I think it's cute Somarco trying to help you out for once after you have tried covering his ass hundreds of times. I need to find me a wingman on here.
Older Americans say they feel trapped in Medicare Advantage plans
- Thread starter Duaine
- Start date
Maybe not their (seniors) fault.
Or maybe it is. I sold my house in Ohio and moved to NC. I would assume I can't just go back... Unless they're willing to sell it back to me. Should I assume, (a) they will and (b) they'll do it at the same price?
I quit my job at Staples selling electronics. Should I assume I can just walk in with a red shirt and sell extended warranties on laptops?
Maybe "no one told them." Maybe they didn't ask. Maybe they should have asked.
But that's not the responsibility of the MA plan. Guess what? They can't go back to Obamacare either. They can't go back to their old employers coverage either. They can't go back to pre-ACA coverage either.
Seems like we're back to that personal responsibility sphere of life.
Some of you may recall my recent client who just had his leg amputated. I spoke with him yesterday. His prothesis representative recommended that he buy a med supp. So he called me to inquire. I didn't beat around the bush. I said, that's the plan I quoted you $110/mo (or whatever) for when you turned 65 that you didn't want. We can't get that now, you wanted to pay $0. So your prosthetic leg will be 9% coinsurance up to your Max OOP.
He chose his plan. He may not like it now but it's what he picked. That is not Humana's fault and it's certainly not mine...
That's life in the big city.
I sat down with a T65 on Tuesday and he was dumbfounded and shocked that he would have to pay $174.70 per month for Part B.
No one ever told him.
We should probably waive that fee for him...and everyone else who tells us that they thought Medicare would be free since they paid into it.
Socialism is amazing! Bernie!!
InsuranceGuy29
Guru
- 842
That would be because of initial bias. All they knew when they went on Medicare was a supplement. They simply got used to "paying nothing" at all points of service.
It doesn't actively dawn on their conscious brain that they are indeed paying a lot of money per month for that benefit, and also missing out on a lot more benefits that original Medicare doesn't offer.
Their brain got used to simply going somewhere and paying zero copays, so of course that bias is going to stick. Of course no one is gonna want any copays, if given the choice.
But they don't realize that choice comes at a large monthly price in both added premium and tons of extra benefits that they're missing out on.
I've tried to logically sit down and explain this to many people and it's like I'm talking to wet paint on a wall. It's very caveman logic bias. All they know and are used to is..... "Doctor...no pay. Hospital....no pay. Me no want copay."
Why? Simply because they're not used to some copays. Their brains interprets it as them spending extra money, when it's actually the opposite in most cases.
For most people that initially had a supplement, telling them they have a $10 copay is like telling them their house is gonna burn down tomorrow. It's not a big deal, but in their biased brain it is, because it's not what they're used to.
It's no different than switching someone that was always on a Medicare Advantage plan to a supplement. It goes like this....."You mean there's no more dental, vision, hearing, OTC card, copay spending debit card, gym membership, health gear allowance, and I have to PAY a huge premium every month???? Yeaaa, NO THANKS!"
It doesn't actively dawn on their conscious brain that they are indeed paying a lot of money per month for that benefit, and also missing out on a lot more benefits that original Medicare doesn't offer.
Their brain got used to simply going somewhere and paying zero copays, so of course that bias is going to stick. Of course no one is gonna want any copays, if given the choice.
But they don't realize that choice comes at a large monthly price in both added premium and tons of extra benefits that they're missing out on.
I've tried to logically sit down and explain this to many people and it's like I'm talking to wet paint on a wall. It's very caveman logic bias. All they know and are used to is..... "Doctor...no pay. Hospital....no pay. Me no want copay."
Why? Simply because they're not used to some copays. Their brains interprets it as them spending extra money, when it's actually the opposite in most cases.
For most people that initially had a supplement, telling them they have a $10 copay is like telling them their house is gonna burn down tomorrow. It's not a big deal, but in their biased brain it is, because it's not what they're used to.
It's no different than switching someone that was always on a Medicare Advantage plan to a supplement. It goes like this....."You mean there's no more dental, vision, hearing, OTC card, copay spending debit card, gym membership, health gear allowance, and I have to PAY a huge premium every month???? Yeaaa, NO THANKS!"
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So you expect people to ask questions about a subject they know nothing about? That's your job. To educate them so they can ask the right questions.
You're right. Wasn't Humana's fault. But may have very well been yours.
Did you take time to educate him about the differences between MA and OM. The pros and cons of both plans. Or did you just take his order.
Since I don't know you nor do I know what or how you sell, I can't say. But you can.
Doubt that's going to happen. You have to post something first.I think it's cute Somarco trying to help you out for once after you have tried covering his ass hundreds of times. I need to find me a wingman on here.
- 30,531
I don't believe when agents say tHeY nEvEr hEaR aNy cOmPlAiNtS (sO cOoL tHe wAy yOu dO tHaT). I know an 85 year old lady that has a HuMaNa MaPd. She had some out-patient surgery scheduled 10 days ago that had to be postponed because of a PA. sTiLl wAiTiNg."NPR." Forgive me while I collect myself after belly laughing on the floor for 5 minutes.
Okay, I'm better now. Yes, the "horrors" of $0 monthly premiums, absolutely no deductibles, WAY more benefits than original Medicare, and being able to get a million dollars worth of medical services for an average of $3,000/year, tops. THE HORROR!!!!!!
NPR won't stop with their sensationalism and propaganda until everyone is sucked into their "utopian" ideal of "MedicAID-For-All."
They say "MediCARE-For-All," but the shitty system they describe is MedicAID. No different than Commie Obama and "if you LiKe YoUr DoCtOr you can keep yOuR dOcToR." Yea, that was indeed a huge lie. Surprise, folks, the government lies constantly!
The fact of the matter is, these people hate anything that's "for-profit," while simultaneously not realizing that, by law, most of the profits MUST go towards Medicare beneficiaries.
I challenge them to name me anything that isn't "for-profit." Hell, even charities are for-profit. These tree-huggers, that are completely out of touch with reality, just hate insurance companies.
That's what this is REALLY all about. So they sensationalize and exaggerate while leaving out key details and nuances.
"Mr. Johnson couldn't get care when he needed surgery on those evil Medicare Advantage plans," and as you dig into the details it turns out that Mr. Johnson's inept doctor's staff submitted the wrong code, which caused the delay.
It's funny because, I have a lot of clients on Medicare Advantage (as well as supplements), and my Medicare Advantage clients never run into these "HORRORS!" that they speak of. So something just isn't adding up.
People in this country have access to the most advanced first-world care that keeps them alive for INSANELY longer than average human expectancy, and what do they do? They still bitch.
This care is massively expensive. It's not "free," nor can it be. If I was them, I'd be appreciative that these plans even exist.
It's just another symptom of a MASSIVE entitlement complex. Not surprisingly being led by massively entitled Baby Boomers.
Spend a few weeks in Nigeria and then tell me how "tRapPeD" you feel by your Medicare Advantage plan, you entitled and unappreciative dopes.
Keep that shit up and I'll personally come up there and take your keyboard away. You almost broke my left eyeball.
InsuranceGuy29
Guru
- 842
rEadiNg ComPreHensiOn.....iT's A SkiLL. Can you show me the line where I said I never receive complaints? I said "they never run into these horrors." "Horrors" meaning, massive issues. There's a rather large difference.
To my knowledge, the longest one of my clients ever had to wait for an elective/non-emergency surgery PA was about 3 days. World ending!! I know. Emergencies....never had an issue. But since we're on the topic, the general complaint department is super small, and I talk to all these people regularly and make it a POINT to ask them about them.
Complaints are indeed very few and VERY far between. Usually minor goofy stuff that is often the fault of the doctor's office errors, delayed paperwork, etc. The few PA's are usually very quick. BUT...the AMAZING thing is over the past year CMS has passed new regulations to streamline any and all prior authorizations.
Insurers have also voluntarily reigned in PA's by about 20%, and the most common things that are always ordered are just getting auto-approved. I know the sky is always falling in the anti-Medicare Advantage world, but here in the real world and on the ground floor, satisfaction rates are still sky high. So, as I said before....something just isn't adding up.
Some people just can't grasp that things change. 6 years ago if someone came to me asking about a Medicare plan, I would've said "Well, you've got a choice between a Plan G or a Plan F.......and a Plan G or a Plan F......take your pick."
Nowadays, Medicare Advantage plans have gotten too good. PPO's coming on the scene was a huge game changer, along with increased pressure to reign in PA's and streamline and auto-approve all codes that original Medicare covers.
To my knowledge, the longest one of my clients ever had to wait for an elective/non-emergency surgery PA was about 3 days. World ending!! I know. Emergencies....never had an issue. But since we're on the topic, the general complaint department is super small, and I talk to all these people regularly and make it a POINT to ask them about them.
Complaints are indeed very few and VERY far between. Usually minor goofy stuff that is often the fault of the doctor's office errors, delayed paperwork, etc. The few PA's are usually very quick. BUT...the AMAZING thing is over the past year CMS has passed new regulations to streamline any and all prior authorizations.
Insurers have also voluntarily reigned in PA's by about 20%, and the most common things that are always ordered are just getting auto-approved. I know the sky is always falling in the anti-Medicare Advantage world, but here in the real world and on the ground floor, satisfaction rates are still sky high. So, as I said before....something just isn't adding up.
Some people just can't grasp that things change. 6 years ago if someone came to me asking about a Medicare plan, I would've said "Well, you've got a choice between a Plan G or a Plan F.......and a Plan G or a Plan F......take your pick."
Nowadays, Medicare Advantage plans have gotten too good. PPO's coming on the scene was a huge game changer, along with increased pressure to reign in PA's and streamline and auto-approve all codes that original Medicare covers.
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I have had more people reference their part b cost, in the last year, than I ever remember. It seems that @DonP is correct about the impact of Ocare. There are so many that are accustomed to paying $0-$100, that the very idea of paying a Medicare premium is unsettling.
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