- 31,476
LBL comes close.
Why Pay More?
- Thread starter somarco
- Start date
- Thread starter
- #22
How many carriers already offer HIP coverage? Less than 100, more than 100, more than 1,000?
My personal opinion is the ancillary coverage market is saturated and overly confusing to the consumer.
The cost of filing and administering a "companion" product is probably a waste of resources, especially given the number of MA plan designs in any particular market.
I count 53 MAPD plans in zip 30549 issued by 8 different carriers. Designing and filing that many plans seems a bit drastic.
The major pocket book threat from MA plans is not the hospital stay but 20% coinsurance up to ???? Plans in the quoted zip have a MOOP of $5900 to $9350 and most folks are more likely to run up big bills under Part B, not Part A.
If someone can't afford $500/day for 5 days in the hospital they have bigger problems that HIP can't solve.
- 6,840
My dad was on a Med Advantage plan for years. He's been in decline for many of those years and the Med Advantage plan was not all that advantageous at times. Recently I moved him into an assisted living/personal care facility near me which put him in a new county and outside of the service area of his Med Advantage plan.
@Northeast Agent did a wonderful job helping us to choose his return to original Medicare and for us to take advantage of the GI Plan F supp. We could have paid for that supplement all along, but some agent got to my parents before I was a licensed agent and some fly-by-night agent flipped them to MA.
I don't pretend to understand the workings of the original Medicare versus MA world at all. As a consumer, especially as the child of seniors, I do think it is wrong that US citizens cannot move back to OM by free choice. My perception as a consumer is that choosing to enroll in an MA plan is like choosing jail.
I am licensed for health but I do not sell it at all. My knowledge of these plans is just a little bit better than most consumers, and I'm sure there are many consumers who know much more than I. I'm just expressing my opinion which is based largely on the frustration I've felt over the years that my dad was getting ripped off because of his "free" MA plan.
I am very grateful to @Northeast Agent for her expert informed guidance and the help she gave to me and my father.
- 7,450
Caveat, I am not an agent.
(I am a Medicare beneficiary holding a Medigap HDF plan.)
You guys (insurance agents) have a term called adverse selection.
In my personal opinion, current agent practices of sucking healthy people out of the Medigap market into the MA market and then freely abusing SEP's to put them back into Medigap plans when they become ill are significant factors in the Medigap premium increases we face.
I understand the sentiment behind your post. There are threads about problems faced by people who can't switch back to OM which are posted on a regular basis. Having said that, I would be strongly opposed to what you suggest because of the additional negative effect it is likely to have on premiums for those of us who have chosen to remain on Medigap coverage all along.
- 6,840
You talking to me?
- Thread starter
- #26
Well, they can change to OM if they want to, no problem . . . the challenge is qualifying medically for a Medigap plan (absent a GI SEP).
- 17,262
I feel like I have always explained the two programs fairly neutrally. 80% of the people I explain them to go with original Medicare with a supplement. My prospect base is mostly middle class up to affluent. Very few poor people want to come into an office and meet with me and I don't go to anyone's homes.
But the thing that I see is the biggest threat to original Medicare with a supplement is in states where there's a birthday rule that does not pay more than a token commission with no renewals. So when you meet with someone who's turning 65 we used to be able to plan on them staying with you for at least six years. And if they were healthy enough to change at that point for six more years.
With the birthday rule, you'll keep them a couple years until the rates increase enough that they will G.I. to a new plan using the birthday rule either through your help or a different agents help, but no one will make a living wage off of helping them.
And states were the birthday rule does pay normal commissions. The companies will term you if you help too many of them change using the birthday rule. At least that's my understanding.
But the thing that I see is the biggest threat to original Medicare with a supplement is in states where there's a birthday rule that does not pay more than a token commission with no renewals. So when you meet with someone who's turning 65 we used to be able to plan on them staying with you for at least six years. And if they were healthy enough to change at that point for six more years.
With the birthday rule, you'll keep them a couple years until the rates increase enough that they will G.I. to a new plan using the birthday rule either through your help or a different agents help, but no one will make a living wage off of helping them.
And states were the birthday rule does pay normal commissions. The companies will term you if you help too many of them change using the birthday rule. At least that's my understanding.
Just had this conversation with a friend today. he had some new neighbors move in and they moved from less than two miles away. And in my opinion, they overpaid for their house. However, they wanted to be in the McIntosh school district instead of the Sandy Creek school district. So they were willing to spend more to have their kids in a different school district.
- Thread starter
- #29
That will definitely kill the Medigap market.
Unlike MA plans which are give away plans, Medigap is sold, not bought. If that mess ever comes to Georgia I will probably hang up my spurs and ride off into the sunset.
Currently there are only 9 states with a birthday or anniversary rule and 4 more that are year round GI.
most states don't have GI options-your Dad was "lucky" and there are no commissions really for the agent on GI plans
