Would any Medd supp. company underwrite someone in nursing home?

[20th Maine]

The poster said the nursing facility wants all residents off MAPD and on to Med Supp. Not their call, not their business and I bet its not compliant to NJ state regs and laws

 

[Speechman]

Gotcha. You wouldn’t believe the number of health care ‘professionals’ I’ve come across who feel they are qualified to advise their clients on Medicare. Whether to go with Supp vs MAPD

 

[20th Maine]

I have a client their Pharmacist told her to cancel her Part D

And an MD told her to use Original Medicare only

criminal

 

[Dale M Krause]

Yes – this is all true. No person would pass UW if in an SNF for a Medicare Supplement. If they move out of the service area of their Medicare Advantage (does not have to be out of state just out of service area) they can get GI on a Med Supp. And yes, I have heard of Med Supp companies terminating or looking into the business that is too much GI (plus most carriers do not pay comp or very little for GI in most states).

Nursing homes do not like dealing with Advantage – but in many cases, that is all the person can afford.

 

[20th Maine]

We as honest brokers must be vigilant about healthcare providers abusing our clients

 

[BALDELMO]

Practicing insurance without a license.

 

[Midlevel]

We as honest brokers must be vigilant about healthcare providers abusing our clients

A couple things you could have your client ask the Dr:

Are you willing to pay the Med Sup premium for me?
Why did you join their network if they are so horrible?
Why exactly do you tell me to never go on an MA plan?
Did you know I will also have to pay full price for all my dental, vision, hearing, OTC, gym, et?
Are you aware the stand alone drug plan that goes with my Med Sup has a premium and a $545.00 deductible on non-generics that I don't have now?
Why do you think you are authorized to give out insurance advice, my agent don't tell me what prescriptions I should take.

Guarantee the only answer they will have is you may have to have prior authorization before some procedures or tests. And that shows it goes right back to the Dr wanting to pad his own pockets and don't give a damn about his patient's pockets. Stay in your lane Doc.

 

[20th Maine]

Practicing insurance without a license.

When that happens I contact their office--tell them "I will stay out of practicing medicine and you stay out of offering insurance advice CLICK"

Have turned a few of them in to State Board of healing arts for damaging clients interests

 

[somarco]

Nursing homes do not like dealing with Advantage – but in many cases, that is all the person can afford.

I presume you mean the PREMIUM is not affordable . . .

But the COST of care (the other side of the ledger) is affordable???

Practicing insurance without a license.

There are plenty of folks on this forum that could be indicted under that provision.

 

[Cenla Agent]

Not that black and white.

we have agents right this very day working all over the state writing MAPD on nursing home patients. On this day, an agent just completed 3 enrollments in a nursing home and here it's not even noon.

I just got off the phone and email on where the rest of my contracting is at so I can do this as well.

Again, "nursing home patients" (or residents) aren't the same as SNF patients, who are only in the facility for a few weeks at most, normally less than 3 weeks.

I also didn't say anything about their willingness to enroll. I said that Skilled Nursing Facilities are the most likely providers (in my experience, which goes back to 06) to disparage MA and to tell the patient that they should disenroll and go back to Original Medicare. The conversation won't come up in a nursing home (long term care facility) because Medicare doesn't pay for that care.

Many nursing home patients are or will eventually be on SNP plans too, and are dual eligible. Somebody who is on Medicaid or probably will be on it sooner than later (in other words, most nursing home patients--the costs deplete one's assets quickly) isn't a real good prospect for a Medigap.