
Donald asks…
Why are people on Medicare happier with their coverage than people with private insurance?
Why do people like a single-payer government-run health insurance plan more than they like private insurance?
Source:
http://www.commonwealthfund.org/Content/News/News-Releases/2002/Oct/Survey–Medicare-Beneficiaries-Report-Greater-Satisfaction-With-Insurance–Better-Access-To-Care-Tha.aspx

Medicare Insurance AZ staff answers:
I would take FREE over PAY any day also. But that isn’t what the GOVT is offering, no matter how much kool aid you drink to try and believe it.

George asks…
Doesn’t Medicare deny coverage? So how can Obamacare say no denial for preexisting conditions?
I am just trying to figure this out. I am not trying to be a smart butt. According to what I heard,
Medicare has a higher denial ratio than does private insurance companies. So if Medicare regularly
denies coverage, why should anyone think Obamacare isn’t going to deny coverage? I am just trying to make sense of it. Thanks.

Medicare Insurance AZ staff answers:
First of all, the requirement to cover pre-existing conditons has nothing to do with Medicare. It is for direct pay plans for everyone not in Medicare or other programs.
Medicare is not an insurance company. Several people have been posting a statistic that indicates Medicare has a higher rate of claim denial than the big insurance companies. I had a look at the published source which did not explain why there were denials. I figured out that these figures were taken out of context from one source, copied to look like authentic reliable sources and put into a question on YA. The fact is Medicare gets claims from providers and suppliers, not patients, and is required to pay them within 30 days. The only time they deny claims is if they are suspicious or fraudulent. And there are plenty of those. That accounts for a delay while they are investigated.They do not take claims directly from patients.
What you call Obamacare has not changed the programs we currently have. It adds to them. We don’t yet know all the changes but it is a 10-year projected plan and will be tweaked, revised over time as needed, I would think.
Everyone is upset about having to buy insurance but no one minds if you have to pay your employer from your paycheck for group insurance. This is better because it is your own policy and you choose from a bunch of them on an exchange and you may get a subsidy to pay for it.

Michael asks…
Do you know of health insurance coverage in the philippines?
I have a relative in the philippines who is in and out of hospitals and so it can become costly. I would like to know if there are health insurance like here in the states such as a government type insurance like Medicare or private ones? It would be less worrisome for me knowing that whenever an emergency arrives, my relative will have insurance to cover whatever cost without waiting to receive money from me to get the medical attention

Medicare Insurance AZ staff answers:
The Government health insurance here is Philhealth. It only costs P100 a month and will cover a family of four. Good news is every citizen is eligable. Bad news is it takes six months to become effective and only covers 25% of the bill up to P100,000. Not great, but better than nothing. There are private health insures that cost way more, the problem there is they all have pre exixiting conditions clauses. With a relative in and out of the hospital it’s obvious they have pre existing conditions that would not be covered by the more expensive insurers like Philippine Blue Cross etc.
Evan with Philheath you pay upfront and wait for reimbursement. Sad but true here if you don’t have money , you don’t get treatment and rarely does the baranguay carry the more expensive meds like antibiotics.

Betty asks…
If the cost of INSURANCE is the problem, why has Medicare gone bankrupt?
Democrats are constantly telling us that their health care ‘reform’ is needed, in large part, to cut the cost of insurance and stop insurance company abuses.
But if this is the case, if insurance companies are the problem, why is medicare bankrupts? Why are states like Virginia having to reduce funding for Medicare and deny coverage to patients who use Medicare? ‘Insurance company abuses’ have nothing to do with the cost of Medicare. So why is Medicare costing the government so much? And what does the government intend to do to reduce the cost of Medicare other than to deny patient’s care and service?
Doesn’t this come back to the fact that the problems with health care is not the cost of insurance, but the rapidly growing cost of the health care itself? And if so, what does the Obama administration propose to reduce the cost of health care?
I don’t see anything, but maybe I haven’t been paying attention.
@oft suspended: That ‘incredible rate’ has bankrupt Medicare. Medicare is not self sustaining and cannot cover the cost of needed health CARE. Your President has done NOTHING to address the cost of health CARE. Nothing. That’s sort of the point. He’s using a bandaid to ‘cure’ a cancer.
@itsamini: So does Medicare, which is why fewer and fewer doctors are accepting Medicare patients.

Medicare Insurance AZ staff answers:
Medicare is like ANY program the Govt. Runs, failing. And we have a President who has NEVER had ANY leadership experience ever in the private sector. And we have a president and Congress who are rejecting options that will actually improve the quality of care and lower costs, in TORT reform and making Health Insurance portable and in doing so increasing competition between companies, and would drive DOWN the costs of insurance.

Steven asks…
PET scan insurance coverage?
My mom had colon cancer that has now been in remission for two years. Her doctor wants her to do all kinds of testing, but will not tell her what will be covered under her insurance plan. My mom has both Anthem and Medicare coverage. Can anyone tell me how often a PET scan can be done per year and still be covered? Thanks!
Can approval be given by the insurance provider before the PET scan is done? My mom can’t afford the procedure so that cost would kill her! She just tole me a CT scan is done at that time too so can approval be given for both prior to haveing them done? Thanks for all your insight!!!
All of you are great! Thanks for your detailed explanations AND for wishing my mom well!!!
UPDATE: My mom called and got some lab work done. All was well AND she got approved to schedule her PET test. They said she didn’t need her CT scan. Thanks again for your insight!!!

Medicare Insurance AZ staff answers:
Her doctor has no idea what will or will not be covered under her insurance . . Everyone in the US has a different plan so it is almost impossible to know who might qualify and who won’t. In either case she needs to have the scans done . . Make sure the doctors office sends off the request to receive the appropriate ‘permissions’ . . We had to go through two steps to get this approved . . There is some type of ‘national clearing house’ that determines if it is ‘medically appropriate’ and than there is the insurance to pay for it. We never were turned down by either of them (we had Anthem and Medicare too).
We have had experience being turned down for different treatments though and here is what we did .. We did not get emotional but called the insurance company and explained . . We than had our doctors office also call to talk to the insurance company . . If we were still denied we would appeal the decision in writing . . We usually would ‘win’ the appeal and the insurance company would pay. I do know others who sometimes went another round of appeals . . But in the end the insurance would pay. The PET is something your Mom needs and is the entire reason she has health insurance to begin with . . Insist that the insurance cover this for her . . But approach it diplomatically and don’t give up.
In general your mother should follow her doctors recommendations for the frequency of the PET scan . . And insurance should cover it. And, yes, approval is generally given before the procedure is done. If denied this benefit you should appeal to the insurance company and keep appealing until they agree to pay.
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