Fraud Police

[somarco]

Officials at the Centers for Medicare & Medicaid Services are encouraging seniors and other members of the public to become fraud detectives by reporting misleading or deceptive sales tactics to 800-MEDICARE, the agency’s 24-hour information hotline. Suspects include postcards designed to look like they’re from the government and TV ads with celebrities promising benefits and low fees that are available only to some people in certain counties.

https://kffhealthnews.org/news/article/medicare-advantage-deceptive-sales-tactics-federal-crackdown/

This sounds like the DIY checkout lanes at Walmart . . .

70% of T65 are coming off EGH . . . many of them have never had to choose a health insurance plan.

They also never had a health insurance plan that included cards to buy food, golf lessons and cab fare to the doctor.

It's not surprising they are overwhelmed and confused . . . the "free everything" pitches only make things more difficult. Many seniors will end up making choices they may later regret only to discover they are stuck in a plan they can't escape. It's like the Hotel California . . . you can check out but never leave.

By the time they figure out the golden plan isn't as pitched it is too late to change and they figure it won't do any good to complain. When everyone including the government is pushing a no premium plan who are they to believe?

 

[axeman462]

I agree, agents who lie about MAPD, and only push medsupps in order to make the bigger commissions should be prosecuted.

 

[somarco]

Why would anyone have to lie about MAPD when the truth works?

 

[fed up]

I agree, agents who lie about MAPD, and only push medsupps in order to make the bigger commissions should be prosecuted.

What is there to lie about? MA plans are great for people with no money and people who have lots of money. The rest of us are better suited to Om and a supplement.

 

[Midlevel]

What is there to lie about? MA plans are great for people with no money and people who have lots of money. The rest of us are better suited to Om and a supplement.

That right there is a huge lie, so MA plans are not good for anyone who is middle class? I'm guessing 80% of my MA clients don't fall in the no money or lots of money categories.

 

[ValeRosso]

I love how basically every thread starts a MAPD vs Supp argument its hilarious

 

[adjusterjack]

I love how basically every thread starts a MAPD vs Supp argument its hilarious

Better than talking about politics or religion.

 

[fed up]

That right there is a huge lie, so MA plans are not good for anyone who is middle class? I'm guessing 80% of my MA clients don't fall in the no money or lots of money categories.

Is it still true that MA plans reset after 60 days from onset of treated ailments? Ie: an ailment treated in January and "cured" would bring on a new OOP if it surfaces again in April?

 

[somarco]

Is it still true that MA plans reset after 60 days from onset of treated ailments? Ie: an ailment treated in January and "cured" would bring on a new OOP if it surfaces again in April?

OM Part A has a 60 day "reset . . .

A benefit period begins when you are admitted to the hospital and ends when you have been out of the hospital for 60 days, or have not received Medicare-covered care in a skilled nursing facility (SNF) or hospital for 60 consecutive days from your day of discharge.

I am not aware of a similar provision in MA plans. However, they do "reset" when the calendar year ends . . . and they have a MOOP for COVERED expenses.

 

[Midlevel]

Is it still true that MA plans reset after 60 days from onset of treated ailments? Ie: an ailment treated in January and "cured" would bring on a new OOP if it surfaces again in April?

Yes, if you are referring to hospital inpatient stays. But their GTL pays 100% of it every time bc it also resets after 60 day period. Had one lady get over $6000 one year from GTL bc she kept going to the hospital with infections throughout the year. Her max OOP was $4500 so she made $1500 being on the dreaded MAPD.