Thank you for this very good wake-up call for many. Great summary article. I have so many family who always tell me I should change from Medicare to MA where you pay nothing and get "free stuff". They don't understand why I have to pay an out of pocket deductible of 200 some odd bucks every year. Fortunately I had a very good big brother 2 years older than me that set me straight on the hoax when I turned 65.. Unfortunately he died of cancer 2 years ago. But he told me to NEVER go with MA plan, as almost all of his cancer treatments were covered by Medicare and his supplement, whereas they would not be approved if he had MA, and he wouldn't have been able to get back into traditional Medicare since he had cancer. It is shameful that this even exists. You pay into Medicare insurance your whole working life so it will be there when you need it and the greedy corps want to take your health coverage away and give you free band-aids and diapers every month!
Private insurance should be what the media & all Americans call MA plans...because that's all it is.
Having greedy CEOs steal precious traditional Medicare's name and reputation, not to mention how they steal between $80-$120 BILLION from traditional Medicare funds--that's OUR money! is insult on top of injury.
I'm sorry for your brother's passing. He was right and you were lucky to have him guide you. Not everybody has that help.
Part c Medicare disadvantages only exist with corporate welfare. This welfare (taxpayer dollars) is mostly given to private for profit health insurance companies with Republican support.
I’m noticing the corporate welfare scam is expanding to giving Medicaid taxpayer dollars to private for profit health insurance companies.
All This money must go to providers and communities that actually care for our health.
The very first Medicare managed care arrangement went into effect in 1973 as a response to Nixon’s HMO Act. Kaiser was the early trail blazer. That’s a 51 year history of name changes (used to be called Medicare Choice) and tinkering by CMS, HHS, presidents of both parties & Congress. A bipartisan majority of Congress has been consistently vocal in supporting MA. The MA member plan churn rate in 2022 was a paltry 5% (much much lower than employer sponsored coverage). Medicaid has also transformed to a predominantly managed care model over the last 25 years (why not rail against “greedy” large Medicaid contractors too?). Sure it’s not perfect & needs further adjustments by Congress going forward. But clearly it’s not going anywhere. May as well get used to it warts and all.
Thomas- We’re not going to get used to it, warts and all. We are going to fight for change.
The greedy Medicare Advantage corporations are the same damn INSCOs that are managing Medicaid- so yes we are coming down on Mediciaid Managed Care Organizations too! That’s just another whole essay.
The INSCOs are the “gang of five”- Aetna, Blue Cross,Cigna,Humana and United. They own our whole health care economy, from medicaid to military insurance to commercial to ACA to medicare.
We the people need to break that monopoly.
And eventually, they are going down for antitrust violations.
Something I just realized as I’m freaking out about this for my parents. 1, 2, and 3 is true for almost everyone’s health insurance. It has been true for the insurance I get through my employer for several years. The smaller employers can only afford HMO plans for their employees anymore. I had long COVID in 2022 and spent $7K max out of pocket for my insurance plus another $10K or so on treatments not covered by insurance. Right now I’m dealing with needing to find a hand orthopedic doctor and am spending tons of time I don’t have trying to find one in network. I get zero coverage out of network. I have Blue Cross Blue Shield insurance. I have a $2K deductible but many things they make me pay for goes towards max out of pocket and not the deductible at all. I’ve never seen one like that before. Does instance I had. A steroid injection into a thumb joint and I had to pay full cost myself. Not even going toward deductible. One thing they do cover is I sure can get pretty much any drug cheap. They pay for drugs but not actual “health” care. So is this situation with Medicare advantage actually any different than what the rest of us are dealing with already with our non-MA HMO insurances?
Private Insurance is private insurance WHICH Medicare DisAdvantage plans all are. MA, that's what I have, play different games to force me to pay out of pocket.
My MA company screws around not responding when my orthopedic doctor requests I go to get a cortisone shot at the doctor he wants me to see. My insurance company just refuses to reply and approve it. Delays with payments to hospitals & doctors they contract with is very very common.
PI denies care every which way they can.
As long as the main goal is profit for private insurance, they all pull the same crap on their "customers."
They are all paid by those private insurance companies to convince you to buy a plan. I would say no.
If MA is all you can afford, all you can do is read all the plans & find the one best for your needs. United Healthcare is always in the news for screwing their customers. Do a Google search to see, if you can, any other reviews that might help you make up your mind. Good luck.
So is one of the things insurance reform should aim for is getting rid of preexisting conditions on medigap policies? Sounds like there's a gap in medical.This gets more complicated as I learn more.
My parents have always been in a Scott and White Medicare Advantage policy and it has been no problem so far. They are 82 and 85 respectively. My mom has significant health issues. She had three hospitalizations in the last 12 months. Scott and White is a regional Texas hospital system. They’re in pretty much just central Texas but have been expanding outward since Texas over the years.
We just got a giant surprise to find that after moving our parents from Waco to Austin, their new residence is one mile outside of the coverage area. I used to have Scott & White HMO health insurance myself in this same area. Not Medicare Advantage though. I’m too young for that. It never dawned on us they couldn’t get a plan here. My Mom is in the middle of treatment for chronic pain and we don’t know what to do. Open enrollment is now. My sister and I know nothing about Medicare.
Our parents are living in a house my sister owns. She also owns and lives in one within the coverage area. We’re considering giving that address as where our parents live but we’re sure that will open a can of worms we can’t know the extent of. This is one Advantage plant that has treated our Mom well through many health issues. I don’t think we’ll find that from any other plan. They live on just social security so I know they can’t afford much more in health costs.
Anyone else deal with something like this? Any advice as to what we should do?
Hooo boy, I can relate to so much of what you say. I too live in Austin, my daughter-in-law works for Scott and White, and I am on the cusp of enrolling in Medicare myself. I find all of this extremely anguishing, a mine field if you will. My employer socked away a large sum of money for me to use to pay for Medicare, but ONLY if I use United Healthcare Medicare Advantage. A lot of retirees from my company refer to it as Medicare disadvantage. I think I need a drink.
That’s a nightmare! To make you use an inferior plan to get access to that money. So far I’ve kept my parents address as their home in Waco because they still own that property and it won’t be sold anytime soon and who knows where they’ll be in a month or two. We need time to figure all this out. What’s really wild is I see SW clinics all around us.
The word on the street is that the Democratic administration and potentially the Republican administration, but less likely are both considering scaling back on MA.
Where did you get that tidbit because no one is talking about this but you?
No. MA plans are here to stay unless and until seniors and disabled & the ones who love us speak up and tell our piliticians how they all stink and that we won't vote for them if they don't change this corrupted system.
All Rethuglicons and some paid-off Democrats are All-In for private insurance screwing the elderly. Tell us how any of that has changed.
It would be a very good idea if it were possible, but it's almost always NOT possible unless you wanna pay 20% of all your medical expenses forever. That's because trad MC has a 20% deductible on most services, and therefore most people buy what's called Medigap, or a supplemental policy, to cover that 20%. The (private) companies who write these Medigap policies are allowed to use medical underwriting, that is, to consider your health, and to either deny you coverage entirely or to exclude your preexisting conditions for some period of time (usually six months). If you have NO preexisting conditions, or can live without them being covered for six months, you should definitely switch. If you DO have preexisting conditions and can't have them excluded for six months, you're gonna be outta luck unless you can take on that 20%. If you're REALLY sick or disabled, you will probably not be able to get any Medigap plan to accept you. Twenty percent of your medical expenses is enough to bankrupt a lot of people.
I am concerned that my healthcare provider, Endeavor, is trying to get me to sign onto its Medicare Advantage plan and tells me that my real Medicare account will be automatically changed without my input if I don't contact Medicare to tell it to keep original Medicare. I can't see how that can happen!
Thank you for this very good wake-up call for many. Great summary article. I have so many family who always tell me I should change from Medicare to MA where you pay nothing and get "free stuff". They don't understand why I have to pay an out of pocket deductible of 200 some odd bucks every year. Fortunately I had a very good big brother 2 years older than me that set me straight on the hoax when I turned 65.. Unfortunately he died of cancer 2 years ago. But he told me to NEVER go with MA plan, as almost all of his cancer treatments were covered by Medicare and his supplement, whereas they would not be approved if he had MA, and he wouldn't have been able to get back into traditional Medicare since he had cancer. It is shameful that this even exists. You pay into Medicare insurance your whole working life so it will be there when you need it and the greedy corps want to take your health coverage away and give you free band-aids and diapers every month!
Private insurance should be what the media & all Americans call MA plans...because that's all it is.
Having greedy CEOs steal precious traditional Medicare's name and reputation, not to mention how they steal between $80-$120 BILLION from traditional Medicare funds--that's OUR money! is insult on top of injury.
I'm sorry for your brother's passing. He was right and you were lucky to have him guide you. Not everybody has that help.
Part c Medicare disadvantages only exist with corporate welfare. This welfare (taxpayer dollars) is mostly given to private for profit health insurance companies with Republican support.
I’m noticing the corporate welfare scam is expanding to giving Medicaid taxpayer dollars to private for profit health insurance companies.
All This money must go to providers and communities that actually care for our health.
True. It's EVERY Rethuglicon & some corporate-owned Democrats, too.
Hey its really bipartisan.
Kamala cut a deal in N. California that's allowing for womens health to be compromised
The very first Medicare managed care arrangement went into effect in 1973 as a response to Nixon’s HMO Act. Kaiser was the early trail blazer. That’s a 51 year history of name changes (used to be called Medicare Choice) and tinkering by CMS, HHS, presidents of both parties & Congress. A bipartisan majority of Congress has been consistently vocal in supporting MA. The MA member plan churn rate in 2022 was a paltry 5% (much much lower than employer sponsored coverage). Medicaid has also transformed to a predominantly managed care model over the last 25 years (why not rail against “greedy” large Medicaid contractors too?). Sure it’s not perfect & needs further adjustments by Congress going forward. But clearly it’s not going anywhere. May as well get used to it warts and all.
Thomas- We’re not going to get used to it, warts and all. We are going to fight for change.
The greedy Medicare Advantage corporations are the same damn INSCOs that are managing Medicaid- so yes we are coming down on Mediciaid Managed Care Organizations too! That’s just another whole essay.
The INSCOs are the “gang of five”- Aetna, Blue Cross,Cigna,Humana and United. They own our whole health care economy, from medicaid to military insurance to commercial to ACA to medicare.
We the people need to break that monopoly.
And eventually, they are going down for antitrust violations.
Something I just realized as I’m freaking out about this for my parents. 1, 2, and 3 is true for almost everyone’s health insurance. It has been true for the insurance I get through my employer for several years. The smaller employers can only afford HMO plans for their employees anymore. I had long COVID in 2022 and spent $7K max out of pocket for my insurance plus another $10K or so on treatments not covered by insurance. Right now I’m dealing with needing to find a hand orthopedic doctor and am spending tons of time I don’t have trying to find one in network. I get zero coverage out of network. I have Blue Cross Blue Shield insurance. I have a $2K deductible but many things they make me pay for goes towards max out of pocket and not the deductible at all. I’ve never seen one like that before. Does instance I had. A steroid injection into a thumb joint and I had to pay full cost myself. Not even going toward deductible. One thing they do cover is I sure can get pretty much any drug cheap. They pay for drugs but not actual “health” care. So is this situation with Medicare advantage actually any different than what the rest of us are dealing with already with our non-MA HMO insurances?
Private Insurance is private insurance WHICH Medicare DisAdvantage plans all are. MA, that's what I have, play different games to force me to pay out of pocket.
My MA company screws around not responding when my orthopedic doctor requests I go to get a cortisone shot at the doctor he wants me to see. My insurance company just refuses to reply and approve it. Delays with payments to hospitals & doctors they contract with is very very common.
PI denies care every which way they can.
As long as the main goal is profit for private insurance, they all pull the same crap on their "customers."
They have no respect for us as a patient.
We were going to find a Medicare insurance broker to see what the options are but can any of them be trusted for honest advice?
They are all paid by those private insurance companies to convince you to buy a plan. I would say no.
If MA is all you can afford, all you can do is read all the plans & find the one best for your needs. United Healthcare is always in the news for screwing their customers. Do a Google search to see, if you can, any other reviews that might help you make up your mind. Good luck.
So is one of the things insurance reform should aim for is getting rid of preexisting conditions on medigap policies? Sounds like there's a gap in medical.This gets more complicated as I learn more.
What "CMS officials"?? Names, please. What is your source?
My parents have always been in a Scott and White Medicare Advantage policy and it has been no problem so far. They are 82 and 85 respectively. My mom has significant health issues. She had three hospitalizations in the last 12 months. Scott and White is a regional Texas hospital system. They’re in pretty much just central Texas but have been expanding outward since Texas over the years.
We just got a giant surprise to find that after moving our parents from Waco to Austin, their new residence is one mile outside of the coverage area. I used to have Scott & White HMO health insurance myself in this same area. Not Medicare Advantage though. I’m too young for that. It never dawned on us they couldn’t get a plan here. My Mom is in the middle of treatment for chronic pain and we don’t know what to do. Open enrollment is now. My sister and I know nothing about Medicare.
Our parents are living in a house my sister owns. She also owns and lives in one within the coverage area. We’re considering giving that address as where our parents live but we’re sure that will open a can of worms we can’t know the extent of. This is one Advantage plant that has treated our Mom well through many health issues. I don’t think we’ll find that from any other plan. They live on just social security so I know they can’t afford much more in health costs.
Anyone else deal with something like this? Any advice as to what we should do?
Hooo boy, I can relate to so much of what you say. I too live in Austin, my daughter-in-law works for Scott and White, and I am on the cusp of enrolling in Medicare myself. I find all of this extremely anguishing, a mine field if you will. My employer socked away a large sum of money for me to use to pay for Medicare, but ONLY if I use United Healthcare Medicare Advantage. A lot of retirees from my company refer to it as Medicare disadvantage. I think I need a drink.
That’s a nightmare! To make you use an inferior plan to get access to that money. So far I’ve kept my parents address as their home in Waco because they still own that property and it won’t be sold anytime soon and who knows where they’ll be in a month or two. We need time to figure all this out. What’s really wild is I see SW clinics all around us.
The word on the street is that the Democratic administration and potentially the Republican administration, but less likely are both considering scaling back on MA.
I haven't seen you comment on that
Where did you get that tidbit because no one is talking about this but you?
No. MA plans are here to stay unless and until seniors and disabled & the ones who love us speak up and tell our piliticians how they all stink and that we won't vote for them if they don't change this corrupted system.
All Rethuglicons and some paid-off Democrats are All-In for private insurance screwing the elderly. Tell us how any of that has changed.
I did not say going away. But this is from CMS officials offline
So is it a good idea for MA patients to switch to traditional Medicare or would that make it problematic?
It would be a very good idea if it were possible, but it's almost always NOT possible unless you wanna pay 20% of all your medical expenses forever. That's because trad MC has a 20% deductible on most services, and therefore most people buy what's called Medigap, or a supplemental policy, to cover that 20%. The (private) companies who write these Medigap policies are allowed to use medical underwriting, that is, to consider your health, and to either deny you coverage entirely or to exclude your preexisting conditions for some period of time (usually six months). If you have NO preexisting conditions, or can live without them being covered for six months, you should definitely switch. If you DO have preexisting conditions and can't have them excluded for six months, you're gonna be outta luck unless you can take on that 20%. If you're REALLY sick or disabled, you will probably not be able to get any Medigap plan to accept you. Twenty percent of your medical expenses is enough to bankrupt a lot of people.
Contact your local council on aging for help in choosing traditional/original Medicare.
I am concerned that my healthcare provider, Endeavor, is trying to get me to sign onto its Medicare Advantage plan and tells me that my real Medicare account will be automatically changed without my input if I don't contact Medicare to tell it to keep original Medicare. I can't see how that can happen!
I hear other ppl saying that same thing. It's what greedy CEOs who run these health insurance companies are allowed to do.