20th Maine
Super Genius
- 228
Im a teetotaler havent been hammered in a long time so looking forward to it
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Do you have any victories you'd like to share for the month of May? Help us celebrate others by posting here.
Mental Health Care + Medicare Advantage
- Thread starter somarco
- Start date
Im a teetotaler havent been hammered in a long time so looking forward to it
5,4,3,2,1........
Well that took a while.
20th Maine
Super Genius
- 228
Supplement rule: Any provider that accepts Medicare must accept Supplement
Advantage PPO: Any provider that accepts Medicare must accept MAPD PPO
In 20 years never had clients treatments/procedures denied
Did a 15 year pro forma for T65 referral and loaded it with numerous hospital stays, ER, Ambulance, Rehab---Over $40,000 for Supp and $10,000 for MAPD.
Of course you can switch from your F to an N to save money--Oh no wait cant do that.
Am I wrong? Please share. Educate me....please
Uhhh, Mayo Clinic AZ takes OM, and will not see any mapd ppo patient. You should report them if they are breaking the law.
And next time I get a mapd patient calling me because of denials, I will be sure to conference you in. Did 5-10 apps just this last AEP, thank God an AZ supp carrier was offering guar issue for that short time period. Went from paying $0 to $215 a month to escape mangled care, and they were not wealthy.
And most of my carriers allow you to downgrade to N with no UW
I’ve been through this so many times I’m just done with it. Have had hundreds on MA for many years and never had problems with prior auth or denials. I don’t think I could find a Dr not in Aetna’s network within 150 miles if I tried. Unless it’s totally different in other areas of the U.S it’s just Med Sup agents thinking of anything they can to scare clients out of MA plans. Obviously it’s not working as MA is growing in enrollment year after year. I think by OM not requiring some common sense on what they pay for it’s actually hurting Med Sup companies terribly. Do you think they like paying for the nursing home resident to do every kind of rehab and not even wake up most of the time? Hence the crazy rate increases year after year while MA plans plug along at 0.00 premium and add more benefits every AEP.
Keep pushing your Med Sups, don’t make me any difference. I have shown every client I’ve ever met a Med Sup option. People just choose the Cost Plan or MA for obvious reasons.
20th Maine
Super Genius
- 228
A carrier must follow the states regs on open enrollment. Never heard of a "special deal" on open enrollment
The higher the income and higher education my clients are the more they go for MAPD.
Most of the T65s ten years ago that insisted on Supps are now insisting on MAPD.
If I get a call and caller wants Sup thats what they get. If I explain supp and MAPD I've yet to have ONE go for Supp. "Why in the WORLD would someone want one of THOSE?"
Just sayin
They will be much better off paying 2500.00 for a Med Sup and then a crappy drug plan with a 505 deductible and lose all their dental, vision, OTC, gym, etc which easily takes them to paying well over the 3500.00 max OOP on an MA plan.
But at least their Dr doesn’t have to get prior auth for an MRI. Ha.
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