You guys want MA to fail so bad but ain’t gonna happen. As Part B premium, deductible, and Med Sup premiums keep going up it’s gonna get worse and worse. Not to mention the price of dental work these days. And not to mention what the crappy stand alone drug plans are gonna do when they have a 2000.00 cap on out of pocket in 2025. You are fighting a losing battle but keep trying every day.
Medicare Advantage Plans being dropped left and right
- Thread starter Robduq23
- Start date
You guys want MA to fail so bad but ain’t gonna happen. As Part B premium, deductible, and Med Sup premiums keep going up it’s gonna get worse and worse. Not to mention the price of dental work these days. And not to mention what the crappy stand alone drug plans are gonna do when they have a 2000.00 cap on out of pocket in 2025. You are fighting a losing battle but keep trying every day.
- 2,111
Yet I can take my raggedy ass supplement and check into any of those hospitals mentioned above. You guys can't even get your parking validated.
And we're the ones losing?
Keep telling yourself you are better off on Med Sup. You may actually start believing it. Ha
- 29,489
I notice some of the MAPD plans are putting deductibles on the RX.
This is very true.
I mean, doctors will fudge things to line their pocket books so they figure out a way to miraculously get 3 days at the hospital.
Had a Plan G guy recently his wife telling me how thankful she was for G. Her husband was in "Rehab" (the SNF) for "3 months." He though he should have gone home much sooner but they "wanted to keep him" and it "paid for everything."
I thought: great. They didn't want to send him home because his insurance was paying too well!!
There is no honesty in the system. Well, very little. Providers love the blank check of Medicare. You can't convince me they don't over prescribe and unnecessarily test. And insurers love red tape. It's all a racket.
My book is 100% OM + Medigap, yet I get a handful of calls from mostly new clients who are told by office staff "We don't take your plan".
Even though I tell them the doc does not need their Medigap card, they will still show it along with their Medicare card. Sometimes the office hands the Medigap card back because that plan isn't listed in our "system".
Last year a new client visited a providers office, owned by a large local hospital, and was told they had to pay a copay up front because the carrier isn't on their list. When the client called me I looked on the website and it clearly states they accept ALL MEDICARE SUPPLEMENT PLANS but does have a list of MA plans they don't accept.
The client goes back to the office and takes a printout from the website and was told they didn't know her card was for a supplement plan.
A few years back, similar problem. The Anthem contract with a local hospital was non-renewed and the business office sent a memo to all departments, free standing clinics and physician groups owned by the hospital, instructing them not to accept patients with Anthem MA plans.
A couple called in January frantically wanting me to change them to an Aetna MA plan because the office staff told them they had to change because they were no longer taking Anthem plans.
The memo clearly stated the hospital and subsidiaries would not accept patients with Anthem MA plans until further notice. There was no mention of Anthem supplement plans, only MA, yet they were refused. I called the office manager and was told the same thing . . . no Anthem plans would be accepted. I had to get someone from Anthem to contact the provider office manager and the hospital business office manager to get this straightened out.
This rarely happens, but still it is something I have to deal with from time to time.
And yet, there are agents here that state their MA clients have NEVER been refused by a provider office.
I find that difficult to accept.
Even though I tell them the doc does not need their Medigap card, they will still show it along with their Medicare card. Sometimes the office hands the Medigap card back because that plan isn't listed in our "system".
Last year a new client visited a providers office, owned by a large local hospital, and was told they had to pay a copay up front because the carrier isn't on their list. When the client called me I looked on the website and it clearly states they accept ALL MEDICARE SUPPLEMENT PLANS but does have a list of MA plans they don't accept.
The client goes back to the office and takes a printout from the website and was told they didn't know her card was for a supplement plan.
A few years back, similar problem. The Anthem contract with a local hospital was non-renewed and the business office sent a memo to all departments, free standing clinics and physician groups owned by the hospital, instructing them not to accept patients with Anthem MA plans.
A couple called in January frantically wanting me to change them to an Aetna MA plan because the office staff told them they had to change because they were no longer taking Anthem plans.
The memo clearly stated the hospital and subsidiaries would not accept patients with Anthem MA plans until further notice. There was no mention of Anthem supplement plans, only MA, yet they were refused. I called the office manager and was told the same thing . . . no Anthem plans would be accepted. I had to get someone from Anthem to contact the provider office manager and the hospital business office manager to get this straightened out.
This rarely happens, but still it is something I have to deal with from time to time.
And yet, there are agents here that state their MA clients have NEVER been refused by a provider office.
I find that difficult to accept.
It's getting boring buddy. You obviously have a small book given the number of posts during AEP. When it grows, you will eventually get that dreaded mapd client call. Doesn't seem like you will feel guilty, and I doubt you will share THAT story when it happens.
Only one I have seen was BCBS and that’s been that way for awhile. I think because they are BC they think they can get away with it and people will still buy. Not to say it couldn’t happen in 2025 when PDP’s change dramatically due to new rules. Something has to give with the drug plans.
InsuranceGuy29
Guru
- 405
What these supplement-only guys don't understand and realize is, every time they bash Medicare Advantage, they're making their OWN job more difficult and subject to scrutiny. Outside of this industry, no one knows any of this stuff. All they know is you're a health insurance agent that helps with Medicare.
These regulator @ssholes....same thing. They're not agents. You're all trying to bash Medicare Advantage as a business tactic and all you're doing is drawing insane scrutiny to our entire industry, because you're sensationalizing things.
My own parents have been on Medicare Advantage for 14 years. Literally zero problems, and my mother has some significant health issues. As a result of your actions, regulators and people think there's these HUGE problems with MEDICARE AS A WHOLE (that includes you, supplement-only agent), when there is not.
You're gonna get the entire industry upended and ALL of our pay slashed (yours included...Fauxcahontas Lizzie Warren already started digging into supplement bonuses), because they all think we're rolling in dough (I sure as hell am not, after taxes and agency fees are accounted for) and signing people up for "crap," when all my Medicare Advantage clients are perfectly happy on it.
It'd be nice if some people started using the 3 pound lump of shit inside their heads and see the big picture for once.
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InsuranceGuy29
Guru
- 405
It's what a lot of these supplement-only guys don't understand. Some of these companies have INSANELY good networks, nowadays. My guess is, because these guys never write Advantage plans, they think it's still 2007, where 5 doctors and 4 hospitals fell in-network and the only thing available were HMO's.
My area.....Aetna. 100% of hospitals are in-network in the region. I look up 100 doctors, 95 are in-network, on average. It's to the point where I'm shocked when I see a doctor who isn't in-network, and my broker manager always says to reach out to him when it happens so that they can reach out and get them in-network.
If a doctor is out-of-network, guess what? Doesn't really matter. It's a PPO. Instead of paying $30 when they see them, they pay $40. Holy shit, the HORROR, I tell you! Not a.....(((GASP))) $10 difference!!!!
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