Hospice to Medicare Advantage

[somarco]

However, any claims not associated with the hospice condition (the main medical condition the client is on hospice for) will not be paid by hospice.

See post #16

client who believes that you've ripped them off by giving them bad advice,

I think there is a bit of that.

Wife thinks I have been trying to talk her out of dropping the F plan for the last 2 years because of my commission. I have been trying to get her to keep it but it has nothing to do with preserving $24/mo commission.

If she isn't smart enough to figure out they have paid NOTHING for his care the last 2+ years and they ZERO out of pocket for all the care they got from Mayo, local hospitals, docs. etc

assuming when they got the supp, he was healthy,

No, he was sick. Hadn't been to a doc in years. Didn't have health insurance. Told me how glad he was that I showed him this plan, something he could afford. Now he can go to a doc and find out what is wrong.

 

[bluediamond]

Got a call today from the wife of a (soon to be) former client. Husband has battled esophogeal cancer for probably 3 years. Several trips to Mayo in JAX (they live across the line in Georgia).

Plan F Medigap.

All of his bills and xs charges have been paid,

Last year the folks at Mayo told her to change his plan to a G to save money.

Had to explain to her that was not possible given his health.

Today she called and said she wanted to cancel his plan. He has been in hospice for a year and is still here. The $200/mo is a drag on their budget.

I have no idea how much the carrier has spent on him but it is probably a lot more than $2400 per year. He had over 200 claims so far in 2017, not including Rx.

She told me they got a "free" supplement plan from Medicare.

She enrolled him in Humana HMO.

How will Humana "treat" his hospice claims? I assume copay's, coinsurance plus probably a bunch of denials for using a non-par provider.

Mayo does not typically accept HMO plans.

At this point even if there is a way to save the case I am not going to push it. Just looking for some insight from folks that sell Advantage plans.

Sometimes you just want to SCREAM!

Hospice is suppose to reverse back to Medicare if on MAPD normally, but don't know about being there a year.

 

[somarco]

Doesn't really matter, Blue. Decision is made. Assuming he is still here in January and beyond they will eventually figure out they screwed up.

Not my problem.