Liberal Forum

EDC4ALL! » 09 Dec 2024, 1:48 pm » wrote: ↑

09 Dec 2024, 1:48 pm

You can ALWAYS get back into the "government plan" ALWAYS! You just don't get to pick another supplement to go with your Medicare. If the "Government Plan" is so **** good, why do you need a Medicare Supplement to go with it? Why do you need a separate drug plan to go with it?
Why do you need a separate dental/vision plan to go with it?

But but but, you have to be "wrong" in every way seeing how......


As of June 2024, nearly 34.1 million people were enrolled in Medicare Advantage, which is just over half of the more than 67.5 million total Medicare beneficiaries


I can ASSURE him that the COST SAVINGS ALONE from Trad Medicare and all you need to PAY FOR to get what Part C offers is MORE than enough reason to go with that plan vs. Traditional Medicare. 

PERHAPS he should realize the reason Traditional Medicare isn't advertised is that IF PEOPLE KNEW HOW LITTLE YOU GET AND HOW MUCH YOU PAY FOR COVERAGE IN THE GAPS, THEY WOULD NEVER PARTICIPATE and take Part C immediately.

This is what happens when the government runs things.

Medicare loses billions of dollars each year due to fraud, errors, and abuse. Estimates place these losses at approximately $60 billion annually, though the exact figure is impossible to measure.

https://smpresource.org/medicare-fraud/ ... %20measure.

Politics
Inside the mind of criminals: How to brazenly steal $100 billion from Medicare and Medicaid
https://www.cnbc.com/2023/03/09/how-med ... he-us.html

Medicare could care less about fraud. They barely enforce things. It would take more man power than they have to go after fraud. And secondly. it's not their money that is getting taken. It's yours and mine and they could give a rats *** if they need to tax us more to get it.
 

DeezerShoove » 09 Dec 2024, 1:43 pm » wrote: ↑

09 Dec 2024, 1:43 pm

Bammycare completely sucks.
My GP retired early because of it. Just said **** it.
That's from a doctor's point of view, no less.

Did you know that private insurance companies pay providers 2-3x MORE than Medicare or Medicaid? Do you realize that many top specialist limit how many people on Medicare/Medicaid they will provide service to? The government pays .20 -.10 on the dollar billed.

DeezerShoove » 09 Dec 2024, 1:52 pm » wrote: ↑

09 Dec 2024, 1:52 pm

ANYONE can opt out of Part C then go to Trad Medicare?
With no problem? No needed underwriting? Regardless of age and health?

btw I am recounting experiences of others. You keep saying I am wrong again.
I am trying to learn in the face of your overly emotional crap.
Why these folks are bitchy is based on their experiences. Must be something to it.
Your rosy picture sounds almost too good to be true.

During OPEN ENROLLMENT, you can go to whatever plan you want- Traditional, Advantage, new carrier, new Supplement and Drug plan. NO HEALTH QUESTIONS EVER!! PERIOD!!!

When you "recount experiences of others" without FACTS to support it, you are WRONG in every way since you are PRESUMING that they are truthful and factual. THAT means you are presenting THEIR "side" as YOUR FACTS!! 

There is no "rosy picture" being presented. What is being presented IS based 100% of facts and how the programs work. IF you don't believe it, try https://medicare.gov and you can FIND OUT THE FACTS FOR YOURSELF which is what MOST PEOPLE WITH A TINY SLICE OF COMMON SENSE WOULD DO!!!

Anecdotal "facts" are mostly **** and come 3rd and 4th hand from ILL INFORMED people who seem to have some axe to grind. 

Add to this, during the Open Enrollment for PART C recipients Jan 1 to March 31, you can ALSO go back to Trad Medicare with a supplement and drug plan WITH NO HEALTH QUETIONS OR AGE RESTRICTIONS. So your "buddies' don't have a **** clue now do they?? AND you can switch to a different PART C Insurance Company during that period WITH NO HEALTH QUESTIONS ASKED EITHER!!
 
 
 

*Beekeeper » 09 Dec 2024, 2:06 pm » wrote: ↑

09 Dec 2024, 2:06 pm

During OPEN ENROLLEMENT, you can go to whatever plan you want- Traditional, Advantage, new carrier, new Supplement and Drug plan. NO HEALTH QUESTIONS EVER!! PERIOD!!!

When you "recount experiences of others" without FACTS to support it, you are WRONG in every way since you are PRESUMING that they are truthful and factual. THAT means you are presenting THEIR "side" as YOUR FACTS!! 

There is no "rosy picture" being presented. What is being presented IS based 100% of facts and how the programs work. IF you don't believe it, try https://medicare.gov and you can FIND OUT THE FACTS FOR YOURSELF which is what MOST PEOPLE WITH A TINY SLICE OF COMMON SENSE WOULD DO!!!

Anecdotal "facts" are mostly **** and come 3rd and 4th hand from ILL INFORMED people who seem to have some axe to grind.

That is not true. A medicare Supplement company can ALWAYS ask health questions unless you have a "guarantee issue period ". You can disenroll from an Advantage plan and go back to Traditional mediare no questions asked.

What the **** is wrong with paying for the 20% that Medicare does not cover out of your own pocket. The medical procedures I have had since turning 65 (hernia operation, heart sonogram, heart catheterization, lung x-rays, 2 ER visits, $625 visit to a heart specialist, plus regular visits to my doctor), I paid for the part that medicare did not cover at $10-$20/month out of my own pocket. Right now I owe $77.00 and will have everything paid off. Providers cannot refuse to take your payments!!! WAAAAY cheaper than a Medicare supplement that may or may not cover the costs. Before that as a self employed individual, there is NO WAY I could have afforded the ridiculously high premiums insurers charge with a high deductible to boot. So I paid for my medical care out of my own pocket.

My CPA told me long ago that health insurance corporations take your money betting you don't use more that you pay in, you pay that health insurer betting that you will get sick...who has more money?

Medicare supplements are a rip-off of taxpayer money because of the higher reimbursement rated to them. Health Insurance is not health care!!!

Since the inception of magic negro care (obamacare) the number of practicing doctors has remain about the same while the number od those in administration have tripled.  What does that say about why the cost of medical care has gotten so ridiculously high?
 
 

EDC4ALL! » 09 Dec 2024, 2:11 pm » wrote: ↑

09 Dec 2024, 2:11 pm

That is not true. A medicare Supplement company can ALWAYS ask health questions unless you have a "guarantee issue period ". You can disenroll from an Advantage plan and go back to Traditional mediare no questions asked.

The guaranteed issue period for Medicare Supplement Plans, also known as Medigap, is 60 days before and 63 days after your current coverage ends. If you wait longer than 63 days after your coverage ends, you won't be guaranteed coverage and your application will be subject to medical underwriting. 
You can apply for a Medigap policy if you experience certain events, such as:

• Your employer-sponsored retiree plan ends 
• Your employer-sponsored retiree benefits are reduced or you lose eligibility 
• Your Medicare Advantage Plan's premium, cost-sharing, benefits, or provider are terminated or reduced 
• You lose or end a group health plan that covered your Medicare cost-sharing 
• You disenroll from a Medicare Advantage Plan within 12 months of becoming eligible 
• Your previous Medigap policy, Medicare Advantage Plan, or PACE program ends its coverage or commits fraud 
• You move out of the plan's service area if you have a Medicare Advantage Plan, Medicare SELECT policy, or PACE program 

Medicare's open enrollment period is October 15–December 7 each year. 
 

*Beekeeper » 09 Dec 2024, 2:22 pm » wrote: ↑

09 Dec 2024, 2:22 pm

The guaranteed issue period for Medicare Supplement Plans, also known as Medigap, is 60 days before and 63 days after your current coverage ends. If you wait longer than 63 days after your coverage ends, you won't be guaranteed coverage and your application will be subject to medical underwriting. 
You can apply for a Medigap policy if you experience certain events, such as:

• Your employer-sponsored retiree plan ends 
• Your employer-sponsored retiree benefits are reduced or you lose eligibility 
• Your Medicare Advantage Plan's premium, cost-sharing, benefits, or provider are terminated or reduced 
• You lose or end a group health plan that covered your Medicare cost-sharing 
• You disenroll from a Medicare Advantage Plan within 12 months of becoming eligible 
• Your previous Medigap policy, Medicare Advantage Plan, or PACE program ends its coverage or commits fraud 
• You move out of the plan's service area if you have a Medicare Advantage Plan, Medicare SELECT policy, or PACE program 

Medicare's open enrollment period is October 15–December 7 each year.

Thanks for backing up my facts. Med Sups can ask questions and deny you. There are only a handful of times they have to take you. The Open enrollment period isn't one of them

*Beekeeper » 09 Dec 2024, 2:22 pm » wrote: ↑

09 Dec 2024, 2:22 pm

The guaranteed issue period for Medicare Supplement Plans, also known as Medigap, is 60 days before and 63 days after your current coverage ends. If you wait longer than 63 days after your coverage ends, you won't be guaranteed coverage and your application will be subject to medical underwriting. 
You can apply for a Medigap policy if you experience certain events, such as:

• Your employer-sponsored retiree plan ends 
• Your employer-sponsored retiree benefits are reduced or you lose eligibility 
• Your Medicare Advantage Plan's premium, cost-sharing, benefits, or provider are terminated or reduced 
• You lose or end a group health plan that covered your Medicare cost-sharing 
• You disenroll from a Medicare Advantage Plan within 12 months of becoming eligible 
• Your previous Medigap policy, Medicare Advantage Plan, or PACE program ends its coverage or commits fraud 
• You move out of the plan's service area if you have a Medicare Advantage Plan, Medicare SELECT policy, or PACE program 

Medicare's open enrollment period is October 15–December 7 each year.

Correction: The guarantee period for Med Sups starts the 1st day of the month that you turn 65, and goes for 6 months. What you said applies to Part C

Buffalo » 09 Dec 2024, 2:12 pm » wrote: ↑

09 Dec 2024, 2:12 pm

What the **** is wrong with paying for the 20% that Medicare does not cover out of your own pocket. The medical procedures I have had since turning 65 (hernia operation, heart sonogram, heart catheterization, lung x-rays, 2 ER visits, $625 visit to a heart specialist, plus regular visits to my doctor), I paid for the part that medicare did not cover at $10-$20/month out of my own pocket. Right now I owe $77.00 and will have everything paid off. Providers cannot refuse to take your payments!!! WAAAAY cheaper than a Medicare supplement that may or may not cover the costs. Before that as a self employed individual, there is NO WAY I could have afforded the ridiculously high premiums insurers charge with a high deductible to boot. So I paid for my medical care out of my own pocket.

My CPA told me long ago that health insurance corporations take your money betting you don't use more that you pay in, you pay that health insurer betting that you will get sick...who has more money?

Medicare supplements are a rip-off of taxpayer money because of the higher reimbursement rated to them. Health Insurance is not health care!!!

Since the inception of magic negro care (obamacare) the number of practicing doctors has remain about the same while the number od those in administration have tripled.  What does that say about why the cost of medical care has gotten so ridiculously high?

Why would a supplement get paid a reimbursement? Supplements are strictly regulated. Everything is based off of the areas Medicare Re-imbursment rate. The Part A deductible is set by the Feds. It's $1632 per medicare benefit period. THAT is what your supplement pays. Medicare Part B pays 80% of the Medicare  APPROVED amount. That can vary by region. Your Supplement pays the othe 20% of the Medicare approved amount. Insurance companies don't get paid a re-imbursment rate. Providers do!
You all need to get more edjumacated before you talk about things you really don't know much about.
Notice I'm not calling people names. I'm just educating you with my 22 years in da biz!

You are correct Buff. The 20% for little **** is nothing. That is why some people drop their supplement and go to Advantage. They actually look at their EOB, and see how little it pays. A Hospital stay if you are just on Medicare will cost you the $1676 in 2025. If you you have a long stay (rare for Seniors) then this applys.
Does Medicare cover 100% of a hospital stay?
Days 1–60: (of each benefit period): $0 after you meet your Part A deductible ($1,632) ($1,676 in 2025). Days 61–90: (of each benefit period): $408 ($419 in 2025) each day. In Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days.

Where a Supplement policy earns it worth is if you need a Part B drug or extensive outpatient treatments. These are cancer infusions (chemo) and treatments for infusions for Crohns, RA, and other autoimmune system problems. 

The word "Advantage" In Medicare Advantage doesn't mean the advantage over Original Medicare and a Medicare Supplement, it means the whats the advantage of a Medicare Advantage plan over Original Medicare. For starters, Original Medicare doesn't have a maximum out of pocket. Get cancer and you could be out tens of thousands of dollars. Advantage plans are nothing more than a private insurance company administering Med A, B, and usually D. They all cover EXACTLY the same thing. They all get paid by the Feds the EXACT same amount per month per enrollie based on region (approx $700-$800 in Wisconsin, $1300 for chronic illnesses), and they all keep the maxiumum amount of .15 on the dollar to pay my comission, adminstration, and marketing. If one plan has really good dental ($3500-$5000 in benefits) the plan will always make you pay more somewhere else to offset the dental bennies.

*Beekeeper » 09 Dec 2024, 2:06 pm » wrote: ↑

09 Dec 2024, 2:06 pm

During OPEN ENROLLMENT, you can go to whatever plan you want- Traditional, Advantage, new carrier, new Supplement and Drug plan. NO HEALTH QUESTIONS EVER!! PERIOD!!!

When you "recount experiences of others" without FACTS to support it, you are WRONG in every way since you are PRESUMING that they are truthful and factual. THAT means you are presenting THEIR "side" as YOUR FACTS!! 

There is no "rosy picture" being presented. What is being presented IS based 100% of facts and how the programs work. IF you don't believe it, try https://medicare.gov and you can FIND OUT THE FACTS FOR YOURSELF which is what MOST PEOPLE WITH A TINY SLICE OF COMMON SENSE WOULD DO!!!

Anecdotal "facts" are mostly **** and come 3rd and 4th hand from ILL INFORMED people who seem to have some axe to grind. 

Add to this, during the Open Enrollment for PART C recipients Jan 1 to March 31, you can ALSO go back to Trad Medicare with a supplement and drug plan WITH NO HEALTH QUETIONS OR AGE RESTRICTIONS. So your "buddies' don't have a **** clue now do they?? AND you can switch to a different PART C Insurance Company during that period WITH NO HEALTH QUESTIONS ASKED EITHER!!

Well, I will investigate this a little further.
Of course I'll do it without the ax to grind you obviously have firmly in hand.

One thing that really pissed off someone was trying to switch from the AARP partner plan (UHC) to Mutual of Omaha.
He had cancer and was treated, but then a couple years later was refused.
Wouldn't be accepted by the next plan he wanted to get into during open enrollment.
Is that UHC or Mutual of Omaha or the cancer or his age . . . what?

It certainly does not fit your claims.
He said he was trying to go back into Traditional Medicare from Advantage.
It is all interesting stuff to me.
 

EDC4ALL! » 09 Dec 2024, 3:50 pm » wrote: ↑

09 Dec 2024, 3:50 pm

Why would a supplement get paid a reimbursement? Supplements are strictly regulated. Everything is based off of the areas Medicare Re-imbursment rate. The Part A deductible is set by the Feds. It's $1632 per medicare benefit period. THAT is what your supplement pays. Medicare Part B pays 80% of the Medicare  APPROVED amount. That can vary by region. Your Supplement pays the othe 20% of the Medicare approved amount. Insurance companies don't get paid a re-imbursment rate. Providers do!
You all need to get more edjumacated before you talk about things you really don't know much about.
Notice I'm not calling people names. I'm just educating you with my 22 years in da biz!

You are correct Buff. The 20% for little **** is nothing. That is why some people drop their supplement and go to Advantage. They actually look at their EOB, and see how little it pays. A Hospital stay if you are just on Medicare will cost you the $1676 in 2025. If you you have a long stay (rare for Seniors) then this applys.
Does Medicare cover 100% of a hospital stay?
Days 1–60: (of each benefit period): $0 after you meet your Part A deductible ($1,632) ($1,676 in 2025). Days 61–90: (of each benefit period): $408 ($419 in 2025) each day. In Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days.

Where a Supplement policy earns it worth is if you need a Part B drug or extensive outpatient treatments. These are cancer infusions (chemo) and treatments for infusions for Crohns, RA, and other autoimmune system problems. 

The word "Advantage" In Medicare Advantage doesn't mean the advantage over Original Medicare and a Medicare Supplement, it means the whats the advantage of a Medicare Advantage plan over Original Medicare. For starters, Original Medicare doesn't have a maximum out of pocket. Get cancer and you could be out tens of thousands of dollars. Advantage plans are nothing more than a private insurance company administering Med A, B, and usually D. They all cover EXACTLY the same thing. They all get paid by the Feds the EXACT same amount per month per enrollie based on region (approx $700-$800 in Wisconsin, $1300 for chronic illnesses), and they all keep the maxiumum amount of .15 on the dollar to pay my comission, adminstration, and marketing. If one plan has really good dental ($3500-$5000 in benefits) the plan will always make you pay more somewhere else to offset the dental bennies.

You can't tell me that there isn't an army of administrative personnel in a for profit health insurance corporation that suck a ridiculous amount of revenue from healthcare for salaries and expenses that have NOTHING to do with the delivery of medica care.  Since the inception of ocare the number of doctors in practice has remained stable while the administrative side has tripled, while the cost of medical care has gone up 10 fold.   Does that money go to the providers or for administration expenses?
 

Buffalo » 09 Dec 2024, 7:25 pm » wrote: ↑

09 Dec 2024, 7:25 pm

You can't tell me that there isn't an army of administrative personnel in a for profit health insurance corporation that suck a ridiculous amount of revenue from healthcare for salaries and expenses that have NOTHING to do with the delivery of medica care.  Since the inception of ocare the number of doctors in practice has remained stable while the administrative side has tripled, while the cost of medical care has gone up 10 fold.   Does that money go to the providers or for administration expenses?

Not what I said.

Who administers Original Medicare?


Group insurance has always been expensive. ACA just made individual insurance cover the same. No pre-ex or life time max will do that. ACA (Obamacare) created the medical records monster that we have now. There were approximately 4000 medical codes before ACA. Now there are 16000 or so. The government created ACA. A Democrat created ACA. Why does anybody think that a Medicare for all insurance would be any different?

Why do providers charge so much more now than 10 years ago?

Please provide links with your answers

EDC4ALL! » 09 Dec 2024, 2:01 pm » wrote: ↑

09 Dec 2024, 2:01 pm

Did you know that private insurance companies pay providers 2-3x MORE than Medicare or Medicaid? Do you realize that many top specialist limit how many people on Medicare/Medicaid they will provide service to? The government pays .20 -.10 on the dollar billed.

^^^^^^^^^^^^^^^^^
worships the rich.
 

DeezerShoove » 07 Dec 2024, 1:22 pm » wrote: ↑

07 Dec 2024, 1:22 pm

All your emotional **** aside, it isn't insurance companies that I get this background nightmare from.
As I said, seniors with real medical issues say this stuff. They are riding inside that Advantage Dreamscape.
There's no way out once you've "signed zee papers, old man."

btw
You made my case with the $2500 max.
Plus you use my favorite squirmy language: Most, some, may, usually, tend to, isn't that hard...

  "So the KEY here is to have SOMEONE educate the beneficiary to HOW TO PROPERLY USE their plan."

what is wrong with a $2500-$4800 max out of pocket if your Medicare Supplement policy and drug plan is over $400/m or $500/m or more? now throw in dental/vision costs. add the rest of the extra bennies. I have had couples spending over $15000 a year on premiums....but hey.....they never see a bill!

Buffalo » 09 Dec 2024, 7:07 am » wrote: ↑

09 Dec 2024, 7:07 am

Since the inception of magic negro care (obama care) the number of doctors has remained relatively the same, but the people in administration have tripled.  What does that tell you about the ridiculous increases in medical costs?  It doesn't translate into better healthcare.  Health insurance is not the same as healthcare!!!
As to private health insurance corporations they take your premiums betting you will not get sick, you pay your high premiums betting you will get sick...who has more money you or the **** private insurance corporations?
Medicare Advantage plans are a scam and ripoff to Seniors!!!

"The bombardment of ads, letters, and brochures also don't tell you that Medicare Advantage plans, like most private insurance plans, typically have limited—and often inadequate—networks of doctors and hospitals. By contrast, almost all healthcare providers participate in the traditional Medicare program, which doesn't even have "networks."
What happens when seniors need care beyond a wellness check-up or lunch delivery? Some networks are so limited that seniors must pay hundreds or thousands of dollars if they travel out of state or need more substantive care. Because networks are usually confined to specific geographic areas, seniors can end up on the hook for the entire bill.
The private health insurance market, like the kind of coverage people get through their employer, doesn't see anywhere near the level of marketing that Medicare Advantage does. Why? Because many Medicare Advantage insurers have learned how to maximize revenue by claiming their enrollees are sicker than they really are. So they are effectively scamming everyone—from the federal government to taxpayers to seniors. To keep the federal dollars flowing, insurers donate millions of dollars to Congressional candidates and spend even more on lobbying. That goes a long way toward explaining why every year hundreds of members of Congress sign on to an industry-generated letter expressing support for the Medicare Advantage program. This despite numerous reports and studies over the years that document how insurers have rigged the program to get billions more dollars from taxpayers unlawfully."

How Medicare Advantage Scams Seniors | Opinion - Newsweek

My Medicare Advantage plans have NONE of these problems. Period. You know NOTHING about Med C other than what you can cut and paste. I have plans where you can go ANYWHERE you want, including Mayo and Cleveland Clinic. As far as them "claiming" they are sicker, do you actually believe that the Feds do not have access to the ACA or MIB database? Buff, it shows EVERY SINGLE CLAIM that person has had. That is EXACTLY why it was developed. It's so a doctor can look at those codes and figure out that person health history. The government damn well knows how many claims and what those claims were for. How can the insurance company FAKE it? That is exactly what "My Chart" is, It's used by many hospital systems across the country. it uses the Epic health records system. if the idiots don't have the person, then personnel to run ACA efficiently they designed a **** system because to do it right would have tripled the cost. Just remember. Medicare Advantage plans are a gov't program administered by a CONTRACTED health insurance company. CMS can look at any claims they want.

Buffalo » 09 Dec 2024, 7:25 pm » wrote: ↑

09 Dec 2024, 7:25 pm

You can't tell me that there isn't an army of administrative personnel in a for profit health insurance corporation that suck a ridiculous amount of revenue from healthcare for salaries and expenses that have NOTHING to do with the delivery of medica care.  Since the inception of ocare the number of doctors in practice has remained stable while the administrative side has tripled, while the cost of medical care has gone up 10 fold.   Does that money go to the providers or for administration expenses?

As a FYI, CMS, who handles Medicare and Medicade Administrative procedures, ONLY has about 6,800 employees. 

The OTHER 500,000 are through CONTRACTS WITH INSURANCE COMPANIES to administer claims and cut checks for the Government. THEY have nothing to do with the delivery of medical care either. And the REASON costs have increased and the admin side has tripled is BECAUSE of the VOLUME OF REGULATIONS that obammycare placed on MEDICAL CARE PROVIDERS- ie, electronic records requirements, CODING requirements, etc.

So please, learn something BEFORE you open your clap trap and dig a deeper hole.

*Beekeeper » 06 Dec 2024, 7:07 pm » wrote: ↑

06 Dec 2024, 7:07 pm

Perhaps you need to shut the **** up about Medicare Part C. IT GIVES SENIORS FAR MORE BENEFITS THAN TRADITIONAL MEDICARE EVER COULD!!!

Your vomitary only show your STUPIDITY and MORONIC ATTEMPTS to deny a free market product from being offered to those who have to decide what to do with their CURRENT PLANS, even if they decide to keep traditional Medicare or want to move to a new plan!!

"These people' do a lot of good for a lot of people who have issues with understanding the differences in Traditional Medicare vs Medicare Advantage, which you DO NOT GET AUTOMATICALLY you **** sucking ASSHOLE!!

  It helps with all of those diapers you're filling doesn't it you old ****.
 
 

Squatchman » 10 Dec 2024, 8:44 am » wrote: ↑

10 Dec 2024, 8:44 am

  It helps with all of those diapers you're filling doesn't it you old ****.

EAT **** AND DIE ****
 

Squatchman » 10 Dec 2024, 8:44 am » wrote: ↑

10 Dec 2024, 8:44 am

  It helps with all of those diapers you're filling doesn't it you old ****.

Still too **** big-a-chicken to SHOW UP for your ritual *** KICKING, huh, big "man"??

Bring bandages and a tetanus shot. You'll need a LOT of both.

Seems the ONLY one that will be filling DIAPERS is you!! WITH A BLOODY ***!!