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<blockquote data-quote="Jim Simmers" data-source="post: 390182" data-attributes="member: 2674"><p>I am not of Medicare age. I have been an insurance agent for 23 years. I have been primarily an advantage plan agent for almost 18 years. Providers are dropping them at an alarming rate? Where at? Not in ND. Program has never been bigger and growing fast as we are close to the middle of the baby boomer generation. These plans grow by 2-3% every year at close to 52% of the Medicare population choosing an advantage plan. I am trained to be an expert in the field. Basically it’s all I do. The main reason why some Medicare providers might not like dealing with these plans is because they require pre authorization before a major procedure can be done. Doctors have to do that for the plan member. Providers have been over billing original for decades helping to break the Medicare program financially. 70% of all insurance fraud is from the doctors office in double billing or billing for services not rendered. Previously those claims would sit at CMS in pending status and it would be 6 months before the federal government would pay that claim without checking to see that the service was actually provided. The feds put a cap on how much profit a carrier can make. Most of all monies paid to part c carriers must be used to pay claims and provide benefits. Fact is, this year there are more plans to choose from than ever before. Plans don’t pop up if providers are dropping. Not sure where you are getting your information but you’re terribly wrong. They are here to stay.</p></blockquote><p></p>
[QUOTE="Jim Simmers, post: 390182, member: 2674"] I am not of Medicare age. I have been an insurance agent for 23 years. I have been primarily an advantage plan agent for almost 18 years. Providers are dropping them at an alarming rate? Where at? Not in ND. Program has never been bigger and growing fast as we are close to the middle of the baby boomer generation. These plans grow by 2-3% every year at close to 52% of the Medicare population choosing an advantage plan. I am trained to be an expert in the field. Basically it’s all I do. The main reason why some Medicare providers might not like dealing with these plans is because they require pre authorization before a major procedure can be done. Doctors have to do that for the plan member. Providers have been over billing original for decades helping to break the Medicare program financially. 70% of all insurance fraud is from the doctors office in double billing or billing for services not rendered. Previously those claims would sit at CMS in pending status and it would be 6 months before the federal government would pay that claim without checking to see that the service was actually provided. The feds put a cap on how much profit a carrier can make. Most of all monies paid to part c carriers must be used to pay claims and provide benefits. Fact is, this year there are more plans to choose from than ever before. Plans don’t pop up if providers are dropping. Not sure where you are getting your information but you’re terribly wrong. They are here to stay. [/QUOTE]
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