General Discussion

Scottie Mom

(5,838 posts)

45. The ins cos are EMPLOYEES of Original Medicare.

Wed Dec 6, 2023, 11:47 AM

Dec 2023

They are not in charge of making denials re treatment. They cannot deny treatment for a patient with Original Medicare.

There is a huge difference between being paid a salary to administer a program over which you have no control how the program functions and what benefits the members of the program receive and being in charge of the program where you can deny benefits and increase your profits.

You know exactly what I’m talking about. It’s the profits they get not the salary they receive as an administrator.

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Highlight:

Medicare Advantage Plans Disadvantage Many Elderly and Disabled People [View all] justaprogressive Dec 2023 OP

Advantage plans are great for the healthy but often not so great for the seriously ill. Lonestarblue Dec 2023 #1

+1. Eyeglasses, dental cleanings and gym memberships are peanuts in the world of medical bills. dalton99a Dec 2023 #10

I have a MA plan and never had any issues as descibed in this article. former9thward Dec 2023 #2

because original medicare is: ret5hd Dec 2023 #3

I have never had to wait for a referral/approval. former9thward Dec 2023 #4

So this guy is lying? Kingofalldems Dec 2023 #8

All of us have been on traditional insurance plans, after which MA is modeled, Ms. Toad Dec 2023 #9

n equals1 in the OP. former9thward Dec 2023 #11

Unless you are being justaprogressive Dec 2023 #25

Thank you for the good wishes! former9thward Dec 2023 #26

So answer me this, OK? Scottie Mom Dec 2023 #42

Insurance companies administer Medicare. former9thward Dec 2023 #43

The ins cos are EMPLOYEES of Original Medicare. Scottie Mom Dec 2023 #45

You don't believe the government website? former9thward Dec 2023 #47

Pls, only relevant replies, OK? EOM Scottie Mom Dec 2023 #62

This Is RobinA Dec 2023 #51

Not everyone can pay thousands of dollars to worry about it later. Ms. Toad Dec 2023 #5

It does not cost thousands of dollars to see a dermatologist. former9thward Dec 2023 #6

Huh? Hassin Bin Sober Dec 2023 #12

The initial appointment to find out if the lump was cancer or not would not cost thousands. former9thward Dec 2023 #15

And likely still stuck with the denial of care Ms. Toad Dec 2023 #19

There was never a denial. former9thward Dec 2023 #20

You are proposing a "kick the tires" appointment? Hassin Bin Sober Dec 2023 #21

Except you won't spend a couple hundred on an appointment Demobrat Dec 2023 #34

Yeah, blow a couple hundred to be told you need a biopsy. Hassin Bin Sober Dec 2023 #39

Read the first paragraph. Ms. Toad Dec 2023 #18

"My last dermatologist appointment was over $700 for a skin check and freeze a couple spots." brooklynite Dec 2023 #36

Yeah I have insurance. I'm saying what the charges were. As in what they would be without insurance. Hassin Bin Sober Dec 2023 #40

But what did your insurance company get charged? That's what he would've had to pay. SharonAnn Dec 2023 #57

You apparently missed the first paragraph in the body of the text. Ms. Toad Dec 2023 #13

Fifteen years ago I had a biopsy in the dermatologist office. Hope22 Dec 2023 #56

I Have Employer Provided RobinA Dec 2023 #54

I'm hardly jumping to a conclusion. Ms. Toad Dec 2023 #59

Maybe they did not have as much money as you, DemocraticPatriot Dec 2023 #61

The person said they were a retired veterinarian. former9thward Dec 2023 #64

States should allow switching from MA to supplement without underwriting. dalton99a Dec 2023 #7

You can also be very healthy and fit as I am... llmart Dec 2023 #14

I know of one that does - Ms. Toad Dec 2023 #16

New York does, thank goodness! Habibi Dec 2023 #63

So much this Politicub Dec 2023 #30

After the next election when Democrats Emile Dec 2023 #17

They're already halfway there justaprogressive Dec 2023 #22

Who is going to outspend the insurance lobbyists? misanthrope Dec 2023 #31

Yes, tell half of all Medicare enrollees that the Dems are going to take away their health care plans. MichMan Dec 2023 #52

Here is the thing, something needs to be done. Emile Dec 2023 #58

They want to end Medicare and their chosen method is working redqueen Dec 2023 #67

Why I Switched NowISeetheLight Dec 2023 #23

So happy you have justaprogressive Dec 2023 #24

Just got my traditional Medicare XanaDUer2 Dec 2023 #27

Interesting how traditional Medicare covers 80% for less than $200/month dflprincess Dec 2023 #28

I have an Advantage plan. PoindexterOglethorpe Dec 2023 #37

Read this thread. The facts are there. EOM Scottie Mom Dec 2023 #46

I read the thread. PoindexterOglethorpe Dec 2023 #48

Read your post. Scottie Mom Dec 2023 #50

Seems like you were lucky. Care to tell us which MA plan that you have? DemocraticPatriot Dec 2023 #60

Humana. PoindexterOglethorpe Dec 2023 #66

The Logical, Actuarial Reason RobinA Dec 2023 #49

Maybe because people have been paying into Medicare for 40 plus years from every dollar they earn? MichMan Dec 2023 #53

My sister is a hospital discharge nurse, JenniferJuniper Dec 2023 #29

Can we assume the "I hate Medicare Advantage" threads will end with the ads on Thursday? brooklynite Dec 2023 #32

No, the threads were here before and they'll be here after. JenniferJuniper Dec 2023 #35

Pretty simple understanding misanthrope Dec 2023 #33

That should be everyone's first clue there is something not quite right with those plans dflprincess Dec 2023 #38

Bingo. dalton99a Dec 2023 #41

In PA we can switch back into regular medicare every november lindysalsagal Dec 2023 #44

It's not switching back to regular Medicare that's the problem. Demobrat Dec 2023 #55

+1. For people with preexisting conditions, it is practically impossible outside the initial sign-up window dalton99a Dec 2023 #65

We need Medicare for All. Failure to get that done is accepting that the right will eventually kill Medicare. redqueen Dec 2023 #68