Exception rules for MA coverage...???

[Limozine]

You not only have to be in the area where there is one available as one mentioned not all over and there are way more diabetes the Heart

2nd they can enroll you based on your answers and then drop you on confirmation

I would hate to be the agent that gets a client dropped because he tried to pass off high cholesterol as Coronary artery disease

Yes you may get SEP, However,The client may not like what they went through and report you

Also, the Ins company may ding you for trying to pass off nonsense especially if there is a pattern

And 3rd many times the CSNP is not better than the reg MAPD plans

Correct me if I'm wrong, but the personal physician is the one who signs the form stating you have or don't have a particular chronic condition. Are you aware of any members who were dropped after their physician vouched for them? Are the carriers going to argue with the pcp? I'm genuinely interested in knowing if this has been a problem in the past.

 

[vic120]

Correct me if I'm wrong, but the personal physician is the one who signs the form stating you have or don't have a particular chronic condition. Are you aware of any members who were dropped after their physician vouched for them? Are the carriers going to argue with the pcp? I'm genuinely interested in knowing if this has been a problem in the past.

And the PCP is going to vouge for heart disease for Cholestorl??

Moreover, you would contribute in putting a false diagnosis of heart disease on clients' records so they cant pass underwriting if they decide to get a supplement instead in the future????

 

[Limozine]

And the PCP is going to vouge for heart disease for Cholestorl??

Moreover, you would contribute in putting a false diagnosis of heart disease on clients' records so they cant pass underwriting if they decide to get a supplement instead in the future????

The Humana CSNP, for example, specifies only that the applicant be diagnosed with a "cardiovascular disorder." I'm not a doctor. I don't make that determination. The applicant tells me they are on heart or cholestrol medication. Whether their condition qualifies as a "cardiovascular disorder" or not is between them, their physician, Humana, and CMS. And it's already part of their medical record. But back to my question: has this been a problem for some people?

 

[DonP]

I’ve written many csnp’s with Humana and United . Humana has a $50 food card this yr on theirs . United much more lenient on approval . United contacts the dr . Humana’s is pia as the client must take to the dr and get filled out. I have one hanging right now as client hasn’t gotten form filled out . I moved her from Humana to Humana . If she doesn't get filled out she’ll be disenrolled from the plan . I have no idea if she goes back to old plan as it will already have been terminated dec 31. But cardiovascular is most things outside high blood pressure or cholesterol.