What % of mapd people actually pay the moop if hit ?

[rmhaire]

The #1 reason 7 hospitals in rural GA closed because the so called leaders in your State failed to expand Medicaid, something is better than nothing

Better 7 hospitals than the whole damn state. If it don't work, don't fix it. Just throw more money at it.

BTW, how does the water taste up there?

 

[somarco]

The #1 reason 7 hospitals in rural GA closed because the so called leaders in your State failed to expand Medicaid, something is better than nothing

Hospitals (and other providers) lose money on Medicaid . . . almost 60% of Georgia deliveries are women on Medicaid, yet several hospitals are still open but closed the OB dept.

Doctors are not required to accept Medicaid patients unless they have admitting privileges to hospitals with govt funding. Any hospital that receives ANY gov't funding cannot opt-out of Medicaid.


The Medicare Payment Advisory Commission found that hospitals experienced a -8.5% margin on Medicare services in 2020, and it projects that margin will fall to -9% in 2022. Combined underpayments from Medicare and Medicaid to hospitals were $100 billion in 2020, up from $76 billion in 2019. Exacerbating this pressure is the fact that Medicare and Medicaid account for most hospital utilization. In fact, 94% of hospitals have 50% of their inpatient days paid by Medicare and Medicaid and more than three quarters of hospitals have 67% Medicare and Medicaid inpatient days. Because of the fixed nature of these payments, hospitals are unable to fully absorb the tremendous inflationary forces they are currently facing.
https://www.aha.org/fact-sheets/202...pital-payments-dependent-medicare-or-medicaid

Care to try again?

 

[hockeyday]

Water is great and we got more than enough of it

Better 7 hospitals than the whole damn state. If it don't work, don't fix it. Just throw more money at it.

BTW, how does the water taste up there?

 

[hockeyday]

Ya something is better than nothing, I know your right on every 20 paragraph reply you do , I sure you will babble on with more nonsense

Hospitals (and other providers) lose money on Medicaid . . . almost 60% of deliveries are women on Medicaid, yet several hospitals are still open but closed the OB dept.

Doctors are not required to accept Medicaid patients unless they have admitting privileges to hospitals with govt funding. Any hospital that receives ANY gov't funding cannot opt-out of Medicaid.


The Medicare Payment Advisory Commission found that hospitals experienced a -8.5% margin on Medicare services in 2020, and it projects that margin will fall to -9% in 2022. Combined underpayments from Medicare and Medicaid to hospitals were $100 billion in 2020, up from $76 billion in 2019. Exacerbating this pressure is the fact that Medicare and Medicaid account for most hospital utilization. In fact, 94% of hospitals have 50% of their inpatient days paid by Medicare and Medicaid and more than three quarters of hospitals have 67% Medicare and Medicaid inpatient days. Because of the fixed nature of these payments, hospitals are unable to fully absorb the tremendous inflationary forces they are currently facing.
https://www.aha.org/fact-sheets/202...pital-payments-dependent-medicare-or-medicaid

Care to try again?

 

[somarco]

When hospitals close because patients are not paying their bills . . . or doctors refuse to book appointments for non-paying patients . . . the folks who order from the dollar menu and expect everything to be free will change their tune.

I have clients living in rural areas where local hospitals have closed and now they have to drive an extra 30 miles or more to get to the nearest facility. This is even more crucial when you are in the back of the ambulance and they go past a closed hospital to get you to the next one that is open, the patient will have a different attitude.

Sometimes I get calls from folks that contacted me before turning 65. I explain how Medigap and MAPD works and they decide to buy the MAPD plan "because it is cheaper".

Had that happen a few months ago with a fellow who called me in 2019. He was on disability from work due to early dementia and turning 65 in a few months. He asked about MA vs Medigap and I explained that if he enrolled in the MA plan he may not be able to qualify for Medigap if he wants to switch.

He enrolled in MAPD . . .

When we talked in 2019 he lived in the metro area . . . now he lives in the hinterlands and the doctors he wants to see do not accept his MAPD plan so he has to drive 100 miles to Atlanta.

Choices have consequences.

 

[somarco]

Off topic, but there is a reason why I use the ignore button with some frequency.

While the reader may not agree with my approach to this business, hopefully the information I post is useful to enough people that the free education (mostly based on decades of experience) is helpful to those who take the time to read, and even click the referral links.

Some of those on ignore bring absolutely nothing to the table. Others simply want to cast stones because they presume to know how I interact with prospects and clients.

It's funny (odd, not humorous) how those who constantly beat the MAPD drum and brag how they have never found anyone willing to pay the premium for a Medigap plan, are willing to castigate me for heavily promoting a better way to set up their Medicare coverage.

Sounds like they are critical of the speck in my eye while ignoring the log in their eye.

 

[Family Man]

Obviously I don't know all of my clients' situations, but typically cancer is the most frequent culprit behind clients hitting the MOOP in my personal sales experience. So, to my limited knowledge, maybe 5-10% will hit the MOOP. Good thought to explore and to share with my clients, thank you for bringing this question up.
I have a fair number of clients on MAPD (almost half of client base). Not because I want them there, but because they choose it over a med supp even after cautions and warnings.

 

[sman]

I see it weekly with my clients that are neither on Medicaid or lis but are in the lower income category. Of course if you have assets or money they’ll come after possibly . About 14 yrs ago I was sent to the Mayo Clinic . I had United group health under wife . All Mayo drs then were supposedly employees . They checked my ins and I went to 4-5 drs they sent me to in the facility . Well one dr after the fact didn’t take United . I argued with them fir months . Out if principal I refused to pay . It was $3k bill . It dinged my credit 125 pts for 7 yrs but they got nothing and never sued . Same principal with all my peeps . They ain’t paying and nobody gets anything

You really showed them. You screwed up your credit for 7 years over a $3,000 bill.

 

[Midlevel]

I have a fair number of clients on MAPD (almost half of client base). Not because I want them there, but because they choose it over a med supp even after cautions and warnings.[/QUOTE

You need to up your scare tactics. Just read through any of the anti-MA agents on the forum and are full of misleading scare tactics that will get your book closer to 100% Med Sups. No idea why you would want that but if you truely do start reading. I can start you with a few commonly used examples.

Can no longer go to your Dr. or Specialist
Everything needs PA and most will be denied and you will die in the waiting room
Drug plan sucks (even though it's way better then stand alone the client never checks)
MA plans are going to be a thing of the past soon (even though they grow each year)
Most people hit their $6700 Max Oop often ( less then 3% do and it's not near $6700
Hospital copays could break you ( copay is $350/day for 5 days covered by GTL HI plan
It's mangled care (from 1973)


Other option is to present the facts of both MA and Med Sups and let the client decide which way they would like to go.

 

[25MercuryHP]

Even if I only met half of an $8,300 MOOP, I'd spend less with Med Supp, PDP and DVH.

Yeah but med sup premiums goto 150.00 a month.