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Opinions are all over the board on this, but if someone has an expensive chronic condition, or impending surgery, as a general rule the MAPD approach will be more costly than original Medicare and a supplement.
There's no general rule. It all depends on where your client is located and what plans are available there.
In our neck of the woods, for example, the top 3 leading plans all have maximum out of pocket of only $2500. You can't purchase a decent Plan F with a decent PDP for under $2500.
So worst case, it's at least a wash, although many clients, especially older ones will fare BETTER with one of those MAPD plans.
Best case - you pay $0 premium all year long and never need medical care, in which case you have neatly saved a couple grand in high priced Med Supp insurance coverage (that you didn't need).
With a MedSupp + PDP, you pay up front while with an MAPD you pay as you go.
Granted, many MAPD plans across the country have substantially higher max out of pocket, often hitting $6,500.
But we don't care, 'cuz we live here, not there.
suckers