Skilled nursing and mapd
- Thread starter keith365
- Start date
Good thing you are not set in YOUR ways . . . . but you do have your head up your a$$ when you imply your way is right and the rest of the world is wrong.
Back on ignore . . .
It’s rare, but I just had to talk a T65 out of not getting a med Supp.
She attended my webinar and scheduled a one-on-one talk the next day. She immediately said, I do not want a med advantage plan. I was relieved that she knew what she wanted, it makes the process way easier.
After I ran a quote for plan G of $250/month, I said, let’s just take a quick look at MAPD in your area. We found a UHC PPo with a $3400 moop, $1k dental, $200 vision, OTC, and paired it with a GTL HI and cancer plan. In my part of the state the Med Supp is $170 and the moop on that UHC ppo is $5500 so this was a rare occurrence.
I’m still prob 50/50 med Supp to MAPD.
She attended my webinar and scheduled a one-on-one talk the next day. She immediately said, I do not want a med advantage plan. I was relieved that she knew what she wanted, it makes the process way easier.
After I ran a quote for plan G of $250/month, I said, let’s just take a quick look at MAPD in your area. We found a UHC PPo with a $3400 moop, $1k dental, $200 vision, OTC, and paired it with a GTL HI and cancer plan. In my part of the state the Med Supp is $170 and the moop on that UHC ppo is $5500 so this was a rare occurrence.
I’m still prob 50/50 med Supp to MAPD.
What was the total cost for the GTL plans?
I think it was $45 with the $5k cancer rider.
selfgen
Super Genius
“Once they get better what about the unlimited exposure with OM only ?”
the facility doesn’t care about that. They just see dollar signs when they see that red white and blue card. They will even waive the co-payment for the patient that now just has Medicare only. They don’t care about collecting from the patient, they just want to be able to bill Medicare for 100 days.
the facility doesn’t care about that. They just see dollar signs when they see that red white and blue card. They will even waive the co-payment for the patient that now just has Medicare only. They don’t care about collecting from the patient, they just want to be able to bill Medicare for 100 days.
You've got that right selfgen. I feel Nursing Homes are the most abused Medicare benefit there is. Run them through therapy like cattle, don't matter if they have alzheimers or if they even wake up while in the room. Easy money because they know Medicare won't blink an eye and just pay it. And then everyone wonders why their Med Sup goes up so much every year.
Skilled nursing facilities (SNFs) do not like the prior authorization requirements, limited lengths of stay for residents, and lower Medicare reimbursement rates that are associated with Medicare Advantage (MA) plans. Some SNFs are responding to these concerns by starting their own special type of MA plan called an Institutional Special Needs Plan (I-SNP). I-SNPs are MA plans that are limited to beneficiaries who require, or are expected to need, institutional long-term care for 90 days or more. While SNF providers can enjoy financial benefits from operating an I-SNP, the outcomes for beneficiaries may be less positive.
I-SNP beneficiaries’ utilization of inpatient hospitals was 38% lower than beneficiaries in traditional Medicare; utilization of emergency departments, 51% lower; and 30-day hospital readmissions, 45% lower. However, use of SNF care was 112% higher.[11]
The analysis did not review the quality of care that I-SNP enrollees received, whether enrollees who should have been hospitalized were not, or even whether the SNF care that enrollees received was actually covered by the I-SNP.
Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries? | Center for Medicare Advocacy
I-SNP beneficiaries’ utilization of inpatient hospitals was 38% lower than beneficiaries in traditional Medicare; utilization of emergency departments, 51% lower; and 30-day hospital readmissions, 45% lower. However, use of SNF care was 112% higher.[11]
The analysis did not review the quality of care that I-SNP enrollees received, whether enrollees who should have been hospitalized were not, or even whether the SNF care that enrollees received was actually covered by the I-SNP.
Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries? | Center for Medicare Advocacy
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