Surprising reasons doctors will DENY your plan.

Medicare Specialist - Abt Insurance Agency

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Опубликовано:

12 июл 2024

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Комментарии : 79

@jcnlaw 2 месяца назад

I was wondering how Congress can send billions of dollars every year to aid other countries, yet Americans who worked hard and paid into the Medicare system for many years are still charged for basic healthcare after 65 years of age. I can’t get my head around the concept.

@idmhead0160 Месяц назад

Because they are 100% immoral and corrupt. They print money at will for perpetual war, but, there is no money for healthcare for the American people. Every other country has universal healthcare except us.

@g0989 2 месяца назад

Although most doctors accept Medicare Assignment, they can at their discretion decline to accept a NEW Medicare patient. Or they may not accept new patients at all, regardless of what kind of insurance the patient has.

@AbtInsuranceAgency 2 месяца назад

Very true!

@StephenMalinowski-qd4hy 2 месяца назад

😊

@danharold3087 2 месяца назад

Medicare needs to take better care of people who can't afford the add on plans. They assume that because you once made decent money you will have others sources of income. That does not happen when your disabled early in your career. Health care is Medicare A+B and SS is enough so as not to qualify for any other assistance. It is insulting.

@steveludwig4200 2 месяца назад

Part G plans are cheap as dirt at around $125/month. And most Part D prescription plans are even cheaper. Not sure what your issue is.

@christopherroberts3047 2 месяца назад

In some parts of the country they are much higher.

@silver6054 2 месяца назад

@@christopherroberts3047 And even at $125, that's $3K a year for a couple, and more than that again for the Part B premium, which can be s significant part of someone with just (small) SS as income

@alansach8437 2 месяца назад

@@steveludwig4200$125.00 may be cheap as dirt to you, but it may not be to others (especially those whose only income is Social Security). Also, it's much higher in many (if not most) parts of the country, and it tends to go up every year. In addition, you are required to pay for a separate plan D for medications, and many people also opt for dental and vision plans, which all add up!

@malinhead322 2 месяца назад

In order for LBJ to pass the Medicare Program in 1965, the Republican Party insisted that Medicare cover only 80%, opening the door for insurance companies to cover the remaining 20% in return for a premium = profit.

@ameliorate777 2 месяца назад

I really enjoy watching your videos. They are very well presented and informative. You have a pleasant vocal timbre and the speed at which you deliver your commentary makes it easy to comprehend the material.

@AbtInsuranceAgency 2 месяца назад

Thank you kindly!

@imanoleonardo6902 2 месяца назад

Very clearly presented!

@AbtInsuranceAgency 2 месяца назад

Thank you!

@geraldinefields1730 2 месяца назад

Thank you.

@AbtInsuranceAgency 2 месяца назад

You're welcome!

@dleverett1963 2 месяца назад

You do a great job of communicating! I work for the school system here in Georgia. In a few years I will retire and a few years after that I will turn 65. How do state healthcare benefits compare when it comes to choosing Medicare or a State Medicare Advantage? Thank you.

@sturisa 2 месяца назад

Stephanie, thanks for clarifying and you are right, I've never experienced a situation where if the doctor takes traditional Medicare they wouldn't take my Medigap plan.

@BlessedBeMyDay 2 месяца назад

Legally they have no choice. If they take medicare , they must accept supplement( medigap) plans

@mraufanmike 2 месяца назад

How did you know that I just had this exact thing happen to me. The office worker tried to tell me that they no longer take Cigna insurance. I have watched enough of your videos to know better. Thanks for keeping us informed.

@AbtInsuranceAgency 2 месяца назад

You are so welcome!

@eMDiKhamPha 2 месяца назад

I like how you put it. Most front desks would not know. It's better to call your provider, ask for the answer then give the phone to front desk to hear what is said. Happened to me and after front desk talked to insurance, everything turned out fine 😓

@masterlee4370 2 месяца назад

I became Medicare eligible this year but I am still working so I kept my companies insurance. I went for a wellness visit back in January and noticed my Family Doctor who has been my doctor for 40 years had a sign on his Bulletin board in the patient room I was in that stated "All Medicare Patients must pay at time of Appointment then they would mail the bill to Medicare for our reimbursement" I found that really odd.

@WhittyPics 2 месяца назад

I would go to medicare.gov and open a chat and question if that policy is legal

@BlessedBeMyDay 2 месяца назад

That is strange. Medicare is very quick on paying ( 2 wks maybe) . Is this Dr. Office trying to get paid the billing price and you only get reimbursed for medicare approved amount. If thats the case then that Doctors Office is not accepting medicare assignment . Just accepting that they have to bill Medicare . If thats the case find another Doctor who does accept medicare assignment . Look for that terminology We Accept Medicare Assignment not just we accept Medicare .

@kevinjarchow8812 2 месяца назад

He's probably doing that due to the delay in payment from Medicare. It's tough to keep the lights on when you can't be sure of when the revenue to support the business will come in. It sucks that he has to do that. But it might also cut down on the people who come in for trivial reasons as well.

@steveludwig4200 2 месяца назад

Just stay away from "Advantage" plans....period.

@cheryaljones9467 2 месяца назад

I agree.

@maryshkamiceli8388 2 месяца назад

These "Advantage" plans are sold to enrollees in deceptive ways and enrollees don't realize it until they use the Plan and find out what the Plan won't cover. Growing medical debt among the 65+ group is a real thing.

@avflyguy 2 месяца назад

@idmhead0160 Месяц назад

That was my thought, but, I am running into a problem with my mother. She was on Medicaid and had everything covered. When my dad died, her Social Security went up which made her no longer eligible for Medicaid. I was told that since she has osteoporosis, which I have been told 80% of women get, she cannot get a supplemental plan at all. So, it looks like I will be forced into getting Advantage for her, which wasn't what I wanted. This system is all one big sham. We should have universal healthcare, like every other country has. We have for-profit corporate BS system that only cares about making money and not helping people.

@maryshkamiceli8388 Месяц назад

@@idmhead0160 I hope they don't deny her coverage based on a pre-existing condition.

@maryjieh38 2 месяца назад

Does Medicare A or B covers ER visits? I have Traditional Medicare with Medigap.

@AbtInsuranceAgency 2 месяца назад

Part B! Part A kicks in if you are admitted.

@davidvaden9468 2 месяца назад

I have a 67 year old (farmer) friend with only 38 quarters of coverage. Income in many years was below Social Security filing requirements. Are exceptions available for people in this situation to apply for Medicare without penalty. Thank you.

@jerryhartman1259 2 месяца назад

Do you and your spouse need to be on the same plan or can you each take a different path or plan?

@AbtInsuranceAgency 2 месяца назад

You can each take a different plan/path!

@kellroy1778 2 месяца назад

When you say you can change your plan once a year, are you referring to the carrier in the advantage plan?

@AbtInsuranceAgency 2 месяца назад

The Advantage plan, yes.

@kenparrent6770 2 месяца назад

Does my original Medicare plan B submit the claim to the plan G insurer, or, does the doctors office submit the claim to both original Medicare and plan G? There always seems to be confusion when I provide both cards to the people handling the billing.

@AbtInsuranceAgency 2 месяца назад

For most all claims the doctor submits to Medicare and then there is an "automatic crossover" where Medicare automatically submits the claims to the Medigap company. There can sometimes be exceptions to this when it comes to Part A hospital claims.

@maryshkamiceli8388 2 месяца назад

Will you address how Medicare with Medicaid works?

@AbtInsuranceAgency 2 месяца назад

I have a future video coming out about that!

@mimi1o8 2 месяца назад

@@AbtInsuranceAgencyusually I never find videos on Medicare +Medicaid insurance, your knowledge will be appreciated

@LinhHa-sd4zf 2 месяца назад

Pls, I have a question, my husband retired with Part A, and he is my dependent on my (employment) health insurance, when time comes for the hospital (in this case is him) should we not involved my insurance? He retired 6 years ago and this is our first time using hospital. Very much appreciated.

@AbtInsuranceAgency 2 месяца назад

If your employer has more than 20 employees then the employer coverage is the Primary Payer and Medicare Part A is secondary.

@LinhHa-sd4zf 2 месяца назад

@@AbtInsuranceAgency and is there any out of pocket for the deductible part? The medication is mine, correct? Much appreciated.

@freecycling6687 2 месяца назад

The Kaiser Permanente example was a bit confusing. So can doctors be "in network" with Medicare Advantage plans, but NOT accept traditional Medicare?

@AbtInsuranceAgency 2 месяца назад

It is confusing! This is one unique example where a network of doctors and hospitals (Kaiser) actually owns and runs their "own" Medicare Advantage Plans (Kaiser Medicare Advantage), so they play by different rules.

@steveludwig4200 2 месяца назад

1. AVOID Advantage plans. 2. AVOID Kaiser Permanente.

@user-yl2bl8ui5o 2 месяца назад

When asked to produce insurance card, do you provide only the Medicare card or do you need to present both? Since Medicare approves and sends to medigap and the doctor does not interact with Medigap insurance, why would you discuss if you have medigap insurance?

@g0989 2 месяца назад

You would show your Medicare card and Supplement card to a medical provider, so they are aware you have coinsurance with your Medicare plan and who it is and what plan you have. This way they know there is a secondary payer involved and that they could be receiving payment from another carrier. Otherwise, with Medicare alone, the patient will be responsible for 20% of approved charges always, after satisfying the Medicare deductible.

@AbtInsuranceAgency 2 месяца назад

You should show both, so the doctor knows you have a Medigap plan/secondary coverage!

@fredstaff4160 2 месяца назад

It's not true that you can see any doctor with traditional medicare. Advantage docs will not see you. Also how could the county function sans the social safety net programs?? Vote this fall

@AbtInsuranceAgency 2 месяца назад

I mention that Kaiser is the exception - what other "Advantage" doctors do you know that are denying Traditional Medicare patients?