Pugsy wrote:NateS wrote:If you have a Medicare Advantage policy and you are not yet 65, then you must have qualified by reason of disability.
Well, duh...I thought I made that fact rather plain...guess I didn't.
I'm sorry - I must have missed where you said that.
Pugsy wrote:No need to educate me on the process...been there first hand. Not sure what your point to all the reference material was.
Hope you don't think I needed to read it which makes me feel like you are talking down to me and everyone knows I don't take that very well.
I apologize - it was not my intention to talk down to you or to anyone else, and frankly you are the last person I would want to annoy or offend on cpaptalk, as you have done so much for me personally and for so many others here.
My impression was that we were all addressing the subject of the thread which was defined by the original poster:
That's the subject I thought we were all addressing. As for references, while they were not necessarily meant to be addressed to you in particular, I am not the only poster who feels an obligation, where referring to laws and insurance regulations, to back them up with citations. I feel it would be presumptuous of me to do less. It is a matter of habit and training.
Pugsy wrote:Also not sure why you can't seem to understand that not everyone can get or even wants a "real" medigap plan.
Some of us are actually intelligent enough to understand the pros and cons and are quite satisfied getting something that I guess you consider inferior for some reason other.
Well, I certainly don't question your intelligence Pugsy or anyone else's for that matter. I don't think choosing one or the other plan is a mark of intelligence or lack thereof. I do think that when Medicare Advantage is sold, especially to senior citizens, that insufficient emphasis is laid on the fact that just because the doctor(s) you have gone to for most of your adult life is/are on the proposed plan in the year you join, that you will not have to change doctors next year or the year thereafter. To me, this is a form of bait-and-switch, which has been going on for years, and of which I know of many, many personal experiences. I understand or assume that because of your years of training and experience in the medical professions, that that might not be a big deal to you. And maybe there are others here who will still be happy with their Medicare Advantage Plan even after their lifelong doctor(s) are no longer on their plan. But it is very traumatic to many persons, particularly those of advanced years. And that's what I understood this thread to be about.
And changing doctors also sometimes means changing hospitals, because not every doctor in a community necessarily goes to every hospital in the community, and this can also be very, very traumatic to the elderly. As you know, not every hospital in a community has the same standard of care or the same rating by national organizations and often with good reason.
Over the years, I have worked within the insurance industry and I have also worked from without, dealing with the insurance industry and seeing how so many people's lives and fortunes get ground up in the process, and I have also seen what they have done to honest, hard-working members of the medical professions by their practices. I am speaking from the heart.
In past years, I attended many of the group meetings of seniors just approaching age 65, sponsored by various health insurance companies, and which are run like pep rallys, and when the BIG question invariably comes up "Is my doctor on the plan?" a big clinching sigh of relief goes up when one of the presenters points to the plan page and says "Yes, look your lifelong doctor is on the plan!" Not once have I ever heard the presenter qualify that by adding something like: "But he/she might no longer be on our plan next year or the year after that!"
I am also acutely aware of cases where Medicare Advantage has flatly turned down approval for a life-saving procedure, calling it "experimental" whereas the same procedure had been routinely approved by regular Medicare.
There is are reasons why, as PST said:
PST wrote:In this connection, it is useful to note that the
Yale Medical Group still takes ordinary Medicare. It is just being dropped by this Medicare Advantage plan.….
Again, I apologize to you Pugsy if I have offended you in any way.
Respectfully, Nate
Central sleep apnea AHI 62.6 pre-VPAP. Now 0 to 1.3
Present Rx: EPAP: 8; IPAPlo:11; IPAPHi: 23; PSMin: 3; PSMax: 15
"I've had a perfectly wonderful evening, but this wasn't it." —Groucho Marx