Silver script $63 a month in 2024 with $525 deductible. Best silver script $116 a month
- Thread starter DonP
- Start date
ValeRosso
Guru
- 591
They wouldn't take ANY MAPD in AZ...with a Mayo campus in AZ? That's rough if so.
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ValeRosso
Guru
- 591
Yeah I made it this far without Wellcare, hoping I can continue that...UNLESS SS blows up then Ill have to do it.
Crazy. If they refused to buy, what happened then? Did they still have the late enrollment penalty for Part D then?
PDPs (and the attendant LEP) were introduced in 2006, so yes.
Mayo Warns It Won't Take Most Medicare Advantage Plans
— Letters to Florida, Arizona patients suggest they enroll in original Medicare with a supplement
The Mayo Clinic sent letters this fall to all eligible Medicare beneficiaries who received care at its Arizona and Florida facilities in the last 3 years, warning them that it is out-of-network "with most Medicare Advantage plans."
The letter sent to Florida beneficiaries said that "marketing for Medicare Advantage Plans may indicate that you can be seen at any facility that accepts Medicare, however Mayo Clinic in Florida is out of network on these plans."
Asked about the reasoning behind the letters, Mayo communications manager Kevin Punsky replied that they are intended to serve as "a courtesy reminder" at the start of the annual Medicare re-enrollment window that began Oct. 15. They are intended to notify those eligible for Medicare that if they want coverag
"This notice allows the patient to make an informed selection of coverage if the patient would like to seek a plan that has Mayo Clinic in network. Out-of-network care is not in the best interest of patients and does not support Mayo's model of care."
The letter also advises recipients that the Mayo Clinic "will not schedule appointments for patients with out-of-network Medicare Advantage Plans."
Medicare Advantage plans have been under increasing scrutiny and investigationopens in a new tab or window because so many of them have been accused by federal agencies of denying care, exaggerating the severity of illnesses to pull billions more from Medicare, and delaying care with lengthy prior authorization requirements.
Additionally, unhappy enrollees who want to disenroll often find they can't sign up for a supplemental plan without underwriting, which can result in rejection of beneficiaries with certain common underlying health conditions.
https://www.medpagetoday.com/special-reports/exclusives/101320
And the LEP for PDP is not owed until they rejoin a pdp plan in the future, if they ever rejoin
Most of them are still without coverage AFAIK. Over the last few years some have asked about getting coverage. When I tell them the LEP is now $30 - $40 plus the premium they opt to stay uninsured (for Rx).
I show them how to use discount cards like GoodRx and SingleCare for generics and how to find generics and brands in Canada https://www.mapleleafmeds.com/ . Many times this combo approach is still less expensive than bellying up to a PDP.
And in some situations they may qualify for a PAP or other help.
If you really analyze the Part D plans you will see very few deliver value if you are willing to do a little legwork to keep your cost down.
The $35 insulin offering is an exception and it is only available to those with a Medicare drug plan.
About 99.9% of the population will never set foot in a Mayo client . For you being near one it works great . For the 999 out of 1000 it’s irrelevant. The #’s don’t lie . I was looking at a United’s earnings . Med sup enrollment has been exactly flat for 10 straight years at 4 mil . Mapd from 2 mil to near 8 mil . I’m sure pdp prices sky the next 2 yrs and push more and more to mapd quicker . Mapd CO’s will simply reduce extra benefits to keep zero premiums and better part d coverage . Throw in skying med sup rate increases in addition to skying part d premiums and it’s a time bomb .
It's not just Mayo.
Took my mom to phys therapy, only a few offer special type of vestibular therapy. Office won't take any mapd. Clerk asked me what I do, and asked if she could refer mapd clients to me to switch to OM. No thanks
Got email from prospect yesterday, referred by a client who is a doctor. Sent to me because she won't accept mapd. Can't help with pre ex.
Have many clients who are nurses or doctors, and won't buy mapd after what they've seen over the years working in hospitals and rehab centers.
Maybe I'm a magnet for these contacts, but I continuously run across barriers with mapd plans.
Took my mom to phys therapy, only a few offer special type of vestibular therapy. Office won't take any mapd. Clerk asked me what I do, and asked if she could refer mapd clients to me to switch to OM. No thanks
Got email from prospect yesterday, referred by a client who is a doctor. Sent to me because she won't accept mapd. Can't help with pre ex.
Have many clients who are nurses or doctors, and won't buy mapd after what they've seen over the years working in hospitals and rehab centers.
Maybe I'm a magnet for these contacts, but I continuously run across barriers with mapd plans.
- If it's true (I think it is) that MA is growing in popularity / market share
- And if it's true (my conspiracy theory hat is now on --) that medigap @ t65 + pdp is often a "funnel" for MAPD -- forced by premium increases on both med supp and pdp (or inferior pdp coverage)
- Then, eventually, these "elite" doctors will have fewer "Medicare + Medigap" clients to prescribe their pills to. They'll eventually either accept MA or they'll stop "treating" seniors.
While the # of MAPD owners are higher, I see the trend of more doctors leaving MAPD networks, and if anything, most doctors are moving to cash only or concierge models. They are tired of dealing with the BS of insurance companies, and tired of having to hire additional staff just to deal with the pre auth and referrals.
