AETNA BEING HELPFUL TELESALING YOUR CLIENTS.

[straightnochaser]

I'm not their agent, so I don't know who educated them on the MAPD details. It's just another reason for med supps, for those on a budget, a med supp provides consistency in their monthly outlays, with no surprises, so they can plan accordingly. Those on free mapd, may not have the resources or savings for the OOP costs when the "time" comes.

Yea its not that simple though is it... Depending on your area there are tons of MAPD with very low moops. I take people out of supps all the time because they just can't afford it anymore, so for those on a budget a med supp isn't always the best choice.

 

[somarco]

It may be that med supp clients actually pay attention to what they own?

Possibly . . .

Medigap clients are well aware of what they have when they pay their premium . . . and especially when their claims are paid. My sick clients will never change to MAPD . . . might lose a handful of the healthy ones each year to MAPD but, unfortunately, lose more to the grim reaper.

I do know, from talking to clients and prospects, doctors plus what I read, that a number of folks have no idea how their MAPD plan works. Bills come in, they pay them (if they can), and never question them. Saw too much of that with PPO group & individual plans. I did get calls on hospital admission balance billing . . . way too many calls.

I also know that the majority of folks just roll over when their carrier denies the pre-authorization claim. They have become conditioned to being mistreated by the carrier and just accept is as the way things have to be.

Pretty sad, actually . . .

 

[ValeRosso]

Who else does this? Aetna has given me more problems and issues and migraines than all other carriers combined...give me a reason to stop writing them. Oh, plus the commission cut on their lowest PDP plan.

 

[goillini52]

Aetna has given me more problems and issues and migraines than all other carriers combined.

You don't sell Wellcare?

 

[wehotex]

Who else does this? Aetna has given me more problems and issues and migraines than all other carriers combined...give me a reason to stop writing them. Oh, plus the commission cut on their lowest PDP plan.

How are UHC and Humana in your area for authorizations? I've had some sticky Aetna denial problems with members from SNF admissions denials and from hospital stay to denial of Supartz, the osteo injection.

You don't sell Wellcare?

Yup, that's another one. I recently lost a new to Medicare Advantage because Wellcare online read that a particular rheumatologist was in-network, when he wasn't. I'm not doing that again.

 

[ValeRosso]

You don't sell Wellcare?

No...I’m taking this as “you should be selling WellCare” lol. Am I missing out by not?

 

[ValeRosso]

How are UHC and Humana in your area for authorizations? I've had some sticky Aetna denial problems with members from SNF admissions denials and from hospital stay to denial of Supartz, the osteo injection.

You don't sell Wellcare?

Yup, that's another one. I recently lost a new to Medicare Advantage because Wellcare online read that a particular rheumatologist was in-network, when he wasn't. I'm not doing that again.

I’ve never had an issue with authorizations with Humana and UHC yet, but I only have about 50 clients with PDP’s between the two carriers so I don’t have a large population to go off of.

 

[goillini52]

No...I’m taking this as “you should be selling WellCare” lol. Am I missing out by not?

No, I just don't see how any company could be a bigger PITA to deal with than Wellcare.

I was being sarcastic.

 

[somarco]

No, I just don't see how any company could be a bigger PITA to deal with than Wellcare.

I was being sarcastic.

You could throw Amana in the mix as well . . . go for the trifecta

 

[ValeRosso]

No, I just don't see how any company could be a bigger PITA to deal with than Wellcare.

I was being sarcastic.

Haha well that’s good to know...one less headache for me then!