Just thought that I would stir the MAPD vs MS pot again: Start at 2:25

[axeman462]

And I specifically said the video within the video. Real people. It really happened.

The man's widow testified before Congress.

Everything else is fodder for another post.

Moving the goalposts.

nope, you're not going to try and put the burden of proof on me. No goalposts were moved by me. I never made my original statement in the context of only that video. I was speaking of the man's marketing techniques in general. And what I said is true. you on the other hand, are obviously just looking for an argument.
Whether or not the video inside the video "really" happened, or are "real" people is a totally irrelevant red herring.
The fact is the man fear mongers for living.

 

[rmhaire]

Whether or not the video inside the video "really" happened, or are "real" people is a totally irrelevant red herring.

So what happened to this couple is irrelevant?

Tells me all I need to know.

 

[axeman462]

So what happened to this couple is irrelevant?

Tells me all I need to know.

to the comment I made which started the conversation, yes.

 

[AgentGeneral]

How do we not have control over our healthcare? If we aren't happy with a provider, we find another one. My wife and I have used 2 different hospitals and 4 different medical groups. My wife has been through 4 Cardiologists in 3 different medical groups and I've changed Pulmonologists in a different medical group. No referrals needed. My Pulmonologist decided he wanted me to have a 2nd CT Scan in 30 days during an appointment. Took them 5 minutes to find out Medicare would cover it. No waiting for a week for a PA.

I'm Med Supp, but I do offer MA, but I don't recommend it. There's a place for it. I'm not against MA as much as Bob. I have to admit, MAPD's have gotten much better. I'm tempted to try Aetna's because of the RX and the OTC, but the PA and denials scare me. If I could get one of those robot pets, I'd do it.

How bout a beer? I have a lady buying her Old Milwaukees best at a Dollar General with her healthy bennies card. I know she shouldn't be but she somehow is....must be keyed in inventory as groceries or who knows...

I see the auths happen just as fast with MAPD in many cases. 10 minutes the other day for a senior patient needing a pain blocker on a PPO at a pain and spine clinic. Office girl says, "oh I need to get an auth". Picks up phone or whatever she did for 10 minutes, comes back and says ok doc be with ya in a bit. Not exactly like that, but it took her 10 minutes. You know what I mean. in that case the auth should have done prior to the patients arrival but wasn't and it didn't take long to get it is the point. It's not the olden days.

That's just an example. BCBS PPO has many providers in their MAPD network. Humana PPO not far off. Aetna HMO POS not my fave, but no ones complaining. PPO might be better. IDK I dont do alot of Aetna, but do some. Don't like the portal. My mains are BCBS and Humana.

It all goes back to what's the market dictate. Many geo areas have plenty of options and not very limited networks. Hence why this debate imo is silly.

If the argument on control over health care is for choosing providers then that's null here. It doesn't happen often where a client can't go where they want here as long as docs in network AND that doc is accepting new patients. One of the main ones I do has close to a million providers and then some. No issues.

 

[straightnochaser]

How bout a beer? I have a lady buying her Old Milwaukees best at a Dollar General with her healthy bennies card. I know she shouldn't be but she somehow is....must be keyed in inventory as groceries or who knows...

I see the auths happen just as fast with MAPD in many cases. 10 minutes the other day for a senior patient needing a pain blocker on a PPO at a pain and spine clinic. Office girl says, "oh I need to get an auth". Picks up phone or whatever she did for 10 minutes, comes back and says ok doc be with ya in a bit. Not exactly like that, but it took her 10 minutes. You know what I mean. in that case the auth should have done prior to the patients arrival but wasn't and it didn't take long to get it is the point. It's not the olden days.

That's just an example. BCBS PPO has many providers in their MAPD network. Humana PPO not far off. Aetna HMO POS not my fave, but no ones complaining. PPO might be better. IDK I dont do alot of Aetna, but do some. Don't like the portal. My mains are BCBS and Humana.

It all goes back to what's the market dictate. Many geo areas have plenty of options and not very limited networks. Hence why this debate imo is silly.

If the argument on control over health care is for choosing providers then that's null here. It doesn't happen often where a client can't go where they want here as long as docs in network AND that doc is accepting new patients. One of the main ones I do has 1.6 million providers and then some. No issues.

Aetna is on fire for PY2024 - Moving tons of people off Humana/UHC to Aetna.

 

[AgentGeneral]

Aetna is on fire for PY2024 - Moving tons of people off Humana/UHC to Aetna.

The few dozen I have on it do love it. we don't have a CVS and a couple are so lonely they love to talk to me each quarter to help them with their OTC orders. Briefly brought it up yesterday to a guy on Aetna, the Blues or Humana, he opted to stay put on his Aetna HMO-POS.

We don't have UHC either in my main county. Or I (might) do it. I'm getting old and like to stay local and F2F most the time. So many T65 right in my back yard I only leave far away when I have to (like in a minute I have a referral 45 mins away). Ugh.

I'm on an oddball reservation most my days. Works great though bc Humana works for the tribal members like it does the VA members here. Some folks get their drugs through their tribe center so the Humana Honor plan works like a charm. Wish I could get more of these clients. They love Humana. Life with no complaints about Xarelto, Victoza, etc would be my dream. I'm slowly working toward this right here. The few complaints I get would not matter one iota if they had a supp though. lol

 

[Midlevel]

The few dozen I have on it do love it. we don't have a CVS and a couple are so lonely they love to talk to me each quarter to help them with their OTC orders. Briefly brought it up yesterday to a guy on Aetna, the Blues or Humana, he opted to stay put on his Aetna HMO-POS.

We don't have UHC either in my main county. Or I (might) do it. I'm getting old and like to stay local and F2F most the time. So many T65 right in my back yard I only leave far away when I have to (like in a minute I have a referral 45 mins away). Ugh.

I'm on an oddball reservation most my days. Works great though bc Humana works for the tribal members like it does the VA members here. Some folks get their drugs through their tribe center so the Humana Honor plan works like a charm. Wish I could get more of these clients. They love Humana. Life with no complaints about Xarelto, Victoza, etc would be my dream. I'm slowly working toward this right here. The few complaints I get would not matter one iota if they had a supp though. lol

Starting in 2024 Aetna will have the dental, vision and OTC loaded on a debit card the client can just hand the dentist or wherever she gets her glasses. Also, the OTC benefit can now be used at CVS, WalMart and Walgreens. Also some major grocery chains. The 600.00 or 1200.00 for fitness equipment like tennis shoes, golf clubs, kayaks, State and Federal park permits, etc. will need to use a reimbursement form still.

 

[kstein]

Did anyone else notice that they were in Connecticut and they have year round GI med sup sales? The story says he got sick memorial day which means he could have been in OM and a supp a week after everything started. Who dropped the ball there??

 

[rousemark]

the thumbnail literally says "The wrong plan killed him."

if you go to his YouTube page, a video automatically starts with him saying "What you don't know about your Medicare Insurance plan could be the difference between life and death. Seriously."

The guy is a fear mongering hack. Any agent that feels the need to spew fear like this does not have the customer's best interest at heart. They lack the skill of persuasion, and compensate for it with unnecessarily scaring people into their products.

are you saying that what the family is saying is not true? If it is true, then it is not fear mongering

 

[sshafran]

I did not watch the video. Don't care to don't have time.

Here is my question:
Since when does a medical provider need permission or prior authorization from an insurance company to provide treatment when a life is in balance?

I'll give you a hint: Never.

Let me ask you a different question: when does a medical provider need a guarantee of payment via prior authorization from an insurance company for providing treatment when a life is in balance?

I'll give you a hint: when they want to make sure they get paid and are willing to let grandma die before they get their guarantee.

My $.02. Gotta make sure they get their $$$$$