You are only guaranteed on Medigap with the best prices if you get it within 6 months of first enrolling in Medicare. That’s why it is critical to get real Medicare + Part D + Medigap when you are first eligible. If you initially get Medicare Disadvantage, and then realize how bad it is, you can switch from Part C to Part B/D during the next enrollment period, but it will be hard to add Medigap to that.
An audit done by the government’s inspector general found that Medicare Disadvantage falsely denied 18% of payments that they were supposed to approve and that real medicare would have approved. This amounts to 1.5 million times per year that Americans were shafted by illegal payment denials from those companies. There are also increased hassles and delays in getting your medical care and limited choice of doctors.
[An estimated 18 percent of payment denials met Medicare coverage rules and MAO billing rules and therefore the provider payments should not have been denied by the MAOs. This projects to 28,949 payment denials that met Medicare coverage rules and MAO billing rules for these MAOs during the first week of June 2019.]
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