エピソード

  • Ep. 714 - MA prior authorization rules impose barriers & delays in needed treatment!
    2024/10/09

    Medicare Advantage Minute consists of an article decrying the increase in prior authorization denials. Of 46 million prior authorization requests, over 3 million (7+%) were denied in 2022.

    "Medicare" on the Wikipedia page discusses criticisms of Medicare and the principles behind having participants of various ages contribute to the cost of the program.

    Finally several clients write in with questions related to drug plans and Medicare supplement plans offering discount gym memberships.

    Spoiler alert: the gym membership deal through an AARP sponsored plan did not work out so well!

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    36 分
  • Ep. 713 - Bob has a million questions about his upcoming Medicare enrollment!
    2024/10/07

    Medicare Advantage Minute: Prior authorization denials have been more numerous in recent years. Only 10% of those denials are formally appealed but of that number, 83% are reversed.

    According to Wikipedia, only 5% of Medicare claims are audited so there is plenty of opportunity for fraud, waste and abuse.

    Finally, Bob from Arizona will be turning 65 and enrolling in Medicare in about six months. He had many questions about the procedure. These were clearly stated and almost seemed designed to make yours truly look like an intellectual giant!

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    33 分
  • Ep. 712 - Is your company insurance better than Medicare? Are you sure??
    2024/10/04

    Medicare Advantage Minute: Prior authorization requests are increasing and so are denials. For those with the moxie to file official appeals, the success rate approaches 83%!

    Wikipedia "Medicare" page: More on funding projections. Actuaries find it impossible to predict future solvency without the assumption that current laws will be followed.

    How does one decide whether Medicare is better than the company plan? Look at contribution vs. premium cost, match deductible and cost sharing and finally consider drug coverage.

    Finally, an article from AMAC: Understanding Medicare coverage; what is and is not included.

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    31 分
  • Episode 711 - Typical of High Deductible Plan G: a very tiny rate bump of $1.26!
    2024/10/02

    We begin this episode with advice about staying safe while planting a lip lock on the Blarney Stone.

    In the Medicare Advantage Minute article, we learn that giant MA purveyor Aetna has had three downward earnings projection adjustments lately. This has cost the CEO his job.

    In the Medicare Wikipedia page, the Feds spend a lot of time projecting the solvency or insolvency of Medicare.

    Finally, Toni King fields a question from a liver transplant candidate: how will Medicare pay for the necessary home care post surgery?

    Toni's answer: they will pay nothing.

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    33 分
  • Ep. 710 - Part D drug plans: good news/bad news coming your way!
    2024/09/30

    Our Medicare Advantage Minute article details the split between Health Partners and United Healthcare. This will affect 30,000patients of Health Partners.

    For even more excitement, listen to our entry on the Wikipedia page about Medicare: Indicators, Long Term Financial Status of Medicare!

    There is a list of the new stages in Part D drug plans. They are still bragging about getting rid of the "Donut Hole" and forcing the plans to eat more of the cost of expensive drugs. Gee, what do you suppose will happen to plan premiums?

    On a lighter note, we list the 10 best and 10 worst cities in which to retire as well as the "hardest working states".

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A++)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    32 分
  • Ep. 709 - Q & A: Correspondents ask the best questions ever!
    2024/09/25

    The Medicare Advantage Minute: Two MA behemoths are cutting back in 2025; which insurers will benefit?

    Communist government health programs like Medicare can only deal with increasing cost of care in two ways: increasing taxes and rationing care.

    MLM podcast guest Clarence Cramer was smart enough to hang up on fraudsters: Medicare will never call you on the telephone!

    Changing from an employer plan to Part D of Medicare is likely to reveal a difference in your drug benefits.

    A new client asks whether there is any hope in rescuing her partner from his unsatisfactory MA plan. We give her encouraging news!

    Finally, a correspondent asks a series of very excellent questions about Medicare & Medicare advantage. I should start a Q & A for the next edition: MLM 2025!

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A++)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    36 分
  • Ep. 708 - Dems spending $billion$ to purchase votes of Medicare participants!
    2024/09/22

    Medicare Advantage Minute announces: Seven insurers are exiting MA markets in 2025.

    Wikipedia page on Medicare: a comparison with private insurance.

    Health systems get ready: here comes the Silver Tsunami!

    Many of the most popular Part D drug plans have stopped paying commissions to sales agents. Consult "Medicare for the Lazy Man" for simple DIY instructions to select the best part D plan for you.

    Finally, an article announcing that Medicare supplement is positioned for growth in the future.

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

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    33 分
  • Ep. 707 - Inflation PRO-duction Act: delivering BIG rate increases to drug plans
    2024/09/20

    Medicare Advantage Minute: Star ratings will be recalculated, resulting in payment adjustments of hundreds of millions of dollars.

    Wikipedia page on Medicare: comparison with private insurance.

    Finally, Joan writes in asking how to remove herself from the hated Medicaid welfare plan she has become mired in. She wants to re-enroll in original Medicare with a beloved supplement plan.

    Contact me at: DBJ@MLMMailbag.com

    (Most severe critic: A+)

    Inspired by:

    "MEDICARE FOR THE LAZY MAN 2024; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers.

    Official website: https://www.MedicareForTheLazyMan.com.

    続きを読む 一部表示
    35 分