Find Senior Care (City or Zip)
Join Now Log In
J
J Asked October 2011

I am considering switching to an Medicare Advantage Plan. Where can I find information on which companies pay providers promptly?

EXPERT Carol Bradley Bursack, CDSGF Oct 2011
Go to www.medicare.gov. The site can lead you to providers in your area. You could call, of course, if you prefer, but the website is very good.
Carol

EXPERT Ross Blair Oct 2011
Hello. Our web site - PlanPrescriber.com - provides this side-by-side comparison service as well. But, whichever site you use, I would strongly encourage you to also look at a Medicare Advantage plan's "Star Ratings."

This is a new rating system created by the Affordable Care Act that provides you with a very good quality indicator for Advantage plans.

I'm copy/pasting information here from our web site that explans the Star Ratings for MA plans:

The Overall Plan Rating provides a single summary score that makes it easy for you to compare plans based on quality and performance.

The Overall Plan Rating combines scores for the types of services each plan offers. For plans covering health services, the overall score for quality of those services covers 36 different topics in 5 categories:

1. Staying healthy: screenings, tests, and vaccines: Includes how often members got various screening tests, vaccines, and other check-ups that help them stay healthy.
2. Managing chronic (long-term) conditions: Includes how often members with different conditions got certain tests and treatments that help them manage their condition.
3. Ratings of health plan responsiveness and care: Includes ratings of member satisfaction with the plan.
4. Health plan member complaints and appeal: Includes how often members filed a complaint against the plan.
5. Health plan telephone customer service: Includes how well the plan handles calls from members.

For plans covering drug services, the overall score for quality of those services covers 17 different topics in 4 categories:

•Drug plan customer service: Includes how well the drug plan handles calls and makes decisions about member appeals.
•Drug plan member complaints and Medicare audit findings: Includes how often members filed a complaint about the drug plan and findings from Medicare's audit of the plan.
•Member experience with drug plan: Includes member satisfaction information.
•Drug pricing and patient safety: Includes how well the drug plan prices prescriptions and provides updated information on the Medicare website. Includes information on how often members with certain medical conditions get prescription drugs that are considered safer and clinically recommended for their condition.

For plans covering both health & drug services, the overall score for quality of those services covers all of the 53 topics listed above.

For quality of health services, the scoring information comes from sources that include:

•Member surveys done by Medicare
•Information from clinicians
•Information submitted by the plans
•Results from Medicare's regular monitoring activities

For quality of drug services, the scoring information comes from sources that include:

•Results from Medicare's regular monitoring activities
•Reviews of billing and other information that plans submit to Medicare
•Member surveys done by Medicare

I hope this is helpful.

ADVERTISEMENT


AgingCareCM Oct 2011
Hi J,

There is an article written by an AgingCare.com Editor that was already posted in our community. We thought this might answer your caregiving question.

How to Choose a Medicare Advantage Plan https://www.agingcare.com/articles/choosing-a-Medicare-advantage-plan-148111.htm

You can also visit out Medicare Open Enrollment Guide that will answer ALL your Medicare Questions
https://www.agingcare.com/medicare-open-enrollment


We hope this helps. Please let us know if you need anything else and we look forward to seeing more questions and discussions from you.

Thank you,
Karie H.
The AgingCare.com Team

N1K2R3 Oct 2011
Yes, J. As Carol mentioned, the website is good, however most of us want to address the issue of Medicare Supplement Plans. Here's where it get dishy. I'm looking for Plan F which pays the remaining 20% that Medicare does not pay, and also a plan administration that pays promptly. Any suggestions?? You do know that the premium goes up ever year, don't you?

astoria22 Oct 2011
I, too, would appreciate this info. I am now with Medicare and Blue Cross of California - and under the auspices of the Presbyterian Pension Fund. My husband is currently in a group home with Alzheimers.

N1K2R3 Oct 2011
I was told recently that Medicare Advantage does not require a supplement plan, Medigap. Is this true? Is there a Medicare Advantage Plan designed for one who does not go to the doctor very often and does not have serious health problems?

J Oct 2011
Thank you for information, gives me a place to start comparisons.
Thanks also to others who have answered. jp

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter