Interesting MAPD Information
The Secretary of Health and Human Services has just released a very interesting report about the practices of MAPD plan administrators.
The report states that United Healthcare Group, Humana and Aetna have denied admission to skilled nursing and rehab facilities at a very high rate. When the families appealed that decision it was reversed over 90% of the time. The issue is most families, when struggling with a senior’s health issues fighting the MAPD plans denial is the last thing they want to do. Yet, it seems that they must do it to get the medical assistance needed for their family members. It’s clear to this blogger that the profit is more important than the health of their subscribers.
This blogger is upset that this is happening nationwide and the average family member is not skilled enough in how Medicare works and how to fix their problem. They are too concerned and rightfully so about their relatives’ health to follow through with the insurance company. That is where the broker can assist as they understand the process and can advise the client how to proceed, to force the MAPD plan to provide the services needed to improve their relative’s health.
My recommendation is to seek a Medicare insurance broker (not an in-house agent as they work for the insurance company) and have them find the best plan for you. That could be United, Humana or Aetna as they all have terrific plans for seniors. Just be aware that insurance companies are out to make a profit and sometimes they are thinking about profit above medical care. Just because there is a new report stating these facts does not mean those insurance companies are bad. They offer some very good plans with many additional benefits over Original Medicare.
This blog is to merely mention this situation, so you are aware and remember if your family member needs these services that you may need to fight the insurance for these services. Knowledge is king and just be aware that this could happen to you.
My credentials are 23 years as a Medicare broker here in Las Vegas and not having one complaint or issue against me on that time. I carry Errors and Omission insurance in the event there is an issue but to-date, no issues or complaints, or claims. Member of NAIFA (National Association of Independent Financial Advisors) and NABIP (National Association of Benefits and Insurance Professionals).
Also, you may want to take a look at 2026 Medicare Information.
The Barend Agency Inc. Len Barend, broker 702-250-2200
