Med Supp Question Need Help!

Discussion in 'Senior Insurance Forum' started by keith365, Aug 7, 2017.

  1. keith365
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    keith365 Active Member

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    I had a prospect call me 2 hours before our appointment. They had both decided to buy plan F from UHC in Florida. But, they spoke with a woman who said that UHC wouldn't cover her elderly mother for some things. She said that its not true that someone with a supplement can go to any provider that accepts Medicare. She said that these doctors have to have a "contract" with the insurance companies. And, maybe this doctor wasn't contracted with UHC? She also said that UHC has been changing their contracts to get out of paying for services that even Medicare has said is necessary. This woman who gave this advice used to "do billing for insurance". And, her husband owns an MRI imaging practice. Does any of this make sense to anyone?! Thanks.
     
  2. LostDollar
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    LostDollar Well-Known Member

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    Plan F-Medigap/MedSupp vs Medicare Advantage?

    Is "a woman"'s elderly mother in a Medicare Advantage plan?

    (And even in a MediGap plan-MediGap will not cover anything Medicare does not cover. It is probably also a true statement that Medicare will not cover the elderly mother for some things.)
     
    Last edited: Aug 7, 2017
  3. ModernInsGuyOH
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    ModernInsGuyOH Member

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    Sounds like they may be referring to a Medicare Advantage or maybe a Medicare Select supplement?
     
  4. Chazm
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    Chazm Well-Known Member

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    This is common. They are indeed referring to a MAPD.

    I have clients all the time say, "my doctor wont take UHC, Aetna, MoO" etc. I let them know it's not their choice. I let them know that their plan is not primary, Medicare is and if the doctor accepts Medicare then they can see them. The doctor bills Medicare. End of story. I let them know that what they are referring to is an Advantage plan, which would be primary to Medicare and then they would have to make sure the Dr. Takes it.

    There is no contract with a Med supp and a Dr. If that doesn't work, I tell my client that we can give the office a call together and I will explain it to the lady at the front desk
     
  5. TwoCents
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    TwoCents Well-Known Member

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    I wouldn't assume anything. No need to get into an argument about what someone else is filling their head with. Walk away.
     
  6. GreenSky
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    GreenSky Well-Known Member

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    Really? I educate people all the time and am able to write more business because of it.

    Rick
     
  7. ritterim
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    ritterim Member

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    It is true that someone with a supplement can go to any provider that accepts Medicare. The contracts/networks apply to Medicare Advantage products, unless it is a Medicare Select Supplement (Select Plans utilize networks as supplements), which UHC does offer.
     
  8. Todd King
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    Todd King Well-Known Member

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    The CSR at UHC obviously doesn't know what the hell she is talking about when it comes to the differences in a Med Supp and a MAPD.
     
  9. traceyemoon
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    traceyemoon Well-Known Member

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    First, it shouldn't be an argument, but an informational conversation. Explain that there is a difference between a supplement and MAPD and that many people confuse the two. People aging into Medicare are bombarded with so much info, it's no wonder that the lingo can get mixed up by a layperson.

    I agree with Rick. Education, then sale, then referrals by satisfied people who know more than they did before because you took the time.
     
  10. roygbiv
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    roygbiv Member

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    You see this a lot in the field and it makes sense that it comes from someone in billing. The billing person is misleading the prospect, albeit not intentionally as much as it is ignorance. She is confusing the Medicare Advantage plans with a Medicare Supplement. Many people just categorize both as "supplements". Medicare Supplements have to cover what Medicare covers...end of story. MA plans still must cover the basics, but have authority to set measures in place to deem necessary services and they can change their contracts within Medicare guidelines. It's your job to make sure that your prospect knows that YOUR the licensed insurance professional and the billing person is not.
     
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