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The Water Cooler
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Medicare Part C
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<blockquote data-quote="JD8" data-source="post: 3326919" data-attributes="member: 24"><p>Yeah, there's something else to that story. </p><p></p><p>One thing you have to realize is that you're not relaying an apples to apples comparison. Medicare supplemental plans are considerably different and costly for those on disability UNDER 65. You simply cannot compare your situation to someone that has turned 65 and is enrolling in traditional medicare, in which there is a night and day difference compared to MA plans.</p><p></p><p>Food for thought.....</p><p></p><p>Medicare Supplemental plans CANNOT deny a claim for a Medicare approved treatment. If it is approved, Medicare pays, and then tells the Medicare Supplemental carrier what to pay. They have no choice in the matter because they are a piggy back to Medicare.</p><p></p><p>Now, Medicare Advantage plans can deny treatment all day long. They've denied coverage, stalled, and refused to pay physicians, who in turn try to bill the patient. In which it's in their best interest to keep you healthy, but it's also within their best interest to deny or stall claims. Several of the carriers have gotten in trouble for this. </p><p></p><p>Here's the OTHER downside....once you're enrolled in Medicare Advantage... it's REALLY tough to get out of it... because they will underwrite you to get BACK into Traditional Medicare Supplemental plans.</p><p></p><p><a href="https://www.medpagetoday.com/special-reports/exclusives/83661" target="_blank">https://www.medpagetoday.com/special-reports/exclusives/83661</a></p><p></p><p>So keep in mind, to everyone turning 65..... once you turn 65 you have rights. You can enroll in traditional Medicare and the Medicare supplemental plans HAVE to take you if you choose one. They CANNOT underwrite you outside of age and being a smoker, but they have to enroll you by law. So if you have a condition when you turn 65, choose wisely.</p></blockquote><p></p>
[QUOTE="JD8, post: 3326919, member: 24"] Yeah, there's something else to that story. One thing you have to realize is that you're not relaying an apples to apples comparison. Medicare supplemental plans are considerably different and costly for those on disability UNDER 65. You simply cannot compare your situation to someone that has turned 65 and is enrolling in traditional medicare, in which there is a night and day difference compared to MA plans. Food for thought..... Medicare Supplemental plans CANNOT deny a claim for a Medicare approved treatment. If it is approved, Medicare pays, and then tells the Medicare Supplemental carrier what to pay. They have no choice in the matter because they are a piggy back to Medicare. Now, Medicare Advantage plans can deny treatment all day long. They've denied coverage, stalled, and refused to pay physicians, who in turn try to bill the patient. In which it's in their best interest to keep you healthy, but it's also within their best interest to deny or stall claims. Several of the carriers have gotten in trouble for this. Here's the OTHER downside....once you're enrolled in Medicare Advantage... it's REALLY tough to get out of it... because they will underwrite you to get BACK into Traditional Medicare Supplemental plans. [URL]https://www.medpagetoday.com/special-reports/exclusives/83661[/URL] So keep in mind, to everyone turning 65..... once you turn 65 you have rights. You can enroll in traditional Medicare and the Medicare supplemental plans HAVE to take you if you choose one. They CANNOT underwrite you outside of age and being a smoker, but they have to enroll you by law. So if you have a condition when you turn 65, choose wisely. [/QUOTE]
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