Mutual of Omaha Rate Adjustments

Mutual of Omaha Rate Adjustments

Mutual of Omaha is a great Company and is one of the three most popular choices for seniors when purchasing their Medicare Supplement Insurance. Mutual of Omaha has an A+ A.M. Best rating and has been offering Medicare Supplement Insurance since Medicare originated. However, when I search online for consumer reviews, Mutual of Omaha has somewhat of a recent bad reputation. I wanted to share my thoughts on Mutual of Omaha and try to explain why they have had a couple of bad years in reference to recent large rate increases.

In Washington, Congress is looking at the financial stability of Medicare. Both sides of the isle seem to agree that “over utilization” of Medicare by Medicare Beneficiaries is a problem. “Over utilization” refers to how often people go to the Doctor, Hospital, or other Healthcare Providers. The reason that this is a concern is because Medicare has to pay 80% for these Services, and Medicare really does not have much control how often a Medicare Beneficiary uses Medicare. Medicare has the right to decline a Service, but in general when a Service is medically necessary, Medicare approves it. Let’s look at a Medicare Beneficiary that has diabetes for example; said Beneficiary probably goes to the Doctor and receives lab work more frequently than a Beneficiary that does not have diabetes, well Medicare has to pay the 80% co-insurance every time.

Medicare Supplement Insurance: As we know, Medicare pays 80% co-insurance for Medical and Doctor Services. Therefore, most seniors purchase a Medicare Supplement Plan, also call Medigap. A short definition of a Medicare Supplement (Medigap): A Medicare Supplement Plan pays the deductibles and co-insurance (the 20%) that Medicare would normally charge the Medicare Beneficiary. The most popular (Though not usually the best value), is the Medicare Supplement Plan F. Medicare Supplement Plan F is the most comprehensive Medicare Supplement Plan that is offered, as it pays all of the copays and co-insurance that Medicare does not pay for Medicare Approved Services.

New Plan, Medicare Supplement Plan N: In June 2011, the Government / Medicare created a new Medicare Supplement Plan with the hope of reducing said “over utilization” of Medicare, this new Medicare Supplement Plan is called Plan N. Medicare Supplement Plan N is less comprehensive than the Plan F, the Plan N does not pay all of the deductibles and co-insurance that Medicare leaves behind. The Medicare Supplement Plan N has four out-of-pocket expenses that the Medicare Beneficiary is responsible to pay.

1)      The Medicare Part B Deductible, for 2014 this is an annual deductible of only $147.00.

2)      Up to a $20 copay for a Doctor Visit.

3)      $50 copay for ER Visit.

4)      Part B Excess Charges.

This blog post is not to recommend Plan N over Plan F, if you want to read about what I recommend please visit my website, www.SrHealthcareDirect.com.

The Copay within Plan N is the Point of Plan N: The idea is that if a Medicare Beneficiary with a Medicare Supplement Plan is required to pay a $20 copay to go to the Doctor, the hope is that it will reduce the “over utilization” of Medicare. See, when a person has Medicare and a Medicare Supplement Plan F, it does not cost the Medicare Beneficiary anything to go to the Doctor, or Hospital. The hope with Plan N, is that if a Medicare Beneficiary is sick, and it costs the copay to go to the Doctor, than maybe the person may not rush out to the Doctor, maybe they will wait a day or two to see if they can beat the sickness without going to the Doctor. (I could argue with Congress against idea of “over utilization” being a bad thing because in theory, it is cheaper to prevent then it is to treat, so wouldn’t someone that goes to the Doctor more frequently actually save Medicare money in the long run??? I digress)

What does this have to do with Mutual of Omaha? In June of 2011 when Medicare introduced the Medicare Supplement Plan N, Mutual of Omaha took a risk that turned out to me a mistake. Mutual of Omaha had the idea of not requiring any Medicare Beneficiary to medically qualify for the Medicare Supplement Plan N. I can only speculate that they were hoping that only healthy people would want the out of pocket exposure of the Plan N, but I cannot know for sure what their thought process was. Whatever they were thinking, it back fired. (And so was the guy that had this idea) Every sick Medicare Beneficiary that either only had Medicare or had a Plan F with high premium price had the option of joining the more affordable Plan N with Mutual of Omaha, and a lot of them did. Due to all of the claims that were associated with the Plan N, Mutual of Omaha discontinued offering the Plan N after about 8 months and 2 years of large monthly premium adjustments / increases followed.

Mutual of Omaha appears to have corrected this: Mutual of Omaha had larger rate increases than normal in 2012 and 2013 which appears to have stabilized their book of business. For 2014 they are back to being competitive, and the future looks bright and stable as Mutual of Omaha is having industry average rate increases for the Plan F and actual rate decreases in some states for the Plan G. (This is the first reference of the Plan G in this blog post, but if you read my blogs or watch my videos then you know that Plan G is my favorite Supplement Plan and offers the best value most of the time).

Summary: Mutual of Omaha made a mistake in 2011, and their Policyholders had to pay for it. However, moving forward Mutual of Omaha appears to have a good and stable outlook.

Please feel free to call my office, 1-855-368-4717 or me directly with any questions pertaining to Medicare, 1-800-525-0299.

Robert W. Bache aka “MedicareBob™”

President / Producer

Senior Healthcare Direct

Direct Toll Free: 1-800-525-0299

Company Toll Free: 1-855-368-4717

www.SrHealthcareDirect.com

Learn more about Robert aka “MedicareBob™”

www.MedicareBob™.com

https://www.seniorhealthcaredirect.com/medicarebob/

Please “Like” Senior Healthcare Direct on Facebook:

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Physicians United Plan

The State of Florida is seeking to dissolve Physicians United Plan (PUP).

Florida is looking to dissolve the local Medicare Advantage health insurance company.

Health News Florida is reporting, The Florida Department of Financial Services filed a petition in Leon County Circuit Court to place the Orland-based plan into receivership because it is insolvent. The company’s May financial statement reported assets of $92.4 million while liabilities amounted to $105.3 million.

Florida’s commissioner of insurance regulation, “PUP’s insolvency poses a serious danger to the financial safety of the policyholders, subscribers, claimants, creditors and citizens of the state of Florida.”

Physician’s United is a Private health insurance company offering Medicare Advantage Plans to Medicare Beneficiaries in the following Florida Counties: Brevard, Broward, Hillsborough, Lake, Marion, Miami-Dade, Martin, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Seminole, Sumter, St. Lucie and Volusia.

This news is in line with a Blog / Video that I posted last year, “Is Obamacare going to destroy Medicare Advantage Plans?”. Click here to watch video:

The Affordable Healthcare Act is cutting funding to Medicare Advantage Plans, as mentioned in last years blog I wrote, “I believe that the smaller insurance companies will either be purchased by a larger insurance company, or go out of business”, Robert Bache.

PUP is an example of  a Company going out of business because it ran out of money. It is reported that in April, PUP’s leaders acknowledged that the company needed $30 million in capital by June 3rd to avoid liquidation. Obviously, they were not successful in getting the capital and now that State of Florida has asked for automatic liquidation on July 1.

What does this mean to PUP Policyholders?

We are not sure, however the most likely scenario that will occur is:

Policyholders will receive a letter from CMS (Centers of Medicare Services) stating that they are losing their Plan and will have 63 days to find a new Plan. To see what Plans are available please call Senior Healthcare Direct toll free, 1-855-368-4717.

Robert W. Bache aka “MedicareBob™”

President / Producer

Senior Healthcare Direct

Direct Toll Free: 1-800-525-0299

Company Toll Free: 1-855-368-4717

www.SrHealthcareDirect.com

Learn more about Robert aka “MedicareBob™”

 www.MedicareBob™.com

https://www.seniorhealthcaredirect.com/medicarebob/

Please “Like” Senior Healthcare Direct on Facebook:

https://www.facebook.com/MedicareBob™?ref=hl