Just thought that I would stir the MAPD vs MS pot again: Start at 2:25

[sshafran]

It's just ironic to me that it's always the insurance company blamed. No one is locking up the pharmacy or barricading the OR.

 

[axeman462]

are you saying that what the family is saying is not true? If it is true, then it is not fear mongering

Never said the story is not true.
Read my other posts in this thread, not saying it all again

This guy is no better than a Bankers agent.

 

[Chazm]

Just moved two med Supp seniors to MAPD yesterday. I told them that if they were my clients, I’d recommend staying with their med Supp and PDP.
They asked to see the MAPD anyways. UHC accepted all of their doctors. I explained PA and denial possibilities.
They walked out the door saving $580/month with 2 MAPDs with $2900 moop each.

 

[Midlevel]

Just moved two med Supp seniors to MAPD yesterday. I told them that if they were my clients, I’d recommend staying with their med Supp and PDP.
They asked to see the MAPD anyways. UHC accepted all of their doctors. I explained PA and denial possibilities.
They walked out the door saving $580/month with 2 MAPDs with $2900 moop each.

But they gave up all their dental, vision, OTC, hearing aids, gym membership etc by going to the cheaper plan. No, I was confused, now they have all of that and saved 7000.00/year. But now have to pay 35.00 for a specialist. Should have probably stayed on their Med Sup’s and subpar drug plan.

 

[axeman462]

Just moved two med Supp seniors to MAPD yesterday. I told them that if they were my clients, I’d recommend staying with their med Supp and PDP.
They asked to see the MAPD anyways. UHC accepted all of their doctors. I explained PA and denial possibilities.
They walked out the door saving $580/month with 2 MAPDs with $2900 moop each.

You moved them to MAPD, but they're not your clients?
--
Oh, I just read it again, nevermind.

Sounds like you just dug these people's own grave. There's a good chance you'll be charged for murder soon

 

[rousemark]

Never said the story is not true.
Read my other posts in this thread, not saying it all again

This guy is no better than a Bankers agent.

Giving thr people the facts is not scare tactics even though you might prefer people not be informed of them.

 

[rousemark]

How bout a beer? I have a lady buying her Old Milwaukees best at a Dollar General with her healthy bennies card. I know she shouldn't be but she somehow is....must be keyed in inventory as groceries or who knows...

I see the auths happen just as fast with MAPD in many cases. 10 minutes the other day for a senior patient needing a pain blocker on a PPO at a pain and spine clinic. Office girl says, "oh I need to get an auth". Picks up phone or whatever she did for 10 minutes, comes back and says ok doc be with ya in a bit. Not exactly like that, but it took her 10 minutes. You know what I mean. in that case the auth should have done prior to the patients arrival but wasn't and it didn't take long to get it is the point. It's not the olden days.

That's just an example. BCBS PPO has many providers in their MAPD network. Humana PPO not far off. Aetna HMO POS not my fave, but no ones complaining. PPO might be better. IDK I dont do alot of Aetna, but do some. Don't like the portal. My mains are BCBS and Humana.

It all goes back to what's the market dictate. Many geo areas have plenty of options and not very limited networks. Hence why this debate imo is silly.

If the argument on control over health care is for choosing providers then that's null here. It doesn't happen often where a client can't go where they want here as long as docs in network AND that doc is accepting new patients. One of the main ones I do has close to a million providers and then some. No issues.

You use terms "in many cases" and "doesn't happen often" which is true. But if you or your loved one is the one that it "rarely" happens to, that is not much consolation.

 

[Russ]

Nice job of the OP to stir the pot

 

[axeman462]

Giving thr people the facts is not scare tactics even though you might prefer people not be informed of them.

Telling people they will "literally die. Seriously." If they choose the wrong insurance plan is not only a scare tactic, it's unethical.
And to condone it is immoral.

 

[rousemark]

Telling people they will "literally die. Seriously." If they choose the wrong insurance plan is not only a scare tactic, it's unethical.
And to condone it is immoral.

Are you saying the person qspoken of in the videqo did not literally die? Failure to reveal all possibilities in order to make a sale is downright dishonest.