She won't eat. How can we improve her appetite?
Doctors at Duke have prescribed a medicine, but insurance won't approve. Buying without insurance is over $1,000 for a small supply. Cannabis increases appetite. Will that work for someone with cancer?
Interested in more discussions like this? Go to the Cancer: Managing Symptoms Support Group.
Hi, my name is Julie. I have been doing medical billing for 27 years. I was a member of the State of Iowa insurance Committee for 10 years. I have done all types of medical billing, inpatient, outpatient, ER but last 25 years have specialized in Podiatry billing as my husband is as Podiatrist. Any eligible person can ALWAYS return to straight government Medicare from any Medicare Advantage plan or Medicare Replacement Plan. First and most important for everyone to understand is these various “advantage” plans Do Not cover all services that “Real Medicare “ provide. In our practice these”plans” do not cover Wound Care. Plans will all cover cost to amputate toes, feet, legs-but only Medicare will cover the wound care needed to have the ability to save a limb. The “plans” might suggest they -cover wound care- the fact.is ; plan will cover 40% of cost after patient pays first $6,000.00 of cost./plan will cover only 2 different products out of 50 possible products that really work/plan will cover 4 applications but only after 6 months of “conservative care” -bandaids and by then the limb is probably already amputated.
Example: last week I assisted a patient who was returning to Medicare after being on United Healthcare Advanage plan. This patient’Don’ was approached at a meal site after getting a phone call from sales person who misrepresented-lied- about the services of plan. Don did not understand what he was signing up for. This plan did not cover services he needed to have the possibility to save his foot.
Don came back to my office, we called Medicare customer service and Don explained he was not informed by salesman details about plan. Salesman just told him he would save lots of money. Medicare helped him reapply for real Medicare, helped him get his secondary insurance back and his part D drug benefits. On July 1 his real Medicare will be activated and my Dr. will apply wound care with real hope of saving his foot.
The reason Medicare customer service logged into system for Don returning to Medicare was:
MARKETING MISREPRESENTATION
Regarding possible penalties you mentioned in your question. I do know that if a person jumps over to an Advantage plan AFTER originally being on regular Medicare, sometimes is is more difficult to go back to the secondary insurance you carried before.
EXAMPLE: if you were originally on Medicare-moved to advantage plan and return to Real Medicare (which you always can) wellmark- blue cross- has a set of pre-existing conditions to be able to pick back up wellmark as your secondary. Remember **you can always return to real Medicare but might have to choose a different secondary insurance depending on your circumstances.
My personal view regarding Medicare Advantage plans.
JULIE’S personal view:
These plans are a terrible injustice to our elderly. The “salespeople “ pray on our elderly to make money to put in their pockets. They confront the most vulnerable people in our communities, elderly who can not possibly understand the ramifications of what they are signing up for. Elderly who have dementia and don’t understand they are giving up their choice to have the best healthcare possible for a few hundred dollars in grocery money. Then these salespeople preach that the elderly CAN NEVER return to healthcare our country has provided for them. Government Medicare is there for the elderly and those with disabilities to be able to live the best life they possibly can. Our country provides this care to those who work hard all their lives. Our elderly do not deserve to be deceived by money grabbing companies who do not care how much someone suffers as long as these companies make a dollar. These insurance companies misrepresent their services and bold face lie in their commercials. In our podiatry practice the grief of a loss of a limb is equal to the grief of losing a spouse of 40 years of marriage. I am sorry if I have offended anyone. The truth is the truth. You can ALWAYS RETURN to your Medicare Plan provided by the great USA we live in. This is an unfair situation I deal with everyday and if I can help answer other questions it would be my pleasure.
Thank you, Julie! for answering my questions. I'll be passing this on to folks i know who wish they hadn't been duped into changing from original Medicare to Medicare Advantage. So appreciate your experience!