Mapd comes with additional free lawyer benefits to fight denials? That would be a nice add on. "Get what you deserve, call 1 800...."
UHC Violates CMS Rules
- Thread starter somarco
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Mapd comes with additional free lawyer benefits to fight denials? That would be a nice add on. "Get what you deserve, call 1 800...."
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- #22
AgentGeneral
Guru
- 289
Had a text 8am today. New MAPD client was found in his running van by his neighbor passed away in drivers seat in the driveway.
Mustve been the MAPD i put him on.
Look, I know it grinds med supp only agents for other agents to be doing MAPD.
Grand scheme. It would not matter who wrote it, someone will. The client that chooses MAPD would do that without one or the other of us.
Full disclosure- I had a client pass away June this year. I couldn't shake the feeling it was bc of his health insurance issues. It probably wasn't though in reality. He was sick. It was not bc of his MAPD. The PDP probably played a roll in not prolonging the inevitable. Rx was so high and the pharmacy made a mistake and had him listed as already picking up 4 more fills than he did, that put him into his donut hole asap. He was understandably upset and said in no way was he already in donut hole. we did some research, discovered it was a mistake at the pharmacy. Before that got fixed, he didn't pay for his needed meds. He passed. Terrible diabetes, uncontrolled. What happened here? Oh sure had to be his MAPD.
The people I see struggling are not struggling bc of their MAPD. It's always on the Rx side. I do see denials. Saw one yesterday with a lady who had 10 extended stay psych hospitalizations in past 3 yrs. Humana denied this past one. Not saying I don't see denials and often when you do the research you find out it's not what you may think. The default thinking of "OHHHH it was the MAPDDDD" is a bit over touted.
Mustve been the MAPD i put him on.
Look, I know it grinds med supp only agents for other agents to be doing MAPD.
Grand scheme. It would not matter who wrote it, someone will. The client that chooses MAPD would do that without one or the other of us.
Full disclosure- I had a client pass away June this year. I couldn't shake the feeling it was bc of his health insurance issues. It probably wasn't though in reality. He was sick. It was not bc of his MAPD. The PDP probably played a roll in not prolonging the inevitable. Rx was so high and the pharmacy made a mistake and had him listed as already picking up 4 more fills than he did, that put him into his donut hole asap. He was understandably upset and said in no way was he already in donut hole. we did some research, discovered it was a mistake at the pharmacy. Before that got fixed, he didn't pay for his needed meds. He passed. Terrible diabetes, uncontrolled. What happened here? Oh sure had to be his MAPD.
The people I see struggling are not struggling bc of their MAPD. It's always on the Rx side. I do see denials. Saw one yesterday with a lady who had 10 extended stay psych hospitalizations in past 3 yrs. Humana denied this past one. Not saying I don't see denials and often when you do the research you find out it's not what you may think. The default thinking of "OHHHH it was the MAPDDDD" is a bit over touted.
- 16,908
I’ve been on a United Healthcare PPO health plan for 15 years. Pay an enormous premium and have had no expensive claims until this year I’ve had two hospital stays of 4-days each. Both stays were unrelated and six months apart.
My experience with them falls exactly what this lawsuit is about. They deny legit claims. They force you and the hospital to waste hours and hours fighting them before they will do what they are supposed to do. It should not be like this.
My experience with them falls exactly what this lawsuit is about. They deny legit claims. They force you and the hospital to waste hours and hours fighting them before they will do what they are supposed to do. It should not be like this.
This, about a MILLION percent.
Seriously, this MAPD vs Med Supp debate has gotten completely irrational and borderline insecure on here. We've been writing high-volume Med Supps with only a small sprinkle of MAPD for 15 years now. In the entire time we've been in business we've gotten non-stop complaints about MAPD's, literally daily.
Am I lying, because you MAPD guys with small books have "never gotten those?" Give me a break.
FACTS
1. Med Supps and MAPDs both exist. Both have their uses
2. No one EVER said their Medigap Plan coverage was bad or didn't pay.
3. I'd NEVER go on a MAPD over a Supp. EVER. And I'd guess many of you wouldn't either. I have the money to buy one, and many people out there do.
4. MAPD can deny your claims (obviously). Med supps do not. Wanna roll the dice? Be my guest. I generate 20X more MAPD traffic as a marketer than I do Med Supp. I happily send it off to my partners and bank with both.
5. MAPD is a good choice for some people. Not ALL people. And vice versa.
6. There are now daily negative news stories about MAPD. Yet none about Medigap. Guess they're wrong and you're all right?
7. Go sell whatever you want to sell. It's your business.
This non-stop complaining about "med supp only agents" while you seem to be spewing "MAPD only" the entire time is laughable. I'm all for MAPD and Med Supp coexisting and could easily sell my business at any time, and I don't even say that shit.
Seems many of you have managed to build up small books of business and have been fortunate enough to have your clients happy on their MAPD, which is great. But take it from the people who've been doing this long enough and in high enough volume, our data is better than YOUR data.
Just go sell and become financially independent. After all, no one would do this shit for free.
UHC is a bunch of bastards. Several years ago I had a mapd with them. It had dental but you had to pay the bill and submit to them for reimbursement. I had a $300 dental bill I paid and sent to them for reimbursement. I got a check from them for $1.36. They said they got an invoice from my provider for $36.00. I told them that wasn't possible but after many phone calls talking to many different customer service reps I gave up. I wouldn't insured my dog with UHC. You want to know how I really feel?
Found out that the doctor didn't state the procedure was needed. They need to refile with Humana. Not Humana's fault.
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- #28
I have marked you as UNDECIDED on this issue . . .
and another UNDECIDED vote . . .
- 29,521
Murderer!!!
I vote for this to be the post of the month. Thanks for sharing your past experience of both products.
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