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To: Yosemitest

First, let me say that I am very sorry for your experience. It’s a shame that there is so much confusion about these programs, because they really do help a lot of folks in need save a lot of money.
I am a very small government person, along the lines of Ron Paul or The Constituition Party. And as much as I hate this system we’ve created of socialized medicine for seniors, and as doomed as I know it inevitably is, my reasoning is that for right now, since millions of seniors have paid into this system for all of their working lives, and they could have done much better for themselves by taking that 15% of their income and investing it elsewhere, whatever value of that I can get back for them at this point is not even close to what they deserve, so I do the best I can for them from that perspective.
I am life and health insurance licensed and I do a lot of Medicare Part C (Medicare Advantage) enrollments, including several Advantra Freedom products. Advantra Freedom is a decent product, and the company is totally legit, but like most companies, there is more bureaucracy than there should be, and Coventry Health (the company that issues Advantra Freedom products) has it’s share of inefficiencies that need improvement. But that’s the case with lots of companies these days, whether they sell computers or mortgage loans.
That’s why no matter what Part C Medicare product my client enrolls in, if they have a problem, question, or concern, I always tell them to call me, not the company, because I can often bypass the phone menus and misdirected call transfers and get the answer quicker than they can by calling my Agent Help Line, and usually with less hassle. Even if it’s a pain for me, and I have to do it through customer service, even when the call must be with the client and the company on the phone, I act as their advocate to get the answer they need as painlessly for them as possible. I know how to run around the run around. That’s my commitment to the client.
I note from the original post that the entire problem would have been nonexistent if you and your relative hadn’t been given misinformation by the clerk at the doctor’s office. It’s clear that she didn’t know what she was talking about, and if you’ll take a look at pages 33-35 of the “Medicare & You 2007” book, this year’s issue of the official government handbook for Medicare that is sent to every Medicare recipient each year, you’ll see exactly what I’m talking about. ENROLLMENT IN MEDICARE ADVANTAGE PROGRAMS DOES NOT DISENROLL A MEDICARE RECIPIENT FROM PART A OR PART B OF MEDICARE. THIS IS PLAINLY STATED AT THE TOP OF PAGE 35.
Unfortunately, there is an astounding amount of ignorance in doctor’s offices about what Medicare Advantage is, even in their billing and insurance departments, and that’s where your misunderstanding arose. Had you not heard that incorrect information, your relative might be enjoying the real benefits of that program now, which are substantial to the recipient in most cases.
Based on your reaction, I question whether the enrolling agent had done his/her job at the beginning, as I do by showing my prospects the Medicare book right off the bat. If they had, you would not have been thrown into a frenzy by an ignorant clerk, and if you had concerns, you would have brought the question back to the agent, who would have given you the clear answer, pointing you back again to the horse’s mouth, the Medicare book.
Trust me, this business is highly regulated, and even without any formal complaints being made, an agent who has an abnormally high ratio of clients disenrolled to clients enrolled within a short period of time will not be allowed to continue very long with that company, because the company will have their contract with Medicare rescinded if they have too many complaints or cancelled enrollments, indicating poor training or screening of agents.
Feeding these problems is also the fear of change. The addition of Part C & D were the biggest changes in the senior healthcare infrastructure since the inception of Medicare in 1960’s, and I imagine 40 years ago there was a lot of fear and resistance amongst both recipients and health care providers when Medicare started as well. And a lot of missteps and inefficient delivery of benefits in the beginning by the new government infrastructure. But today, of course, most of us are more comfortable with it and take the system for granted, because the largest kinks have been worked out in day to day operations, we’re used to the remaining inefficiencies, and by the time we become recipients, we’re intractably in the system, like it or not. We all here understand and agree on why that’s not necessarily good in the long run, but that’s water under the bridge at this point.
Again I’m sorry for your difficulty. Don’t let that turn you off completely from the concept of Part C, which when done well is a godsend for seniors as a whole. All companies and all plans are not the same, so shop around. Part C and D are the future of Medicare, by necessity, if it is to have one. The domination of supplements is waning because they are quicky becoming too expsensive for most clients. That’s why C exists.
As a last note, I see that the bulletin you cited from your state says nothing about any particular Part C program, and you don’t say that the enrolling agent in your relative’s case claimed to be from Medicare, which as the bulletin says, would have been unethical, even though they may have been representing a Part C plan that was subsidized with your relative’s Part B premium and taxpayer money, the administration of which was contracted out by the federal government to a private health care company, because the private company is able to provide substantially more benefits to the Medicare recipient for the same money, than can the government. More benefits, lower consumer costs. Isn’t that what we’re all supposedly after?
Again, for clarification on what Medicare Part C really is and what is really does, please see pages 33-35 of the Medicare and You 2007 book.
May God bless you and your family, and give you peace!


18 posted on 06/01/2007 8:32:27 PM PDT by Briansurance
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To: Briansurance
Okay ...you're sorry. NOW tell me another lie. Let's address the money "saved" issue. Like they had a choice of declining Social Security taxes all of their lives...

Listen! This is a rip off, made to enrich shysters. I'm retired military and was promised free medical and dental care for life. But thanks to William Jefferson Blythe Clinton and the democrats, that promise was broken in 1993, as well as increasing taxes on Social Security, and taxing the dead postmortem.

I appreciate you helping your clients. But that didn't help my parents, and I'm not sure you're telling the truth. For all I know, you're just doing damage control for Advantra Freedom (May God reward them according to their works). But for me and my parents, we'll drink a toast to their demise, and will tell everyone just how rotten they were.

I'm sure the doctor's office knew what they were doing. I'm also sure that we will NEVER--- EVER--- talk to a Medicare Part C or Part D agent again!!!! The Advantra Freedom agents said they were with Medicare and would not take away my parents Medicare Part A or their Part B coverage. But the first thing they done was to cancel my parents Medicare Part A and B coverage with the hospital, doctor's office and drug store. The agent told all three to file those cost to Advantra Freedom, according to what the drug store pharmacist, the hospital insurance claims agent, and the doctor's secretary said.
I still think you're just doing damage control for Advantra Freedom.

It wasn't just the Hospital and Doctors clerk, but the Social Security Agent that told us what to do. When we finally got rid of that crooked company Advantra Freedom, and got verification that we re back to the normal Medicare, the doctor and the hospital's insurance agent told us that thousands of people had been lied to by Advantra Freedom, and several people had suffered severe health issues because of the delay caused by having to change doctors, and by the delay of verifying coverage for a certain procedure.

I'm not buying it and I'll cheer the day that the government revokes Advantra Freedom's license to operate. When we asked the customer service agent at the hospital what to do, she said, "I can't advise you what to do". But with her hand, she took the Advantra Freedom Card and held it over the trash can, while with the other hand, she gave the Medicare and Medicare Supplement Cards back to my mother. I thank God for her help and for the Social Security office's help.

Yes, we're all for lower cost. But this is another democratic boondoggle bigger that the Congressional Post Office Stamp and Rubber Check scandal. By the time the errors are corrected, the scammed money will be long gone, like Global-Crossings and World Comm.

I'll look for it, but it's really doesn't matter if your parents doctor won't accept the insurance. That's where the bullshit walks.
19 posted on 06/15/2007 10:59:49 PM PDT by Yosemitest (It's simple, fight or die)
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To: Briansurance
Upon second reading...

From this statement alone, it's plane for anyone to see that Advantra Freedom doesn't want to serve their clients. They want to delay, deny, and confuse their customers with the phone menus and misdirected call transfers and ... hassle. ...the run around.

Again ... may the Lord reward Advantra Freedom... according to their works.

20 posted on 06/15/2007 11:10:08 PM PDT by Yosemitest (It's simple, fight or die)
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