09-09-2009, 08:35 PM
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CC Member
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Join Date: Apr 2008
Location: Scottsdale,
Az
Cobra Make, Engine: Black CSX 4910, Roush 511 8 stack
Posts: 1,206
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Not Ranked
Both of you have some valid points but just to add another opinion - I am a heath care professional (Respiratory Therapist) who own a durable medical equipment company (paid under part b) My insurance salesman you are quite wrong that the Medicare replacement plans(or whatever cool name you all want to give them) are not HMO's. They are much closer to the HMO family at least on the on the part B side than a PPO plan. The medicare replacement plans are NOT open to any medicare participating provider, since they give exclusive contracts to the lowest bidder to increase their profit. They restrict the Medicare patient from their choice (a Medicare hallmark) The contracts are capitated meaning that the provider is paid by the # of members a certain dollar amount whether they provie nothing, a beside commode, or a $15000 power wheelchair. The incentive is for the providing company to provide the least amount of service possible to maximize profit and to keep the costs fixed for the insrunace compnay. Often, senoirs find out too late that their premiums are higher with less coverage than they had with Medicare.
You sell the plans - we have to deal with what the reality of reimbursement with Medicare and the other plans after the fact. Would you be so hot to trot for these if you didn't receive a commission for them? What if you got a commission for selling Medicare? Would that change your story? And by the way, If I am signed up as a medicare provider I will NOT get paid if I treat and provide equipment for a Medicare patient.( I am not sure where you pulled that one from!)
Ron
Valley Respiratory Services
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