Fraud Police

[straightnochaser]

And you probably did. Several companies still have them. A lot of companies are moving away from deductibles but they're increasing their copays to make up for it.

Several plans have them, not companies... always limited to PPO plans and there's almost always an option in the area for a plan without a deductible (with low copays).

 

[goillini52]

I figured as much. Just another forum troll with no balls.

If she's a biological female, she ain't supposed to have balls.

 

[LostDollar]

To answer Dons question. I have 75% first year GTL not sure I'd ever do another one except for maybe Medico. I'm sort of interested in Surebridge, but havent heard enough about it. I know Gollini told me something about it earlier, but AEP got so busy forgot all about it.

And wth is a pet boarding benefit? My pet can board the plane without a ticket, or can go to the doggie hotel for cheaper? All I care about is if they pay the claim for cancer and hospital in a timely fashion. and GTL does.

What other ones are fast at claims. Is LBL?

If I had to be in the hospital, I would have a concern about how my dog would be cared for while I was gone.

 

[goillini52]

To answer Dons question. I have 75% first year GTL not sure I'd ever do another one except for maybe Medico. I'm sort of interested in Surebridge, but havent heard enough about it. I know Gollini told me something about it earlier, but AEP got so busy forgot all about it.

And wth is a pet boarding benefit? My pet can board the plane without a ticket, or can go to the doggie hotel for cheaper? All I care about is if they pay the claim for cancer and hospital in a timely fashion. and GTL does.

What other ones are fast at claims. Is LBL?

Pet boarding is paying a benefit to keep your pet at the doggie hotel while you're in the hospital. Dog lovers with MAPD's should love that benefit.

I have no idea how quickly LBL pays their claims.

 

[goillini52]

Mind boggling.

Still going at it. This has to be the longest running debate ever. MAPD vs Med Supp.

Anyone ever count the threads of this debate. And is there one in which the Leader of the Pack isn't involved in it, screaming from the rooftops how inferior MAPD is.

All that shouting (barking) doesn't stop it's momentum. It's rolling full force.

Bark more. Wag less, I guess.

I was explaining the difference between a Med Supp and a MAPD to my wife. She said, "you mean we can't choose where we go, we have to pay for services, what will this insurance be next year and how many toothbrushes do we need? What do you call this crappy insurance?"

I laughed and said Medicare Advantage. Hahaha


With that being said, we switched from Plan G's to Aetna's Premier MAPD PPO. Went with the $13 a month premium. The additional benefits over the free one is worth it.

I added up the premiums we were paying for the Med Supp, PDP and DVH and their deductibles. I also added the OTC, fitness benefit, gym, additional DVH benefits over our Manhattan plan and extra FYC. I didn't figure the commissions for year 2 on, but in my case the renewals will be higher on MAPD, as I was only making 10% on my Med Supp. Also, the Med Supp premiums will continue to rise.

Even if we both MOOP out, we'll still be almost $3,000 ahead. If we have a good year health wise, we could be $12,000 ahead.

Aetna has all of the hospitals, clinics and doctors in a 75 mile radius in their network, I didn't check any further out. To make sure, I called every doctor, clinic and hospital we've used and they all accept Aetna. My only concern is PA's.

MAPD's are getting better and since I'm going to sell both, I'm trying it for a year so I can see 1st hand how well it works. My wife had some blood tests and has used the dental and I used the OTC and the gym and we used the RX. Hasn't cost us a dime yet, except we each take a drug with a $47 copay.

I gave this a lot of thought before I did it because I've always been a Med Supp only guy. Times are changing.

I have a triple safety net in case I don't like it. OEP, Trial Right and BCBS(which I had) is GI in Illinois.

I just met with a referral. He wanted to know the good and bad of both. He's retiring and waiting for his Medicare card. I showed both and he's leaning toward MAPD.

The bad thing about having a book of MA, is having to certify every year, That's getting harder to do as I get older and my brain fog gets worse..........SQUIRREL...................

 

[rmhaire]

With that being said, we switched from Plan G's to Aetna's Premier MAPD PPO. Went with the $13 a month premium. The additional benefits over the free one is worth it.

Damn Hippie

 

[Midlevel]

I was explaining the difference between a Med Supp and a MAPD to my wife. She said, "you mean we can't choose where we go, we have to pay for services, what will this insurance be next year and how many toothbrushes do we need? What do you call this crappy insurance?"

I laughed and said Medicare Advantage. Hahaha


With that being said, we switched from Plan G's to Aetna's Premier MAPD PPO. Went with the $13 a month premium. The additional benefits over the free one is worth it.

I added up the premiums we were paying for the Med Supp, PDP and DVH and their deductibles. I also added the OTC, fitness benefit, gym, additional DVH benefits over our Manhattan plan and extra FYC. I didn't figure the commissions for year 2 on, but in my case the renewals will be higher on MAPD, as I was only making 10% on my Med Supp. Also, the Med Supp premiums will continue to rise.

Even if we both MOOP out, we'll still be almost $3,000 ahead. If we have a good year health wise, we could be $12,000 ahead.

Aetna has all of the hospitals, clinics and doctors in a 75 mile radius in their network, I didn't check any further out. To make sure, I called every doctor, clinic and hospital we've used and they all accept Aetna. My only concern is PA's.

MAPD's are getting better and since I'm going to sell both, I'm trying it for a year so I can see 1st hand how well it works. My wife had some blood tests and has used the dental and I used the OTC and the gym and we used the RX. Hasn't cost us a dime yet, except we each take a drug with a $47 copay.

I gave this a lot of thought before I did it because I've always been a Med Supp only guy. Times are changing.

I have a triple safety net in case I don't like it. OEP, Trial Right and BCBS(which I had) is GI in Illinois.

I just met with a referral. He wanted to know the good and bad of both. He's retiring and waiting for his Medicare card. I showed both and he's leaning toward MAPD.

The bad thing about having a book of MA, is having to certify every year, That's getting harder to do as I get older and my brain fog gets worse..........SQUIRREL...................

You will both be lucky to make it through the year being on MAPD. Like a death wish. Good luck though, hope it works out for you both and wife gets tons of tooth brushes. You getting the fitness benefit also?

 

[myinsurebiz]

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.

[EXTERNAL LINK] - Uncle Sam Wants You ... to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics - KFF Health News

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?

Exactly why we don't do Part C or Part D. We refer it out . . .

 

[goillini52]

You will both be lucky to make it through the year being on MAPD. Like a death wish. Good luck though, hope it works out for you both and wife gets tons of tooth brushes. You getting the fitness benefit also?

Yes, we'll use the fitness benefit. If not on ourselves, on the grandkids.

 

[AgentGeneral]

I was explaining the difference between a Med Supp and a MAPD to my wife. She said, "you mean we can't choose where we go, we have to pay for services, what will this insurance be next year and how many toothbrushes do we need? What do you call this crappy insurance?"

I laughed and said Medicare Advantage. Hahaha


With that being said, we switched from Plan G's to Aetna's Premier MAPD PPO. Went with the $13 a month premium. The additional benefits over the free one is worth it.

I added up the premiums we were paying for the Med Supp, PDP and DVH and their deductibles. I also added the OTC, fitness benefit, gym, additional DVH benefits over our Manhattan plan and extra FYC. I didn't figure the commissions for year 2 on, but in my case the renewals will be higher on MAPD, as I was only making 10% on my Med Supp. Also, the Med Supp premiums will continue to rise.

Even if we both MOOP out, we'll still be almost $3,000 ahead. If we have a good year health wise, we could be $12,000 ahead.

Aetna has all of the hospitals, clinics and doctors in a 75 mile radius in their network, I didn't check any further out. To make sure, I called every doctor, clinic and hospital we've used and they all accept Aetna. My only concern is PA's.

MAPD's are getting better and since I'm going to sell both, I'm trying it for a year so I can see 1st hand how well it works. My wife had some blood tests and has used the dental and I used the OTC and the gym and we used the RX. Hasn't cost us a dime yet, except we each take a drug with a $47 copay.

I gave this a lot of thought before I did it because I've always been a Med Supp only guy. Times are changing.

I have a triple safety net in case I don't like it. OEP, Trial Right and BCBS(which I had) is GI in Illinois.

I just met with a referral. He wanted to know the good and bad of both. He's retiring and waiting for his Medicare card. I showed both and he's leaning toward MAPD.

The bad thing about having a book of MA, is having to certify every year, That's getting harder to do as I get older and my brain fog gets worse..........SQUIRREL...................

If youre being serious, I don't think you need to worry too much about PAs it happens seamlessly in most cases.

Only one lately who had an issue with a PA was on the Rx side. Darn it, she only got 46 of her norcos while they had a PA wait for a bit, I think 3 days, meanwhile she had enough of her norco to last. She was raising holy hell with me. This was last week. Yesterday her PA went through and she got the rest. of her 195 norcos per month. Not exactly sure the real number bc she changed it several times, but she claimed 195.

With Aetna, I've not had one complaint on a PA. Or any other carrier for that matter. Maybe it matters the area and how many docs take it. But I'm always hard pressed to find a doc that doesn't accept most mapds in my area. Found one that didn't take bcbs. but he doesn't accept medicare in general. Found a few hospitals that don't take UHC but thts fine too, it's not in my counties at all as far as MAPD. Two years ago there was a supposed week wait on a neurologist for Humana with a lady being tested for dementia. I believe that wasn't quite accurate as he also had a wait list to get into...i knew who the neuro was and he's a hard to get a fast appt doc anyway.

Let us know if you use your trial period (or another safety net) to move back. So far I've told everyone they have that option, and NOT ONE has wanted to go back, not even the cancer patients or otherwise (my cancer people so far have all had GTL). I get an occasional call about what was this $325 bill for an outpatient....or something like that....I nver have to remind them about what they saved during the year. They already know and tell me the minute I remind them of their trial period. Took this exact call today which is why the example was top on my mind. She says, oh no we love our humana plan. had a minor complaint of getting eyeglasses at Costco and being out of network, but got a claim form and not an issue. She said even if it doesnt work out shes still happy. Both her and hubby combined has 3 outpatient surgeries in past year. Only received the one $325 bill which kind of confused me but I kept it quiet. I knew on Humana it shouldve been 3 bills but they only received one on the most recent outpatient surgery.

Michigan is even nicer in some aspects with the BCBSM PPO MAPD, many things do not need a PA at all and there are quite a few things that have zero copays, like hip or knee outpatient surg, cardiac and pulmonary rehab etc. Yes these plans aren't the worst at all. Not near as demon like as some would proclaim.

Dont worry about the certs. Once you do em once, theyre easy. And here, the older ones with memory problems get in office "help". You could too if need be. Theyre still a pita, but generally painless, more a time suck than anything. I'm betting youll do it all yourself with ease.