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From: Hachiroku on 22 Mar 2010 15:49
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.

From: SMS on 22 Mar 2010 16:34
On 22/03/10 12:49 PM, Hachiroku 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.

Depends on who she has her Medicare Advantage with. The subsidies to
insurance companies for Medicare Advantage will be frozen until 2011,
then will come down. The way it stands now, the private, for-profit,
insurance companies take the Medicare subsidies, charge an additional
fee over what Medicare pays, and then do everything they can to deny
coverage. It's abusive to seniors. It all seems fine to the seniors
until they need an expensive medication like Revlimid, or are
hospitalized for a long period. By that time they Medicare Advantage
provider will be pressuring the family to put the patient into hospice
so they can stop spending. You want death panels, you got 'em, but
they're not the ones Sarah Palin was lying about. Pity the senior that
doesn't have well-educated and tenacious children, preferably with
medical training, as their patient advocates.

I've been through that hell with my mother, fighting Hxxxxa to get them
to provide the coverage she paid for. The doctors shake their heads when
you ask why the drugs they prescribe are not being approved they simply
say, "Hxxxxa won't approve them." One doctor of my mom's doctors said it
right in front of the Hxxxxa nurse that they send to the hospital when
one of their patients is hospitalized.

With the improvements in standard Medicare coverage in the health care
bill, the benefits of Medicare Advantage become less and less appealing,
and the co-pays and the extra cost are likely to go up if the Medicare
Advantage is with a for-profit company.

The amount of fraud in Medicare Advantage is incredible. The service
providers know exactly how to fill out the forms to get Medicare to pay,
even when Medicare shouldn't be paying. What's too bad is that the cuts
in Medicare Advantage are also going to hurt the honest service
providers, of which there still are some, mainly the non-profit HMOs.
From: edspyhill01 on 22 Mar 2010 17:45
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.
From: Hachiroku ハチロク on 22 Mar 2010 17:54
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.


From: in2dadark on 22 Mar 2010 19:42
On Mar 22, 4:34 pm, SMS <scharf.ste...(a)geemail.com> wrote:
> On 22/03/10 12:49 PM, Hachiroku 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.
>
> Depends on who she has her Medicare Advantage with. The subsidies to
> insurance companies for Medicare Advantage will be frozen until 2011,
> then will come down. The way it stands now, the private, for-profit,
> insurance companies take the Medicare subsidies, charge an additional
> fee over what Medicare pays, and then do everything they can to deny
> coverage. It's abusive to seniors. It all seems fine to the seniors
> until they need an expensive medication like Revlimid, or are
> hospitalized for a long period. By that time they Medicare Advantage
> provider will be pressuring the family to put the patient into hospice
> so they can stop spending. You want death panels, you got 'em, but
> they're not the ones Sarah Palin was lying about. Pity the senior that
> doesn't have well-educated and tenacious children, preferably with
> medical training, as their patient advocates.
>
> I've been through that hell with my mother, fighting Hxxxxa to get them
> to provide the coverage she paid for. The doctors shake their heads when
> you ask why the drugs they prescribe are not being approved they simply
> say, "Hxxxxa won't approve them." One doctor of my mom's doctors said it
> right in front of the Hxxxxa nurse that they send to the hospital when
> one of their patients is hospitalized.
>
> With the improvements in standard Medicare coverage in the health care
> bill, the benefits of Medicare Advantage become less and less appealing,
> and the co-pays and the extra cost are likely to go up if the Medicare
> Advantage is with a for-profit company.
>
> The amount of fraud in Medicare Advantage is incredible. The service
> providers know exactly how to fill out the forms to get Medicare to pay,
> even when Medicare shouldn't be paying. What's too bad is that the cuts
> in Medicare Advantage are also going to hurt the honest service
> providers, of which there still are some, mainly the non-profit HMOs.

Sounds like you don't know what you're talking about. One, there is
very little if ANY fraud in Medicare advantage. When your mom signed
up to the plan she was given a formulary. This spell out all of the
drugs that are covered. If your mom HAD to have a drug not in the
formulary, the doctor can apply for an exception.

If you don't like medicare advantage you can go back to medicare and
buy a supplement and a seperate PDP. This will cost you up to 300 a
month or so. Insurance companys don't tolerate fraud. If she's on MA
or has an MAPD, the insurance company is paying the benes.
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