately play a major part on the future of the business.

Very informative responses, Great to see you busy folks sharing your opinions on the matter.