Med Supp vs Med Advantage in Georgia

Dec 2, 2008

  1. Slim
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    Slim Super Genius

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    Is there some help for retired Military Veteran on Oriignal Medicare with Supplement C (I believe) and Tricare (For Life, I think)?

    He is diagnosed with diabetes , CHF (Chronic Heart Failure) and COPD ( Chronic Obstructive Pulmonary Disease?) .

    If he wants a SNP for Chronically Ill beneficiaries (Medicare Advantage) will that improve his position in receiving care in his last days/years? In state of GA ?

    If so what company has a plan which works, coordinates or compliments his current Tri-Care plan benefits.

    He needs to improve his position by either more in-home care if he gets out of hospital again, and through rehab again , and gets to go back home again . He has the fight in him but needs caregivers. He is not dual eligible.

    Last hospitalization (16 days) about one month and a half ago and then 10 days in nursing rehab. Home for several days with relative , short-term nurse then quickly relapse when left alone to care for self independently.

    His nursing home stay was, he did not fit in because he was too healthy and able. He is now in ICU in another Georgia hospital with another round of pneumonia. Getting excellent care but when he gets home he will need time still if he is able to get home.

    It is my assumption that he may have more benefits available for lower or similar costs to get specialized treatment/benefits available more in line with his condition and with his need for long - term in - home care .

    His condition may not be terrible enough for Nursing Home constantly. He needs better care though and better benefits and is a retired veteran . hHe lives alone in rural GA.

    Any help would be appreciated if he can help improve his current position and improve his quality of life and possibly prolong it , if he is eligible for a Med-Advantage without losing Tri-care.

    Do you have any opinion or guidance or plan to help a client like this?
    Would you have any advice for him to make a best possible decision?
    I have asked a nurse and a social worker and the client and his power of attorney.
    I am not sure if my assumptions are worth him considering to possibly help him, or if it is totally erroneous of me to think he can improve his current position.
    Do you know of any help for such a Medicare Beneficiary?

    I am in TN and have no "Mediicare and You Book" and have not found anything in research to help him any better than I have so far. Thanks for your input.
     
    Slim, Dec 2, 2008
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  2. jacobtn
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    jacobtn Guru

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    dude this sounds like a mess. first off, guy has tricare than he is wasting $$ on supp. doesn't need it. I'd stay away from this and move on to the next healthy senior looking for med supp or annuity.
     
    jacobtn, Dec 4, 2008
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  3. Todd King
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    Todd King IMO/FMO Owner

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    Jacob is right, he doesn't need a supp if he has tricare. I have a few clients that have tricare and a supp. Can't convince them to drop the med supp though. It's like they are afraid that tricare will fold on them or something.
    You can d/l a copy of the medicare and you handbook from medicare.gov.
     
  4. Russ
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    Russ Guru

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    Slim...I wouldn't touch that prospect either.

    Speaking of Tricare....I lost about 20 grand a year in renewals when it started...believe it was Oct. 2001. Med-supp renewals were falling off like bowling pens in a perfect strike. Plus the sales I might have made.

    Just about everyone that had a med-supp with me that got Tricare has dropped the supplement. There's no need for it.
     
    Russ, Dec 4, 2008
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  5. Slim
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    Slim Super Genius

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    Thanks for the info.

    Does this mean the Medicare Advantage is not necessary with TriCare beneficiary either?
     
    Slim, Dec 4, 2008
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  6. Bob_The_Insurance_Guy
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    Bob_The_Insurance_Guy Guru

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    I am not a Social Worker, but I am married to one - who works for the VA. Have to agree. If he's on Tricare there is nothing you can do to better his situation. He does need to contact the VA and be assigned to a better case worker perhaps.

    The VA is growing its footprint in Georgia. Let me know what part of Georgia he's in, and I can ask my wife where he needs to go and what services he needs. Beyond that, turn and walk away. It will tug at your heart. Don't let it take you down.

    Some vets, and I'm not implicating this gent, know how to "play" the system by being a victim and presumably not getting proper treatment.
     
  7. Joe Moore
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    I have never seen a situation where an agent could help a TriCare beneficiary with a Medicare Supplement or a Medicare Advantage Plan. Medicare acts as primary and TriCare acts as their supplement.

    We teach our agents to leave TriCare alone.
    Just VA benefits is a different story.
     
  8. Slim
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    Slim Super Genius

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    I appreciate the input. Was trying to help a relative. Turned out too late. He desreved better than he got I'm sure. He didn't live off of or try to milk the system . I guess he just wasted money on a supplement he should have dropped years ago.
     
    Slim, Dec 10, 2008
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  9. Joe Moore
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    I had an interesting call yesterday on the TriCare subject. An old high school classmate had enrolled with us with an MAPD in August, at the time he thought he was losing his TriCare.

    Our thought was there would be no problem; he would only be left with Original Medicare, so a Medicare Advantage would work fine. The problem was he really did not lose TriCare until February, 2009.

    As he told me, "nobody is paying my bills, I don't know what to do". He has spent the most of this week on the phone trying to get some answers, but has none. I really did not know how to advise him except to bug Medicare until they could get the mess straight. I suggested if TriCare could cancel back until August 2008, then everything possibly would fall into place.

    Anybody got any ideas, or been through this type of situation before?
     
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