MAPD/pre-auth denied cancer treatment

[straightnochaser]

By inference, you think a "lot" of MAPD folks are lefties?

I didn't say that. Feel free to answer my question though as I am genuinely curious.

 

[InsurancePimp_]

Once again I don't understand why a rich person has to take a Med Sup and a crappy PDP. They should take more expensive coverage with no other benefits just because they have money? It's like saying they should take a $0 deductible plan on their home and auto insurance because surely they can afford the higher premiums. Makes absolutely no sense.

That’s some mid level thinking
[

 

[Midlevel]

That’s some mid level thinking
[

Or common sense.

 

[InsurancePimp_]

Or common sense.

Im just being mean but I had to for the jokes. I respect your opinion

 

[InsuranceGuy29]

It’s all good until something major happens. Until then you’re a fucking genius, then when they need care it’s a mission

I've had many clients on MAPD that have had something major happen to them, and a few do right now. Literally zero complaints and zero denials of care. Just another guy screaming at the sky "mApD iZ BaD!!!!! I saiD sO!!!!!!!"

 

[InsuranceGuy29]

I am currently undergoing treatment for cancer. I am receiving both radiation and chemo. It sucks btw. Too young for Medicare, but I do have MM. I have been able to choose my doctor's. This isn't important for most people UNTIL IT IS. I get that some can't afford a supp premium. If they can't then hey MA is almost always superior to original Medicare. A person making 500k not getting a supplement is foolish.

You can choose your doctors with a PPO. This doesn't make a ton of sense.

 

[NewbieNewbie]

You can choose your doctors with a PPO. This doesn't make a ton of sense.

That is not what a PPO means necessarily. At what cost? PPO does not mean you get to pick your own doctors and I really hope you are not telling people that.

 

[NewbieNewbie]

You can choose your doctors with a PPO. This doesn't make a ton of sense.

You don't need a referral with a PPO vs hmo. More flexibility yes but it does NOT mean you are without dealing with networks.

 

[BibH]

You don't need a referral with a PPO vs hmo. More flexibility yes but it does NOT mean you are without dealing with networks.

Sorry to hear about your cancer . In the Atlanta area I’ve not seen 1 dr or hospital not in the big mapd CO’s networks . I’ve moved so many from med sup to mapd . Never a complaint once . No doubt their will be some issues at times . All self employed people me included are in closed aca hmo plans . I have Ambetter and have been very happy . But I agree a wealthy person should be on a med sup . He has no reason to worry about the premium .

 

[Midlevel]

Sorry to hear about your cancer . In the Atlanta area I’ve not seen 1 dr or hospital not in the big mapd CO’s networks . I’ve moved so many from med sup to mapd . Never a complaint once . No doubt their will be some issues at times . All self employed people me included are in closed aca hmo plans . I have Ambetter and have been very happy . But I agree a wealthy person should be on a med sup . He has no reason to worry about the premium .

And the wealthy person could care a less about the 3900.00 Max OOP either. They are smart enough to keep the premium in their savings account and get free dental, vision, gym, great PDP etc. Part of the reason these people are wealthy is because they have common sense with their money. I will NEVER understand the reasoning of agents saying rich people need a Med Sup.