Med supp -need experienced view here

[tommyk]

WTF: Senior, you and the others really need to know what the competition is doing. Just approved here in Illinois by Sterling Life Insurance was an enhanced F plan. This adds dental and vision and other stuff to the F. So I figure if Sterling is in other states they probally have applied for that plan in those states also. I know the DOI approved it here. So.....

I try to keep up with my own and also keep an ear to the ground to find out what is coming in and going on.

Senior: I believe that you once said that one has to contribute to this board to receive back....

Tag your it....LOL

 

[Winter_123]

It's now after 5pm in Missouri so Frank is busy starting his weekend drinking binge - allow me to answer for him. It's only 3pm in California.

Virtually all Med Supp carriers receive information directly from Medicare. The doctor really has no reason to bill the carrier.

I find it interesting that many providers recommend AARP to their patients because of this automatic billing. They don't seem to care that other companies do the same at a lower price.

Rick

Thanks but how does that work exactly. If the patient incurs costs that are billable to his med supp plan what happens next. The doc/hospital uses a standardized form to send to Medicare, then they approve and forward the bill along to the carrier that was designated on the form that the doc/hospital sent ? And then, if the doc accepts assignment the carrier sends check there. Is that how the flow works, and is it true to say that the bill goes through medicare so they decide whether it is payable or not and just notify the carrier to pay it?

Winter

 

[GreenSky]

Thanks but how does that work exactly. If the patient incurs costs that are billable to his med supp plan what happens next. The doc/hospital uses a standardized form to send to Medicare, then they approve and forward the bill along to the carrier that was designated on the form that the doc/hospital sent ? And then, if the doc accepts assignment the carrier sends check there. Is that how the flow works, and is it true to say that the bill goes through medicare so they decide whether it is payable or not and just notify the carrier to pay it?

Winter

The flow is that the doctor sends the bill to medicare - electronically. The supplement plans are then told by Medicare to pay their share.

If a doctor does not accept assignment, all the above still happens but the check goes to the patient from all sources.

Mutual of Omaha includes sticker that they instruct the patient to give to the doctors. The stickers state:

ATTENTION: This patient's Medicare supplement claims are automatically filed by the Medicare carrier. DO NOT file paper claims.

Hope this clarifies things.

Rick

P.S. Frank, did I do okay with this?

 

[Winter_123]

The flow is that the doctor sends the bill to medicare - electronically. The supplement plans are then told by Medicare to pay their share.

If a doctor does not accept assignment, all the above still happens but the check goes to the patient from all sources.

Mutual of Omaha includes sticker that they instruct the patient to give to the doctors. The stickers state:

ATTENTION: This patient's Medicare supplement claims are automatically filed by the Medicare carrier. DO NOT file paper claims.

Hope this clarifies things.

Rick

P.S. Frank, did I do okay with this?

Alright. Good deal. So would it be correct to flat out say that the carrier does no decisionmaking whatsoever in regard to the validity of the claim - that medicare does that and simply instructs them to pay?

Winter

 

[GreenSky]

Alright. Good deal. So would it be correct to flat out say that the carrier does no decisionmaking whatsoever in regard to the validity of the claim - that medicare does that and simply instructs them to pay?

Winter

Give the man a cigar! Exactly correct.

Rick

 

[senior-advisor-indiana]

WTF: Senior, you and the others really need to know what the competition is doing. Just approved here in Illinois by Sterling Life Insurance was an enhanced F plan. This adds dental and vision and other stuff to the F. So I figure if Sterling is in other states they probally have applied for that plan in those states also. I know the DOI approved it here. So.....

I try to keep up with my own and also keep an ear to the ground to find out what is coming in and going on.

Senior: I believe that you once said that one has to contribute to this board to receive back....

Tag your it....LOL

The plans are standardized by the government. HOw can Sterling make up their on plan Mr. Smarty Pants?!?!? It is illegal to add beneifts to the standard plan. Are they alos adding the $0 premium life to that plan?

 

[GreenSky]

The plans are standardized by the government. HOw can Sterling make up their on plan Mr. Smarty Pants?!?!? It is illegal to add beneifts to the standard plan. Are they alos adding the $0 premium life to that plan?

I don't know the answer to this so let me ask it.

If the Sterling plan is a Medicare Select, can they add benefits?

Rick

 

[Frank Stastny]

Give the man a cigar! Exactly correct.

Rick

Yea, what Rick said.

Jacqueline and I always go out to dinner on Friday night.

Winter,

I'm sorry I had to leave you in Rick's hands but he didn't do a bad job, for a rookie.

Med Supps are so smooth and easy. There is virtually no service work. Never any claims problems unless someone in the doctors office codes the bill incorrectly. If that happens it can be easily taken care of with a phone call.

This is why most agents only have their Med Supp clients for a relatively short time. THEY DON'T STAY IN CONTACT WITH THEIR CLIENTS!

I contact mine on a regular basis. I still have people I sold in 1993 that have their Med Supp insurance with me.

 

[senior-advisor-indiana]

NO!!! You cannot change the benefits on a SELECT plan either. They can only make you use certain hospitals on a select plan. I think TOmmy might be getting his info from a shiester.

 

[Frank Stastny]

The plans are standardized by the government. HOw can Sterling make up their on plan Mr. Smarty Pants?!?!? It is illegal to add beneifts to the standard plan. Are they alos adding the $0 premium life to that plan?

Damn Senior, you did it again. Got to say once more, what you said.