Medicare Advantage is great. Except for taxpayers
Bloomberg Opinion,
by
Staff
Original Article
Posted By: Harlowe,
11/3/2023 6:11:45 PM
Every year, from mid-October to early December, millions of Medicare beneficiaries get the chance to pick a new health plan. With dozens to choose from and a blizzard of advertising, more seniors are going with the simplest, cheapest option: privately run plans known as Medicare Advantage.[Snip]Yet Medicare Advantage has drawbacks--notably, its exorbitant cost. Government reports show the program routinely overcharges taxpayers relative to original Medicare--to the tune of $27 billion this year alone--at a time when the system’s solvency is at risk.[Snip]How did Medicare Advantage become, as one study put it, a “money machine”? (Or, less charitably, a “great big rip-off”?)
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Reply 1 - Posted by:
rememberwhen 11/3/2023 6:39:47 PM (No. 1591316)
Medicare Advantage has distinct disadvantages to the patient as well, such as the inability to choose your own physician and the inability to see a specialist without a referral from a gatekeeper physician whose job it is to keep people from seeing more expensive specialists. I am convinced this kept my mother-in-law from receiving lifesaving care from the specialists she needed.
14 people like this.
Ten years ago, when my PSI test came in high, my physician refused to refer me for biopsy. Under Medicare Advantage, that would have been final. Fortunately I had regular Medicare with a very good secondary insurance. I got a second opinion, found a cancer and had curative treatment. For a while I joined a group of prostate cancer patients that met regularly. Those of us on regular medicare got treatment. People with verified prostate cancers who had Medicare Advantage were usually treatment. I am convinced that Medicare Advantage offers a bunch of cheap extra benefits (Dentistry, Optometry, etc.) but denies expensive care that may be lifesaving.
11 people like this.
In reply 2, I made a typo. Art should have read: People with verified prostate cancers who had Medicare Advantage were usually DENIED treatment.
11 people like this.
Reply 4 - Posted by:
stablemoney 11/3/2023 7:21:20 PM (No. 1591337)
27 billion? While Biden asks for 106 billion for foreign wars, many billions for the 15 million illegals allowed in the country, money for 80,000 IRS agents, 34K ea for members of Congress, 10% annual increases in budgets for federal agencies, a new FBI headquarters, the federal payroll padded with hundreds of thousands of people not needed to keep up the illusion of no unemployment. BTW, Medicare premiums are based on Modified AGI, which means the premiums are progressive.
10 people like this.
Reply 5 - Posted by:
Daisymay 11/3/2023 7:37:03 PM (No. 1591352)
I have had Medicare Advantage for over Ten years and I love it! If you choose a PPO plan, you can go to any Doctor you like without a referal. I have had ER visits a d hospital stays. They were always paid to my satisfaction. My Prescriptions are reasonable and now we get $1,000 per year of Dental coverage. Life is good for this 82 year old Lady!
22 people like this.
Reply 6 - Posted by:
Gordon Mills 11/3/2023 7:48:10 PM (No. 1591360)
#1, I've been in a Medicare Advantage plan for 20+ years and nothing you wrote in your first sentence has any truth regarding my coverage or anyone else that I know who is in a Medicare Advantage plan. Please be more precise and careful with your statements. Prior to my Medicare Advantage plan I was enrolled in a Medigap plan and the coverage was limited in what it would cover which could have hurt big time.
10 people like this.
Reply 7 - Posted by:
3XALADY 11/3/2023 8:29:10 PM (No. 1591385)
I just enrolled in a Medicare Advantage plan last January. Prior to that I had Plan F. I am diabetic. During one of those years, I paid $8,000 for medications. This past year, my co-pays were less than $2,000. Included were tests to determine why I had iron deficiency anemia, two iron infusions and one blood transfusion. I never had an issue with seeing a specialist or for having any test. I will stay with Medicare Advantage.
10 people like this.
Reply 8 - Posted by:
padiva 11/3/2023 8:53:40 PM (No. 1591398)
I have Medicare Advantage. It's fine.
I pay $170+/month for Medicare.
Medical fees are jacked up to cover Medicare's reduced rate of payment to the doctors/hospitals/testing services/etc.
5 people like this.
Reply 9 - Posted by:
Corndoggies 11/3/2023 10:57:38 PM (No. 1591456)
I turn 65 next September and half of my fb feed are ads for Medicare plans. It seems confusing. I’m not overweight and take no medications. I wear glasses and have good teeth. I’d make a great horse lol except I have a hip giving me problems. What plan should I sign up for?
3 people like this.
Reply 10 - Posted by:
padiva 11/3/2023 11:48:49 PM (No. 1591481)
#9 I have Aetna. Happy with them. (I get several hundred dollars worth of selected OTC CVS stuff that I choose sent to my home several times a year.)
Don't go with any of the cold callers with funny accents who call from a noisy room.
8 people like this.
Reply 11 - Posted by:
Harlowe 11/4/2023 1:58:52 AM (No. 1591501)
#9~ Delightful sense of humor. The decision between Medicare and Medicare Advantage is a personal decision; however, for numerous members of this family, the resounding preference is Medicare. A family member initially having Medicare Advantage incurred unexpected substantial financial expenses in addition to be restricted with personal choices of physicians as well as hospitals and during open enrollment, chose to go with Medicare and is very pleased with having made that decision. A close friend of that same family member has serious medical problems but is prevented from seeing one of the best medical specialists in the area due to the restrictions of a Medicare Advantage plan. Always do the research. As the old adage goes, “If something seems too good to be true, it probably is not.”
4 people like this.
Reply 12 - Posted by:
ussjimmycarter 11/4/2023 3:19:25 AM (No. 1591528)
Just went through this choice! Was referred to a wonderful insurance agent! She had multiple choices for us. We picked Blue Cross and couldn’t be happier! Their customer service is AA+++!
5 people like this.
Reply 13 - Posted by:
cheeflo 11/4/2023 11:58:47 AM (No. 1591768)
Medicare Advantage isn't for everyone. I have a Medigap plan (Part G) that covers monthly infusions for RA. Advantage plans won't do that. My drug and dental/vision/hearing plans are à la carte.
#9 -- I consulted an insurance professional who was very helpful when I was choosing. Didn't cost me a thing to talk to her. I would suggest you find one to help you choose.
3 people like this.
Reply 14 - Posted by:
ladydawgfan 11/4/2023 12:57:13 PM (No. 1591804)
I find this whole thing incredibly confusing. I am disabled and have both medicaid and Medicare. I was informed that one of my doctors will not be available to me if I choose Medicare Advantage. He is associated with the Mayo Clinic and is very good. I was also informed that some of my medications will no longer be covered by my insurance, which presents new problems that I don't need.
Before I had Medicaid, I had an excellent Blue Cross plan that covered everything that I needed it to. However, because I am disabled thay won't let me keep it and insist on Medicaid and Medicare. It would be a LOT easier for me at least and for the taxpayers as well if they would let those of us who are disabled choose whether or not we wanted to be on government health plans at all.
1 person likes this.
Reply 15 - Posted by:
Harlowe 11/4/2023 1:05:40 PM (No. 1591810)
#11 Supplement~ Another old adage to keep in mind is, “You get what you pay for.” A family member’s personal experience while with a Medicare Advantage plan not only restricted physicians, hospitals, and pharmacies, but also home health care needs. While researching immediate medical coverage, the need to research long-term medical coverage may be overlooked and can result in being restricted to home health care agencies/providers that are less than desirable. Having switched to Medicare provided this family member the freedom to choose physicians, hospitals, long-term agencies/providers, and pharmacies.
4 people like this.
Reply 16 - Posted by:
franq 11/4/2023 1:42:18 PM (No. 1591829)
We are opting for MA. Know people that have it, and are very satisfied. Good to see positive comments above.
1 person likes this.
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