Medicare Disadvantage?

What’s Being Said About Medicare Advantage:

MARKET REALIST (7/20/22)

Over the years, your Medical Advantage plan can change, resulting in you having to switch healthcare providers or forgo certain medications. And even though these plans boast low premiums (sometimes as low as $0 per month), they might incur unforeseen out-of-pocket expenses. Moreover, private insurers are able to establish their own rules regarding service.

LA PROGRESSIVE (6/17/22 & 6/8/22)

This privatized insurance deceptively sold under the Medicare name (thanks, George W. Bush) allows the corporations that sell it to challenge every single doctor’s recommendation, drug, procedure, or surgery, and also refuse to pay for doctors or hospitalizations that are “out of network.”

Medicare Advantage plans are endangering the lives of older adults and people with disabilities. The HHS Office of the Inspector General (OIG), which works to fight waste, fraud and abuse, recently issued a devastating report showing that these corporate health plans, which contract with the government to deliver Medicare benefits, are denying large amounts of care inappropriately.

This is not the first time that the OIG has raised serious concerns about Medicare Advantage. But Medicare Advantage plans continue to engage in widespread wrongful denials of care with little accountability. What will it take for the administration and Congress to protect people with Medicare from these bad actors?”

AMERICAN PROSPECT (4/29/22)

Medicare Advantage Is a Massive Scam

If you’ve ever watched cable news, where the average viewer is in their late sixties, you’ve probably seen an advertisement for a Medicare Advantage plan. They usually star some washed-up celebrity whose career peaked right around when today’s retirees were young adults (think Jimmy Walker or Joe Namath). And they always make a lot of big promises about how great Medicare Advantage coverage is.

There’s just one problem: The sales pitch is an abject lie. Medicare Advantage is much worse than traditional Medicare for people on the program and costs a great deal more to boot. But unless the Biden administration changes course, private companies will soon devour the rest of the program.

NEW YORK TIMES (4/28/22)

The industry’s main trade group claims people choose Medicare Advantage because “it delivers better services, better access to care and better value.” But federal investigators say there is troubling evidence that plans are delaying or even preventing Medicare beneficiaries from getting medically necessary care.

The new report, from the inspector general’s office of the Health and Human Services Department, looked into whether some of the services that were rejected would probably have been approved if the beneficiaries had been enrolled in traditional Medicare.

AMERICAN PROSPECT (1/24.22)

The Dark History of Medicare Privatization

But neither more regulation nor billion-dollar fines will suffice. The history of the MA dance shows that by the time the music ends, the private partner has swept the public one off her feet. He’s taken control over every step.

To put a stop to MA’s distortions and its systematic theft would require a campaign to make Medicare a more public health insurer. From the start, it ceded significant financial authority to private hospitals, doctors, pharmaceutical, and insurance companies. The more beneficiaries and money handed over to MA, the greater its power to resist. The ascendency of DC is the latest and most serious warning sign that the private profit-maximizers are close to victory. Nothing short of full public control can keep that from happening.

NPR (11/11/21)

Switching seniors to Medicare Advantage plans has cost taxpayers tens of billions of dollars more than keeping them in original Medicare, a cost that has exploded since 2018 and is likely to rise even higher, new research has found.

Richard Kronick, a former federal health policy researcher and a professor at the University of California-San Diego, says his analysis of newly released Medicare Advantage billing data estimates that Medicare overpaid the private health plans by more than $106 billion from 2010 through 2019 because of the way the private plans charge for sicker patients.

MORE EXCERPTS

New York Times (4/28/22)

“…federal investigators say there is troubling evidence that [Medicare Advantage] plans are delaying or even preventing Medicare beneficiaries from getting medically necessary care.”

Investopedia (6/27/22)

“You will find that many [Medicare Advantage] plans unexpectedly won’t cover certain expenses when you get sick—resulting in unforeseen out-of-pocket costs for you—and what they pay can differ depending upon your overall health.”
“Many enrollees have been hit with unexpected costs and denial of benefits for various types of care deemed not medically necessary.”

Consumer Reports (10/14/21)

“But there can be hidden risks to Advantage plans, especially for those with major health issues. ‘Some people in Medicare Advantage end up paying unexpectedly high costs when they become ill or find their network lacks the providers they need,’ says Tricia Neuman, senior vice president at Kaiser.”

American Prospector (4/29/22)

“The sales pitch is an abject lie. Medicare Advantage is much worse than traditional Medicare for people on the program and costs a great deal more to boot.”

Medicare Wire (7/27/22)

“7 Most Common Reasons We’ve Documented That Make People Feel Medicare Advantage Plans Are Terrible” –

California Medical Association (5/2/22)

“The U.S. Department of Health and Human Services (HHS) released a report on Thursday that found every year Medicare managed care organizations inappropriately deny medically necessary care to tens of thousands of people enrolled in private Medicare Advantage plans.”