Med Sup

[LostDollar]

Stop already. Please

Jimmy, I'm sorry. Rick has been on my case since the 2nd or 3rd day I've been a member of the forum, posting in the consumer section.

I have gone so far as to take down an incendiary post I made about him "above the line" in the agent's section.

At one point he went so far as to make a comparison about me in relation to another poster that painted me, in what for him, were glowing terms.

I have apparently now done something to threaten his sense of wellbeing, and lost my grace period, because he is now back on the attack.

greensky and FLM2 are both making statements in direct contradiction of factual information from CMS, NAIC and the Medico insurance company. They are justifying these statements on the basis that one could not present the factual information as provided by those authorities to a customer because of the potential for lawsuits and carrier discipline. A statement about how something can or cannot be safely or effectively presented to a customer is not something I am in a position to agree or disagree with. However, what has been determined by experience to be an effective customer presentation, within the framework of CMS legal guidelines does not change the specific details and requirements of the guidelines themselves.

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Not comic relief.. Compared to me, Rick is just a young 'un. Come July I will celebrate my 46th anniversary in the business at the grand old age of 72. Rick has always treated me well and he is my up-line with Washington National..

Thank you for saying those things. I appreciate the frame of reference.

It is truly amazing the different faces people can present to others or in different situations. Rick has been on my case from close to the first time I started posting here in the consumer section. At least three times I have thought I should change that opinion, but each of those times within a very close timeframe to that decision he has chosen to do something that impacted me in negative way so I made different decisions.

Unfortunately this particular thread situation is going to continue a bit longer because greensky and FLM2 want to have both sides of the coin as it relates to me. They want to be able to freely criticize anything I say because I do not have the benefit of an insurance credential or insurance sales experience with my name. At the same time they want to "teach" me by telling me "facts" that directly contradict CMS and NAIC and then tell me that those "facts" are the actual CMS rules because their over 50 years combined experience show that is how one has to behave in the field. There is an additional statement in regard to HDF and F that the agents want to see from me, which I am perfectly willing to make when I see them ready to acknowledge that effective behavior in the field does not define the parameters of CMS rules, rather CMS rules set constraints on the effective behavior in the field.

While I think, or at least hope, there are some people in the forum I could have that conversation with, I don't think greensky and FLM2 are going to be 2 of them.

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from FLM2

It is a High Deductible Plan F with its own set of benefits, just like a Plan C is exactly the same as Plan F except it doesn't cover Part B Excess Charges and just like Plan G is exactly like Plan F except that the Part B deductible must be paid out of pocket before benefits start.

This isn't rocket science...

In the real world, it's NOT Plan F. But I know you'll argue with me about it because you've never sold insurance which apparently makes you an expert.

And that would be Mr. Troll to you.

Rick

Dear Mr GreenSky, (no problem with Mr, just out of practice but that's how I was raised up) in the real world who trumps in the arena of Medicare supplements? The insurance agent/customer combo or CMS?

I am exchanging posts with 2 agents at a site called Insurance Forums. These two agents seem to believe that statements made based on their experience with their customers take precedence over statements made by CMS and other authoritative Medicare information sources.

Do you have any comments about that situation?

Thank you.
LostDollar

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I would also make the comment that there are Part B services which do not have a deductible requirement, so it would be possible to have a part B item paid for before the Part B deductible is met.

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I agree with the post above. This is my 40th year as an insurance agent. I'm relatively certain I know more about Medicare supplements than most other agents.

When a "civilian" argues with me that blah,blah,blah Medicare that it's time for me to realize I'm dealing with someone that won't listen and likely won't ever learn.

I'm not sure what your purpose on this forum might be but "troll" does come to mind.

I'm glad that Prick likes you. He needs a friend.

Rick

Rick,
When I was in high school I had a date with an out of town girl one weekend. I found myself sitting in the normal gymnasium or similar type school gathering place with a bunch of kids I did not know. I had no idea what to do for conversation. I finally settled on taking jibes at some kids at another table. I got some laughs and got through the evening. Except for my date, I never saw any of those people again-at least to know who they were-and only saw my date a few more times. I have never felt right about that experience. The rest of those people continued school together and I am sure that some of them probably have continued at least intermittent acquaintance to this time.

People remember the oddest things. While I have no memory of what I said, I wonder sometimes about what damage I might have done to one person's perception of another in that situation. I know that I have made remarks to a boss that have caused someone to get fired, and I know I have made remarks to another sales person that caused them to leave the selling field. I can look back from those and just wonder what damage I might have done in that school gym that evening.

I have no idea why you feel the need to present the crust and guff you have to the world or to have the avatar you have. I can only say to you that in my own life anger based attitudes and expressions have had deleterious effects on my marriage relationship, my mental health and my physical health. I truly hope that some small miracle will happen in your own life that will allow you to move on from those attitudes before they affect your life in some significant and unanticipated way.

LD

 

[FLM2]

greensky and FLM2 are both making statements in direct contradiction of factual information from CMS, NAIC and the Medico insurance company. They are justifying these statements on the basis that one could not present the factual information as provided by those authorities to a customer because of the potential for lawsuits and carrier discipline. A statement about how something can or cannot be safely or effectively presented to a customer is not something I am in a position to agree or disagree with. However, what has been determined by experience to be an effective customer presentation, within the framework of CMS legal guidelines does not change the specific details and requirements of the guidelines themselves.

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.

LD

There is one very important thing missing in the above statement-IN MY OPINION.

To me, your opinion is completely worthless since you have no credible training nor true knowledge of the subject matter.

Have a nice life while I continue to help my clients (about 500) with their health insurance and Medicare benefits in a manner both fully compliant with all regulatory agencies and in my clients' best interests.

I sincerely hope that nothing you say will ever wind up hurting an unsuspecting consumer but I will leave further policing of your comments to other agents and the mods (if they choose to do so), I just don't have time for this crap in my life.

 

[GreenSky]

LD -

No anger but when you say a HDF is the same as a Plan F it's obvious that you haven't clue what you're talking about.

I have real world experience. You like to read and read and read and......

Believe what you want. You have an opinion on everything and although you want to site chapter and verse, you tend be be wrong.

I'd be happy to teach you insurance but doubt you would believe what an agent with 40 years of experience would have to say.

So continue to post here and realize that 99% of the agents here are glad you don't have a license.

Rick

 

[LostDollar]

There is one very important thing missing in the above statement-IN MY OPINION.

To me, your opinion is completely worthless since you have no credible training nor true knowledge of the subject matter.

Have a nice life while I continue to help my clients (about 500) with their health insurance and Medicare benefits in a manner both fully compliant with all regulatory agencies and in my clients' best interests.

I sincerely hope that nothing you say will ever wind up hurting an unsuspecting consumer but I will leave further policing of your comments to other agents and the mods (if they choose to do so), I just don't have time for this crap in my life.

The Office of Insurance Regulation has a public use document here:
http://www.floir.com/siteDocuments/OIR-B2-MSC2.pdf

It includes these statements:

*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2000] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$2000]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.

This basically says that HDF is a member of the plan F family and includes precisely the same coverage of the medicare beneficiary's share of medicare covered expenses as plan F does. Not all part B expenses are subject to the part B deductible, so there are some part B expenses that could be paid by the plan (F) or the beneficiary (HDF) before the entire part B deductible is paid by the responsible party. In addition, the fact that it is most likely that the holder of an HDF medicare supplement plan will find that most to all of his or her part B deductible is an early portion of the payments required to meet the high deductible requirement does not change the fact that the part B deductible is a covered benefit in BOTH the plan F and its HDF option.

 

[rousemark]

The Office of Insurance Regulation has a public use document here:
http://www.floir.com/siteDocuments/OIR-B2-MSC2.pdf

It includes these statements:


This basically says that HDF is a member of the plan F family and includes precisely the same coverage of the medicare beneficiary's share of medicare covered expenses as plan F does. Not all part B expenses are subject to the part B deductible, so there are some part B expenses that could be paid by the plan (F) or the beneficiary (HDF) before the entire part B deductible is paid by the responsible party. In addition, the fact that it is most likely that the holder of an HDF medicare supplement plan will find that most to all of his or her part B deductible is an early portion of the payments required to meet the high deductible requirement does not change the fact that the part B deductible is a covered benefit in BOTH the plan F and its HDF option.

You really need to give this a rest.. You are titling at windmills.. See my response to your post in the other thread.

 

[sman]

The Office of Insurance Regulation has a public use document here:
http://www.floir.com/siteDocuments/OIR-B2-MSC2.pdf

It includes these statements:


This basically says that HDF is a member of the plan F family and includes precisely the same coverage of the medicare beneficiary's share of medicare covered expenses as plan F does. Not all part B expenses are subject to the part B deductible, so there are some part B expenses that could be paid by the plan (F) or the beneficiary (HDF) before the entire part B deductible is paid by the responsible party. In addition, the fact that it is most likely that the holder of an HDF medicare supplement plan will find that most to all of his or her part B deductible is an early portion of the payments required to meet the high deductible requirement does not change the fact that the part B deductible is a covered benefit in BOTH the plan F and its HDF option.

I don't think anyone is disputing that HDF is "in the Plan F family". The problem, as I stated before, is your terminology. Specifically saying you have a Plan F for $55 per month. If you say you have a High Deductible Plan F for which you pay $55 there would be no issue.

You constantly arguing that the HDF covers the Part B deductible is irrelevant to those who have a HDF. In the real world, a traditional Plan F is what is known as first dollar coverage. Specifically because it pays the Part B deductible and requires no additional out of pocket expense to the beneficiary on Medicare covered claims. A HDF is NOT first dollar coverage. No matter how many times you want to say the benefits of F and HDF are the same, that just isn't true. I said this earlier as well, if you want to say "once the $2,200 deductible is met the benefits are the same", go right ahead. That is a true statement. As explained before, you can say the same thing for Plan G. And that makes Plan G closer in benefit to Plan F than HDF (based purely on how quickly one gets to having no additional out of pocket expense).

You're so hellbent on trying to prove somebody wrong you can't see the forest for the trees. You remind me of the professor teaching the students how to run a business when the professor has never run a business. He/She has only taught the theory of it and has no practical knowledge of actually doing it.

 

[LostDollar]

I don't think anyone is disputing that HDF is "in the Plan F family". The problem, as I stated before, is your terminology. Specifically saying you have a Plan F for $55 per month. If you say you have a High Deductible Plan F for which you pay $55 there would be no issue.

You constantly arguing that the HDF covers the Part B deductible is irrelevant to those who have a HDF. In the real world, a traditional Plan F is what is known as first dollar coverage. Specifically because it pays the Part B deductible and requires no additional out of pocket expense to the beneficiary on Medicare covered claims. A HDF is NOT first dollar coverage. No matter how many times you want to say the benefits of F and HDF are the same, that just isn't true. I said this earlier as well, if you want to say "once the $2,200 deductible is met the benefits are the same", go right ahead. That is a true statement. As explained before, you can say the same thing for Plan G. And that makes Plan G closer in benefit to Plan F than HDF (based purely on how quickly one gets to having no additional out of pocket expense).

You're so hellbent on trying to prove somebody wrong you can't see the forest for the trees. You remind me of the professor teaching the students how to run a business when the professor has never run a business. He/She has only taught the theory of it and has no practical knowledge of actually doing it.

Ok, I do have to concede a point. I have just done some reading-

I have misused the term " First Dollar Coverage" and I apologize to all for misusing it in regard to an HDF plan.

As punishment I will make no more posts in this thread (after I've completed this one) for a week.
LD

However, both Plan F and its HDF option do provide coverage for the same Medicare approved health expense risks faced by a Medicare beneficiary. The fact that some of those risk categories are more likely to be included in itemized lists of the components of the deductible paid by the plan holder in a given year does not mean that all the risks covered by plan F are not included in coverage provided by the HDF plan option.

 

[goillini52]

As punishment I will make no more posts in this thread (after I've completed this one) for a week.
LD

You also need to stand in the corner for an hour LD.

 

[sman]

Ok, I do have to concede a point. I have just done some reading-

I have misused the term " First Dollar Coverage" and I apologize to all for misusing it in regard to an HDF plan.

As punishment I will make no more posts in this thread (after I've completed this one) for a week.
LD

However, both Plan F and its HDF option do provide coverage for the same Medicare approved health expense risks faced by a Medicare beneficiary. The fact that some of those risk categories are more likely to be included in itemized lists of the components of the deductible paid by the plan holder in a given year does not mean that all the risks covered by plan F are not included in coverage provided by the HDF plan option.

The same could be said for all Med Supps in that if it's a Medicare approved charge, the Med Supp will pay its portion of the claim as defined by the benefits of the plan (all letter plans - not just F). At which point and how much they pay is determined by the specific benefits of each plan letter.

There really is no "however" here. The facts are pretty straight forward. A traditional Plan F provides first dollar benefit and HDF does not. Now you're just sounding like a prideful teenage boy trying to come up with some technicality.

Ad it makes no difference to me whether you post in this thread or not.

 

[LostDollar]

Update-Just for the record:

I now have $39K of gross provider billings, so far, for the year.

The Medicare deductible from the Medicare EOBs for those claims is included in the Covered Charges on my Hi-F EOBs for the same claims.