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I was estimating a 4500 MOOP per year and 2400 per year for Plan G. You just make my argument better
Medicare Advantage Plans Accused of Denying Care and Overcharging
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I was estimating a 4500 MOOP per year and 2400 per year for Plan G. You just make my argument better
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It would be even better using my wife's rare. She is only paying $1320 for her sup. I was able to change hers last year but due to health I am stuck in a closed block of business with SILAC.
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If you have a MA plan and have charges that weren't preauthorized, do these charges count toward the MOOP?
Now you are back to the position where PROVIDERS can kick folks off their MA plan. I asked for proof, and you have not provided it.
Several others in this thread agreed that a PROVIDER cannot disenroll someone from an MA plan.
What part of this are you having difficulty understanding?
In the same post, you suggest a facility in NJ paid a fine for
How did they accomplish this? How were they able to disenroll the individual.
I have asked for citations before and all you give is rhetoric and anecdotes.
It's easy to see why so many folks have you on ignore. You have NOTHING to contribute that is credible.
At least you didn't brag about how many apps you write every day
Yes I have proof . 2 of my mapd clients went in nursing facilities the past 3 months and both were disenrolled . My good agent friend has had 4 in the past yr . It’s well known by agents this happens a lot .I won’t answer your negative bs . I understand old people are grouchy.
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Just had my semi-annual coffee with a client. Usually it's "wassup?"
"Not much" Today he says he and wife (also MA client) been commuting to Jacksonville. What's in Jacksonville? MD Anderson. Wife has been treated for cancer after walking out of two local facilities. They couldn't be happier with UHC or MD Anderson. Total copays after MRIs, biopsy, surgery, chemo, radiation, etc was $320. Biggest expense was travel and lodging.
"Not much" Today he says he and wife (also MA client) been commuting to Jacksonville. What's in Jacksonville? MD Anderson. Wife has been treated for cancer after walking out of two local facilities. They couldn't be happier with UHC or MD Anderson. Total copays after MRIs, biopsy, surgery, chemo, radiation, etc was $320. Biggest expense was travel and lodging.
Just curious how out of pocket was only $320 . I’m assuming a night or 2 in hospital ? Chemo and radiation alone is 20% . How so cheap ?
i didn't ask for details. No overnights. I only heard after the fact. He did tell me that MD Anderson has a financial person who says she can get anything paid. When client showed the $320 bill, she said that's your copay. If client is happy, I'm happy. Spare me the details.
I have a client on Humana PPO
was sent to Mayo in Jacksonville- her transplant out of pockets were $ 601. 00
And she goes up each yr for a check-up.
I know everyone here hates MAPD's but I'm sorry not everyone enrolls incorrectly.
And many people fall thru the cracks.
They don't qualify for medicaid but cant afford the HIGH FIXED monthly cost of a supp in SoFl. So if we have a problem we look for various types of assistance.
was sent to Mayo in Jacksonville- her transplant out of pockets were $ 601. 00
And she goes up each yr for a check-up.
I know everyone here hates MAPD's but I'm sorry not everyone enrolls incorrectly.
And many people fall thru the cracks.
They don't qualify for medicaid but cant afford the HIGH FIXED monthly cost of a supp in SoFl. So if we have a problem we look for various types of assistance.
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No offense, none of this is proof. It's anecdotal information. Can you present the Medical policy that allows a provider to disenroll a client? I've tried to look for it and have been unsuccessful..
Like I said earlier, I'm happy to be wrong about this. I just can't find anything that supports your stance. NOW, could an SNF refuse to accept MAPD and the client self disenrolls? Sure.
Your description is vague and that's likely not telling a whole story. Not intentionally misleading, maybe you don't know the whole story.
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