- 598
I just remind people that, "you get what you pay for".
Do you ever come across someone paying $200 per month for an MAPD? What do they say about how much they're getting out of it?
Medical Necessity
- Thread starter somarco
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- medical necessity
Do you ever come across someone paying $200 per month for an MAPD? What do they say about how much they're getting out of it?
- 29,487
Don't think I've seen any that high. That would be dumb to carry one of those.
fun2drum
Super Genius
- 140
It's interesting to me that the lady had the N plan, which is basically a med supp option to reduce premium by paying some deductible and copays. People with an F plan always complain about premium but just try to take it away from them. Show them anything with a copay no matter how cheap or how many free toys it comes with and they'll say "but I don't pay nothin' at the doctor! NOTHIN'!"
joe92275
Super Genius
- 165
Once in ahwile I'll get someone like you just fired. I let them ramble on and on, I agree with them and offer them some "options". I let them know I would help them write a letter to their congress person and advocate on their behalf....but then the hammer comes down and I tell them that despite how you feel, this is how it is....love it or hate it....it is what it is.....you can either work with it or work against it...its up to you.....and I basically do whatever they want but just make sure they understand the risks.
I have learned over the years it is so much easier to agree then to argue/debate.
I have learned over the years it is so much easier to agree then to argue/debate.
- 1,737
Debating the opposite point here for contrast. Why wouldn't a healthy person just enroll in an MAPD & make a Iarge emergency fund instead of spending increasing thousands of dollars a year for MedSupp premiums if they are healthy? Maybe no discipline?
Some want to be able to go anywhere they wish for medical treatment, & don't mind paying for the option, and I can relate to that. Some are lovers of low cost HMO's. I have family members on both sides of this divide.
I am trying to help one of my clients' family friends. The situation has gotten out of hand with out of pockets on the parents' MAPD's, $6,700 each. Sad. They won't change doctors to get into an MAPD carrier with lower max out of pocket. They didn't know about asking manufacturers for financial help with prescriptions or the hospitals that waive payments for out of pocket for under 200% of poverty level. Couldn't afford MedSupps at this point, even if they could pay for them, let alone qualify medically. That gray area of not qualifying for Medicaid, and not doing well managing the possible ways to reduce the debt. Really ill MAPD insureds with enough money to be above the line for financial help on their out of pocket costs can be pretty frustrated as the bills mount. No perfect answers.
Some want to be able to go anywhere they wish for medical treatment, & don't mind paying for the option, and I can relate to that. Some are lovers of low cost HMO's. I have family members on both sides of this divide.
I am trying to help one of my clients' family friends. The situation has gotten out of hand with out of pockets on the parents' MAPD's, $6,700 each. Sad. They won't change doctors to get into an MAPD carrier with lower max out of pocket. They didn't know about asking manufacturers for financial help with prescriptions or the hospitals that waive payments for out of pocket for under 200% of poverty level. Couldn't afford MedSupps at this point, even if they could pay for them, let alone qualify medically. That gray area of not qualifying for Medicaid, and not doing well managing the possible ways to reduce the debt. Really ill MAPD insureds with enough money to be above the line for financial help on their out of pocket costs can be pretty frustrated as the bills mount. No perfect answers.
Because they might not be healthy tomorrow.
- Thread starter
- #27
This woman is healthy but also wants (expects) anything and everything to be paid for by Medicare. She refuses to allow a carrier to direct her care.
In other words, the "rules" don't apply to her.
She has been a PITA ever since she signed up for Medicare. This year she pushed too far and I booted her.
In other words, the "rules" don't apply to her.
She has been a PITA ever since she signed up for Medicare. This year she pushed too far and I booted her.
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It feels good when you are not strapped for money and can afford to pick and choose with whom you want to do business..
joe92275
Super Genius
- 165
You did the right thing by letter her go. People like that steal our time away from others who truly need it and value it.
- 1,737
It is possible to imagine a medical condition that could go on for years with some kind of expensive treatment that could use up much of the maximum out of pocket on a Medicare Advantage. I wonder what the percentage is of those who pay thousands of dollars for Medicare supplements over the years, then die in their sleep, vs those who have Medicare Advantage and spend more than the average a supplement would have cost them over the years. One big problem, most who buy MA's don't or can't set aside enough money to have a decent emergency fund.
