A dying agents warning ‼️

[goillini52]

How many teeth do you have?

None.

 

[InsuranceGuy29]

Maybe they could do their job with an extra $460,000,000,000 in funding??

We have steadily defunded OM for 35 years now, and somehow people are surprised they struggle to do the job correctly.

They'd just steal most it anyway, like they do with everything else. You can't trust this government to handle money. Corporations actually have something to lose and they're held accountable.

Does that mean no fraud is going on? Nope...but overall, corporations are far superior to handling peoples money, as they have something huge to lose. Government takes our money and goes "Oh yea, and what are you gonna do about it??? NOTHING...that's what!"

Not sure what type of utopia you're existing in, but you can't trust this government to run a lemonade stand. I'm also not super pro mega-corporation control, either.

There needs to be both....government and private corporation involved. The business people are the ones that know how to run things well. Career politicians and/or defense lawyers (which are many politicians) do not.

It keeps things balanced, and corporations provide some healthy competition, which some in the (liberal-minded) government don't like. Because they want to control absolutely everything we do.

 

[somarco]

@goillini52 are you from KY (the state, not the lubricant) or WV? I believe those states have the fewest teeth per capita.

 

[rmhaire]

@goillini52 are you from KY (the state, not the lubricant) or WV? I believe those states have the fewest teeth per capita.

Neither. He's from the lubricant.

 

[WinoBlues]

None.

Ha, paying for several implants now.
If I was a little older I'd just choose to go commando. I like soup.

 

[kgmom219]

You had me until " You are assigning your rights from Original Medicare over to a private company" that sounds scary no wonder they all buy med supps

Maybe.

But its accurate. There's a reason they were called Medicare Replacement at the beginning.

 

[kgmom219]

This is not true. Good lord.

You’re still in the Medicare program. You still have all the rights and protections that come along with having Medicare, but you will access your benefits through a private company with a Medicare contract. The plan has a network and there are rules. It is managed care. Your doctor may need to get permission before fixing you certain care.

Its 100% accurate.

Its why the MAPD can kick you out after X days in SNF. Its why you need Prior Auth for everything. And you cannot appeal to Medicare. The Medicare Managed Care Manual does NOT equate to Original Medicare.

 

[kgmom219]

Meant for Ron. Do you have clients whose MA plan denied them a heart transplant? Have you ever met someone with MA who couldn’t get a heart transplant? Have you ever read a credible story about a person with MA who wasn’t allowed to get a heart transplant?

I hear you about MA plans coming with the potential for red tape. You’re signing up for managed care. But your example, and ones like it, grossly exaggerate the pitfalls of MA.

Ive got a lady with bum knee, doc is convinced its a torn meniscus. MRI denied twice. Doc said screw it and went for a surgery PA. Denied due to no MRI. Its 6 months of pain.

A couple of years ago, I had a clients mom literally break her ass and get surgery while at the granddaughters graduation in Dallas. She was on some local MAPD in New Mexico. Hospital won't release her except to a SNF. Dallas SNF won't take her because the MAPD wouldn't guarantee payment to an out of network SNF. I'm on the phone with the MAPD screaming, quoting page numbers out of the MMC manual, telling them they are going to guarantee payment to the SNF or else.

The mom "moved" to Dallas to get out of the service area and get a GI Med Supp.

This crap happens all the time.

 

[kgmom219]

Also, remember their kids have $$, and they are the ones who have to deal with all the parents mapd chit. I have found many low income seniors who have kids who are willing to pay for the med supp so they don't have to deal with parent health issues or surprise bills. I pay for my in laws supps just for that reason. I don't have to worry about having to show a power of attorney just to speak on their behalf be able to speak to carrier of why they are kicking them out of rehab

THIS. 100%

 

[somarco]

I have never seen the ABN form to use with MAPD. Does it exist? If not, then MAPD does NOT have the same protections as OM.