Medicare Missives...from the Beach

When your Medicare Advantage Plan denies your claim.

Medicare Advantage plans replace Traditional Medicare with private insurance.

This puts a for-profit carrier in between you and your Dr. as gate keeper with a motivation to reduce "unnecessary" tests and proceedures.

However, over 80% of the time, when challenged the carrier backs down and approves the originally denied claim. They are contractually obligated to approve everything Traditional Medicare would.

Only 11% of denials are appealed!

If you have an Advantage plan and your claim is denied...appeal!

https://www.axios.com/2023/02/03/medicare-advantage-prior-authorization-requests