Selling MAPD? Hear From the Provider Side
- Thread starter rousemark
- Start date
XpressInsurance
Super Genius
- 244
If all that really happened, I would be happy to be alive and the last thing I would worry about it who paid the hospital. I would be more concerned about lifestyle changes to make things better.
Hmm thats odd, The first thing I would be thinking about how was my access to care, How well was it covered
In fact my MIL went through it when she signed up for Medicare she didn't go through me she and husb both went through cancer on MA plans he died too, and when she moved her I got her GI for med supp
She is going through dialysis now and she really notices the difrence in both access to care and cost
- 6,472
Hi,
Nice to see you posting.
You have probably not followed all of rousemark's health posts.
If he posted this, there is no doubt in my mind that it happened. He is a long-term stage 4 cancer survivor and has already had to make a bunch of lifestyle changes. He is NOT one of the ones that needs the "lifestyle change" lectures.
I can tell you from my own very recent experiences there is a level of assurance that at least some of us receive from knowing that we have Medigap coverage with the original medicare and we don't have to worry about doctor networks.
He is just using his health experiences to validate his opinion in the Medigap vs MAPD argument, just as a FL agent who is probably my worst hater on the forum, in telling me that HDF was probably the most stupid purchase I could make, used his MAPD experience with a, then recent, serious medical event to justify his opinion about MAPD.
Regards,
LD
XpressInsurance
Super Genius
- 244
I am not lecturing anyone. My point is that if he has survived these health problems he should be happy that he is alive not whoever is going to pay the bill. I have been selling Medicare plans for a very longtime. I see people in bad situations both with Supplements and MAPD's. I don't agree that without a supplement you are not going to get the proper care. Very few people survive stage 4 cancer. Many seek clinical trials which coverage is very limited because it is a clinical trial vs. a proven treatment (not any real good cure for cancer).
People tend to seek treatment with hospitals and doctors in the local community that they are comfortable with. I myself would buy a MAPD. I am a type 1 diabetic, I am 55 years old. I do everything to take care of myself, so that I don't end up with long term problems. I got into this business of selling health insurance because I understand the cost. I see how much I have put out in medicine for almost 40 years. I also inform myself and don't blindly follow everything doctors say.
KandKsmommy
Expert
- 99
Sending prayers I cannot imagine the hell you have been through.
As for MAPDs having worked for a hospital the number of issues I have seen and the bills that came along with them has made me do everything I can to help people get Med Supps before resorting to them. I have had cancer patients denied scans to check on the progression with 5 peer-peers done, individuals unsafe to go home denied additional days in Swing Beds, Psych patients getting denied more than 3 days after having a suicide attempt, and on and on. I always try for grants to cover premiums before resorting to MAPD due to cost and I always caution clients interested in them due to the cost on the potential bills they will face if they have something major happen.
- 4,039
Just saw this post. I’m sorry to hear this! I’m praying now, and will continue to pray for you. Feeding tubes aren’t any fun! Several of my family members who passed away from ALS lived the last several months of their lives with a feeding tube. The good thing was that helped them stay with us a little longer. Praying for a quick recovery, and that you’ll be able to be there for that little girl into her adult years.
- 4,039
I’m turning 65 in July. I’ll be writing a Plan G on myself, the same as I wrote on my wife when she turned 65 a couple years ago. She has multiple health issues and has to see a pain management doctor every month. We’ve only had a couple of issues with things not being approved by Medicare, which we’ll be appealing. Other than those couple of glitches, it’s been a great experience! I’ve never been a fan of HMO’s, anyway. No reason to become one now.
- 29,516
Chances are that you don't need to appeal. Chances are that the provider didn't code it correctly, and if they refile with the correct code, it'll get paid.
99 times out of 100 when I get a bill from a client if its an issue its either that,
Or actually most of the time it says this is not a bill on it
but if its actually bill its miscoding the only time it was an actual denial was when extra therapy needed to be applied for which I told her to have doc do, She did and got approved
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