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From: in2dadark on 22 Mar 2010 19:48
On Mar 22, 5:54 pm, Hachiroku ハチロク <Tru...(a)e86.GTS> wrote:
> On Mon, 22 Mar 2010 14:45:53 -0700, edspyhill01 wrote:
> > On Mar 22, 3:49 pm, Hachiroku <Tru...(a)e86.GTS> wrote:
> >> Medicare Advantage.
>
> >> Does anyone know the implications of this? Think Nancy Pelousy knows
> >> yet? The bill's been passed, she said she'd know what was in it when it
> >> passed.
>
> >> I'm getting on, but in my entire life I can't recall a bigger bunch of
> >> morons in government service.
>
> > Medicare Advantage is not government Medicare. The government will stop
> > the 15% additional payment to her insurance company for her Medicare
> > coverage. Probably the private insurance company will raise her rates the
> > 15% or drop her. Find out how to get her back into government Medicare.
>
> This is unfortunate because she has a good plan. She paid $500 for a
> $25,000 surgery.

You don't need to do a thing at this point. MA companies have a huge
lobby. Just because there are cuts to MA in 'this' bill, it doesn't
mean they won't put the money back in another bill. I have hundreds of
customers in MA and MAPD plans. Nothing has changed at this point.
You'll know something in October or November if they are pulling out
of your county or raising her rate. These plans won't go down without
a fight. They have deep pockets. Obama is already a puppet to
insurance companies.

From: Jeff Strickland on 22 Mar 2010 19:58

"Hachiroku" <Trueno(a)e86.GTS> wrote in message
news:ho8hko$qq5$4(a)news.eternal-september.org...
> Medicare Advantage.
>
> Does anyone know the implications of this? Think Nancy Pelousy knows yet?
> The bill's been passed, she said she'd know what was in it when it
> passed.
>
> I'm getting on, but in my entire life I can't recall a bigger bunch of
> morons in government service.
>

It means they will schedule her for another test.






From: SMS on 22 Mar 2010 21:00
On 22/03/10 4:42 PM, in2dadark wrote:

<snip>

> Sounds like you don't know what you're talking about. One, there is
> very little if ANY fraud in Medicare advantage.

Oy, you have a lot to learn. There's fraud on two levels.

The first level is the fraud perpetuated on the patients. The insurance
companies are selling extra coverage that they then go to great lengths
to avoid providing. Went through this with my mother and stepfather for
two years. When they needed rehab after a hospital stay the insurance
company wouldn't pay for the rehab one floor up at the public hospital,
they wanted to send them to a rehab center 30 miles away that is really
run down and dirty, and is of course cheaper. Then they said they could
send a PT to their house instead for the rehab, but it took weeks to get
this set up and more weeks fighting to get the number of home visits
they promised. They also deny prescription drug coverage if they feel
the drug is too expensive, even when the doctor files an appeal, even
when there is no alternative drugs.

The second level is the fraud of the insurance companies perpetuated on
Medicare. They get reimbursed for non-covered procedures and false
outcomes by those insurance companies that know the system and know what
to write on the documentation, even when it's untrue.

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