California not paying 'MAPD commission' --- is this a national trend?

The question is what beneficiaries can "afford". A premium bill for a supplement is a fixed expense. Paying a monthly premium for many beneficiaries means foregoing other necessities of life. And most beneficiaries would prefer to have food on the table, rather than be free of potential copays.

Don't need your advice...
And when they start having a number of copays because they actually need health care then they will often have the same choices - food/rent vs medical care. That is where it would be prudent to use a network that doesn't cut off care and sue or refuse to see you if you don't pay the copay up front.

The Cleveland Clinic just went to if you don't pay the copay in full when you show up for your appointment they will refuse to see you. I have heard that some other systems are doing that as well.
 
I present a $400 a day for 8 days, $10k cancer and Hospital rider on all non dual /Lis . Runs around $75 a month and takes care of much of the moop for the bad things
If their problems fall under that then that sounds like a cheaper solution than a supplement (well presuming in network includes the doctors they need and that are good doctors/good systems).
 
Every non profit health system has a financial assistance program. Some of them provide support at up to 400% FPL and almost all of them do up to 200%. Frequently, there is no asset test.

I connect clients to these programs all the time. Greatly reduces their MAPD out of pocket liability.

Except in states where supplements are still super cheap, the only reason a supplement makes sense is when the client insists on seeing any provider and without the possibility of a prior authorization. Medigap isn't about saving money.
 
Every non profit health system has a financial assistance program. Some of them provide support at up to 400% FPL and almost all of them do up to 200%. Frequently, there is no asset test.

I connect clients to these programs all the time. Greatly reduces their MAPD out of pocket liability.

Except in states where supplements are still super cheap, the only reason a supplement makes sense is when the client insists on seeing any provider and without the possibility of a prior authorization. Medigap isn't about saving money.

there is some agents on this forum who are experts on MA even though they have never sold an MA plan in their life who would beg to differ with you i am sure. lol
 
there is some agents on this forum who are experts on MA even though they have never sold an MA plan in their life who would beg to differ with you i am sure. lol
Yes, there are so many one trick biased agents out there. For some reason, the ones who sell a supplement to everyone they meet believe they're a "different" kind of biased.

Lazy agents are the worst. They give good agents a bad reputation.
 
And when they start having a number of copays because they actually need health care then they will often have the same choices - food/rent vs medical care.

Ooooor… they get there copays covered by charity-care… ooooor… they get put on a $50/mth payment plan. Ooooor… because they haven't been paying monthly premiums and higher rx costs they have money in savings to pay the copays.

If you had more than 50 clients you might have more perspective.
 
Ooooor… they get there copays covered by charity-care… ooooor… they get put on a $50/mth payment plan. Ooooor… because they haven't been paying monthly premiums and higher rx costs they have money in savings to pay the copays.

If you had more than 50 clients you might have more perspective.
There is limited charity care around here and now it is only for the uninsured (didn't use to be that way but changed to that when 2 of the 3 hospital systems were bought out a couple of years ago and almost all docs are employees of one of the 3 big systems which limits choices). Yes there are some independent foundation programs but those grants are hard to get as demand tremendously exceeds supply.

Even if someone is on a payment plan that doesn't reduce the amount they owe - their "pot" of money is still the same. If they can't afford premiums then they may well not be able to afford what they owe even on a payment plan. Certainly if their copays end up less than premiums they will come out ahead. Of course that is an unknowable "if" for many people, especially as they age.

It appears to me that being rude and nasty is your best skill. You practice it a lot. It is possible to disagree with people without behaving they way you behave. I feel so fortunate not to know you in real life. Or to have to do business with you for any reason.
 
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There is limited charity care around here and now it is only for the uninsured (didn't use to be that way but changed to that when 2 of the 3 hospital systems were bought out a couple of years ago and almost all docs are employees of one of the 3 big systems which limits choices). Yes there are some independent foundation programs but those grants are hard to get as supply tremendously exceeds demand.

Even if someone is on a payment plan that doesn't reduce the amount they owe - their "pot" of money is still the same. If they can't afford premiums then they may well not be able to afford what they owe even on a payment plan. Certainly if their copays end up less than premiums they will come out ahead. Of course that is an unknowable "if" for many people, especially as they age.

It appears to me that being rude and nasty is your best skill. You practice it a lot. It is possible to disagree with people without behaving they way you behave. I feel so fortunate not to know you in real life. Or to have to do business with you for any reason.

Hang on a sec, weren't you just saying people should rely on charity care to pay rent so they can afford a med supp?
 
Every non profit health system has a financial assistance program. Some of them provide support at up to 400% FPL and almost all of them do up to 200%. Frequently, there is no asset test.

I connect clients to these programs all the time. Greatly reduces their MAPD out of pocket liability.

Except in states where supplements are still super cheap, the only reason a supplement makes sense is when the client insists on seeing any provider and without the possibility of a prior authorization. Medigap isn't about saving money.
They are required to have an assistance program if they accept medicare however, if what goes on around here is any guide, how much help you get depends on where you go. Although it didn't used to be this way, now none of the hospital systems here offer any financial aid to anyone who has insurance, regardless their income % of the poverty line. The state system lowers the costs more than the two non-profit systems do however it is still more than many can afford and all three systems make you pay most of it in advance.

As this state didn't expand medicaid there are a fair number who qualify but mostly what they get offered is still beyond what they can afford. Sometimes I think the goal of this state is to kill the poor by preventing them from being able to afford medical care, have enough food, etc.

I am glad to hear some other states are more generous.
 
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