Fraud Police

[DonP]

Helloooo, an HSA contribution is a front page tax deduction on your 1040, and fully deductible regardless of your income level. Higher the income, the larger the savings.

Im doing one this yr . I have over a $1500 deductible and over a $7500 moop . I can put $4850 in it. I meant tax benefits on subsidy

 

[Yagents]

You LITERALLY just called MAPD inferior to a Med supp.

And I see the same with med supp reps. Supps can be sold earlier than MAPD and about 50% of them don’t present both options, OR, like you and the rest of the med supp agents on here, don’t present both objectively.

And.... I stand by that statement.

And, most agents on here who sell both have agreed with that statement.

But you're new here, I get it.

As I said, I explain both, and refer those mapd prospects to another agent. Most of them have been my highly subsidized ACA CSR clients paying $0 to $50 a month. They are shocked already with the $175 part B premium news, and go mapd of course.

 

[rmhaire]

And.... I stand by that statement.

And, most agents on here who sell both have agreed with that statement.

We can argue this shit back and forth all day but no one can escape the facts. OM plus a supplement is as close as you can get to complete coverage. Advantage plans can't say that.

After the part b deductible and assuming Medicare approves the charges, you've got 80% plus 20% coverage. That equals 100%. Or at least it did when I went to school.

Advantage plans have deductibles, copays and coinsurance. Definitely not 100%.

 

[somarco]

but the line about 'not truth agent would say MAPD is better than medsupp' I can't agree with.

Nor can I . . .

The best product, is the one that meets the needs and budget of the customer.

Amplification . . . The BEST product meets the needs and budget WHEN COVERAGE IS NEEDED . . .

For years I have had people tell me they "Need insurance so I can go to the doctor". No, you need cash, money in the bank, or maybe a credit card that is not maxed out for a routine doctor visit.

You need INSURANCE when the bus hits you or you have a serious illness that will cost a ton of money when you need treatment you can't afford.

 

[rmhaire]

This is like exhibit “w” at this point.

You are assuming everyone prioritizes complete coverage over 1) saving money 2) dental and vision 3) their light bill.

So, for someone who prioritizes being able to to any doctor whenever they want without getting permission, a supplement is most suitable for them. But for others it may not be.

I'm not assuming anything. I simply stated the facts. Feel free to dispute what I posted.

 

[somarco]

$300/yr forever

Forever . . .?

I believe UHC modified their MA comp to pay commissions "for life" (your client's life, not yours) . . . but I seem to recall it was more a modification of terms more than anything. Didn't they change "service fee" to commission after X years and the commission was something like $10 per month "for life"?


FWIW, I put our newest rookie on ignore after the 2nd post proved beyond a shadow of a doubt that she would not contribute anything meaningful to the discussion. . . . so it looks to me like you are debating a ghost . . . which is essentially what is happening.

 

[somarco]

After the part b deductible and assuming Medicare approves the charges, you've got 80% plus 20% coverage. That equals 100%. Or at least it did when I went to school.

And there is no guarantee MA will approve the charges . . . in fact, a number of reports indicate a number of claims denied by MA would have been approved by OM.



Medicare Advantage plans denied two million prior authorization requests for health care services in whole or in part in 2021 . .
Only about 11 percent of denials of prior authorization requests were appealed, the analysis finds. However, of the appeals that were filed, the vast majority (82%) resulted in fully or partially overturning the initial denial.

https://www.kff.org/medicare/press-...on-requests-in-2021-about-6-of-such-requests/

A recent STAT investigation found Medicare Advantage companies increasingly have used unregulated algorithms to determine when they can cut off patients’ care. Many of those people are in nursing homes, rehab facilities, and other post-acute settings, and judges often rule that the algorithms run afoul of Medicare law and should have covered the care.

“MA organizations must ensure that they are making medical necessity determinations based on the circumstances of the specific individual … as opposed to using an algorithm or software that doesn’t account for an individual’s circumstances,” the regulation states.
[EXTERNAL LINK] - Medicare Advantage plans will have to stop denying required care, federal officials say

Who needs/wants insurance that requires an appeal to get your claims paid?

 

[somarco]

Who let the annoying fly in the forum? Someone please swat her so we can discuss insurance concepts on an informed, intelligent level.

 

[rmhaire]

FWIW, I put our newest rookie on ignore after the 2nd post proved beyond a shadow of a doubt that she would not contribute anything meaningful to the discussion. . . . so it looks to me like you are debating a ghost . . . which is essentially what is happening.

I must have missed something. How do you know the rook is a she?

And all this time I've been sitting here waiting for his balls to drop.

 

[DonP]

Speaking of United amd mapd . Those sweet mapd commissions showing in your portal today . I freakin love this business .