Medicare Advantage Plans being dropped left and right

Question for those MAD agents that look up docs for prospects and always find 100% participation.

When you look for docs they may need in the future, is the participation level still 100%

And what do you tell prospects to do when the MCO contract is not renewed?

Keep trying, hasn't been an issue for at least 6 years now. I look up Drs daily and have yet to see one that wasn't in network with UH and Aetna. Maybe I'm just lucky to live where I do.
 
OM won't pay for skilled nursing if you were under observation and not admitted for 3 days. MA pays whether under observation or if you were only admitted for 1 day instead of 3. The copay for observation is usually $350 on MA plans. Figured you knew that already since you are all MA experts even though you have never looked at a plan guide. Gee, maybe I should start using this as a scare tactic. Nah, no need they already can see MA is usually their better option without trying to scare them.
You might want to read the article I posted.
 
As far as Observation Status goes, you're making it out as some kind of death penalty.

I seriously doubt that a lot of agents have had to deal with it. I have. Hell, I doubt that some agents on here even know what it is.

Here's a pretty good article that describes it.

[EXTERNAL LINK] - What Is Observation Status And How Does It Affect Those On Medicare?

Surely over the last 5 years you have had a few clients on Med Sups that were under observation and then sent to skilled nursing only to find out they aren't covered and have to pay 100% themselves. Hell I have very few on Med Sups and I had a couple get hit with it.
 
I have always wondered how agents can say with such confidence, that any provider you use now, or will EVER USE IN THE FUTURE, will always be in network.

Apparently the folks they are pitching are uneducated enough to believe such bullshit that they will buy anything if it sounds good.

I participate in another (private) forum where most of the agents are new, and most write almost 100% MAPD because that is what their upline pushes.

The folks they deal with have no money and always (seem) to be in really bad health yet the docs push the most expensive meds that are rarely covered by a formulary, and both the prospect and agent are looking for assistance to help pay for the drug.

Many times the drug is a last ditch effort that will (most likely) neither cure the illness nor extend their life for more than a few months. It's almost like they are guinea pigs used for testing drugs for hail Mary situations . . . lots of money for folks who will spend their last few months in misery.

It is a side of medicine you don't really want to see, but like a train wreck, you are also compelled to watch.

I honestly don't know how some agents sleep at night, selling their soul to the devil for a few extra commission dollars.

These folks will never get well and the medical bills will never be paid. In the interim they will be shot up with expensive poison that is usually worse than the illness.
 
I have always wondered how agents can say with such confidence, that any provider you use now, or will EVER USE IN THE FUTURE, will always be in network.

Apparently the folks they are pitching are uneducated enough to believe such bullshit that they will buy anything if it sounds good.

I participate in another (private) forum where most of the agents are new, and most write almost 100% MAPD because that is what their upline pushes.

The folks they deal with have no money and always (seem) to be in really bad health yet the docs push the most expensive meds that are rarely covered by a formulary, and both the prospect and agent are looking for assistance to help pay for the drug.

Many times the drug is a last ditch effort that will (most likely) neither cure the illness nor extend their life for more than a few months. It's almost like they are guinea pigs used for testing drugs for hail Mary situations . . . lots of money for folks who will spend their last few months in misery.

It is a side of medicine you don't really want to see, but like a train wreck, you are also compelled to watch.

I honestly don't know how some agents sleep at night, selling their soul to the devil for a few extra commission dollars.

These folks will never get well and the medical bills will never be paid. In the interim they will be shot up with expensive poison that is usually worse than the illness.


Nice, found a couple new scare tactics. Keep trying but you are losing the battle to people who see right through your bullshit you post daily. Wrote 9 MAPD's today, hope they don't all die tomorrow like I've heard will happen.
 
Have an agent look up all your Drs and Hospitals within 100 miles and see how many aren't in network. You may be amazed. Be careful with OM bc if you aren't in the hospital for at least 3 nights they won't pay. Also if under observation they won't pay. More rules that you don't have to worry about with MA plans.

I can look it up myself. I'm certified with most plans around here. Just because they are today doesn't mean they will be tomorrow.

[EXTERNAL LINK] - Baptist Health, out of Humana Medicare Advantage network since Sept. 22, is now in a similar dispute with insurer United Healthcare – Kentucky Health News

https://www.cleveland.com/metro/202...cy-health-anthem-blue-cross-isnt-settled.html
 
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