Hospitals dropping Medicare Advantage agreements leaves patients in lurch

[StephanieCJ]

I see people having to choose between the premium on a supplement and groceries or utilities. If they do get hospitalized and incur some of the larger copays, hospitals will work out payment plans at $10 of $15/mo. I don’t know about where anyone else is, but if your medical bills reach a certain threshold in relation to your income, you can apply to have Medicaid step in and help out in Louisiana on an incidental basis. I help my clients apply for and negotiate these things when needed. Maybe I’m a sucker, but I don’t just sign someone up on a plan and tell them to call customer service if they have an issue, I help resolve the issue. That’s also probably part of why I can get by with almost no paid advertising, but a boat load of referrals. I figure I’m either going to spend the time helping people or spend the money on mailers/telemarketing, so...

 

[rousemark]

I see people having to choose between the premium on a supplement and groceries or utilities. If they do get hospitalized and incur some of the larger copays, hospitals will work out payment plans at $10 of $15/mo. I don’t know about where anyone else is, but if your medical bills reach a certain threshold in relation to your income, you can apply to have Medicaid step in and help out in Louisiana on an incidental basis. I help my clients apply for and negotiate these things when needed. Maybe I’m a sucker, but I don’t just sign someone up on a plan and tell them to call customer service if they have an issue, I help resolve the issue. That’s also probably part of why I can get by with almost no paid advertising, but a boat load of referrals. I figure I’m either going to spend the time helping people or spend the money on mailers/telemarketing, so...

I can't afford $200 per month for my med Supp but I can afford $4k-$6k (350 -500 per month) out of pocket if I am sick? Doesn't add up to be me. I am 74 years old, licensed since 1971, sold med Supp for many years to people of all walks of life and in all those years I neve saw a person actually have to make a choice between food and a med Supp.

 

[fun2drum]

I know people who were paying annual supp + D premiums close to the $3400 MOOP limit in a $29/month MAPD that I sell. They were paying that premium even if they didn't go to the doctor that year. I think MAPD has it's place and so does A+B+Supp+D.

 

[XpressInsurance]

I can't afford $200 per month for my med Supp but I can afford $4k-$6k (350 -500 per month) out of pocket if I am sick? Doesn't add up to be me. I am 74 years old, licensed since 1971, sold med Supp for many years to people of all walks of life and in all those years I neve saw a person actually have to make a choice between food and a med Supp.

You are assuming they would actually pay the hospital bill. I had a med supplement customer who has been on Extra Help for quite a few years call me last week & wanted to switch to a MAPD. She is 85 years old has been on a supplement I wrote her, for the last 8 years with a Aetna Company. She can't afford the premiums & has been late with them for last 4-5 months. She said goes the doctor 3-4 times per year, struggles to pay her bills, she has no assets & lives in an apartment. I had a referral form a client, she is a woman that was paying BCBS $300 per month on $1,100 monthly income & she is on a Medicaid spend down. She ended up switching to MAPD.

I spoke to a client yesterday that between the supplement & PDP the total premium between H&W was $545 per month or $6540 per year. She asked about a MAPD with $18 premium & $3400 MOOP which she is considering worst case if both hit MOOP it would cost them $260 more than they currently pay. I don't know if they will switch but if it was me I would switch, I just don't think for me, spending $32K in premium over 5 years is wise.

The original post about the seniors in NE MS & on MAPD with Humana, this is because they don't have a lot of options in NE MS or the rest of MS other than Humana. Humana has 56% of the MA market.

 

[Higru]

With MA's biggest concern is whether providers outside of hospitals will accept arrangements as the news story states. Cost wise as express insurance stated, money wise for some MAPD may be the best choice.

 

[StephanieCJ]

I'm not saying MAPD is the right choice for all. In fact, my preference is that someone would buy a Med Supp because of the lack of barriers to care. Unfortunately, I do have clients who cannot afford the premium or come to me later with health conditions that will not qualify them for a med supp. In those instances, I show the MAPD. It is not for everyone, but at least having predictable costs for care can remove some of the barriers to care. People may not go the the primary care doctor because their 20% is $30 and in the same instance, when its a $0-5 copay, they go and find health conditions earlier. You might not have seen the instance where someone had to choose between premiums and utilities, but I have clients that hunt and grow to provide groceries. There are different solutions for different people in different circumstances.

 

[somarco]

hospitals will work out payment plans at $10 of $15/mo.

Which old wives club do you belong to?

In many states, including GA medical debts often go to collections if not paid in 6 months. If you have anything worth taking, including your paycheck, they will do that to collect the debts.

Also many docs (and hospitals) will refuse to treat you (non-emergency) if you have outstanding bills.

I have friends and relatives that love to stiff docs because they feel they can get away with it. When the doc refuses to treat them untit they pay their bill they either find the money or go looking for a new doc.

Of course most of them have credit scores under 700 so I guess they don't care.

There are a number of agents that bellyache about how their clients can't afford a Medigap so they sell them $0 premium then add on a cancer plan, dental plan, hospital indemnity, blah, blah.

Not pointing fingers but I know you can make close to $1,000 on $0 premium plus a bunch of add on stuff. The "client" is paying $100+ per month and still has less coverage than they would have with Medigap and OM.

I have no paid advertising. Haven't paid in years. But I do get a number of referrals and balance by organic search. Can't recall when the last time was that someone told me they could not afford to pay the premium.

 

[StephanieCJ]

I don’t know how Georgia works, but this is how it works in Louisiana. You have to call and negotiate a payment plan, but once they agree and as long as you aren’t late on the payments, they can’t turn you over to collections. I have had to do it for myself when I was in college and didn’t have any insurance coverage. Maybe this is one of the few things we got right in our state (believe me, there isn’t much).

 

[Higru]

Which old wives club do you belong to?

In many states, including GA medical debts often go to collections if not paid in 6 months. If you have anything worth taking, including your paycheck, they will do that to collect the debts.

Also many docs (and hospitals) will refuse to treat you (non-emergency) if you have outstanding bills.

I have friends and relatives that love to stiff docs because they feel they can get away with it. When the doc refuses to treat them untit they pay their bill they either find the money or go looking for a new doc.

Of course most of them have credit scores under 700 so I guess they don't care.

There are a number of agents that bellyache about how their clients can't afford a Medigap so they sell them $0 premium then add on a cancer plan, dental plan, hospital indemnity, blah, blah.

Not pointing fingers but I know you can make close to $1,000 on $0 premium plus a bunch of add on stuff. The "client" is paying $100+ per month and still has less coverage than they would have with Medigap and OM.

I have no paid advertising. Haven't paid in years. But I do get a number of referrals and balance by organic search. Can't recall when the last time was that someone told me they could not afford to pay the premium.

We have at least 20 people a year tell us they cannot afford the premium. I'm no advocate for MAPD's but there are many O65 who cannot afford the premiums. We try and sale the high deductible Plan F.

 

[StephanieCJ]

Higru, Myself as well. I will look at High F, Plan N (just have to be careful here, because we have a pretty decent sized area that tends to be low income where 90% or so of doctors don’t take assignment so have to warn them about that).