After years of federal support and little oversight, Medicare Advantage is facing rare scrutiny from longtime ally Sen. Grassley — just as rural hospitals say MA is pushing them to the brink.
Further. Look at the extremely generous compensation, percs, bonuses paid to MA executives. I would posit that the MA insurance companies care, alright - but that caring is not exactly directed toward shareholders; the care is instead lavished financially upon the upper echelon management.
A well researched article and focus on a much needed topic.
Providers too are made to *Fight* to be paid, and being that they are either Small groups or Singular Practices imagine the *Negative* time and money investment they have to put in to get the Denials approved.
These need addressing and high time they are looked into.
I worked part-time after retiring from full time work (no thanks to you, Covid). This was archiving legacy files and doing patient intake in an ophthalmology clinic specializing treating vision disturbances such the (often horrific) problems from brain traumas like from car accidents. This clinic was doing amazing work in restoring at least some vision capability. I remember one very elderly woman in tears thanking the doctor because she could actually see her new grandbaby's face. The clinic eventually had to employ a full-time billing staffer specifically to do that "fighting." She eventually confided in me that the clinic had to stop taking Medicare Advantage patients because the clinic simply was never paid. [edited for typo]
Medicare advantage took over my insurance without me authorizing it I've hated them for years and found out they inserted themselves into my insurance and knocked out my original Medicare. I started getting letters from doctors in the hospital about bills due and went to bcrc and complained and they got rid of Medicare advantage in 72 hours. Check and make sure which is your original Medicare on the Medicare site it'll tell you that they're first or not. I found out when the hospital sent me a bill saying that Medicare original is not my first insurance. Make sure you protect yourself.
Medicare Advantage is a scam. They offer freebies to mask their unfair practices of denying coverage, even to cancer patients,making people’s health records seem sicker than they are to maximize profits, and delay, delay, delay. If we are forced into this program, many people will die unnecessarily.
Freebies? Lol. I just have to laugh at Regence Blue Cross (for just one pathetic example) "freebie" -- the so-called "flex card." Which is administered by an internet-based entity calling itself a "bank." A whole $15 per quarter - not month - of alleged benefit for purchasing over-the-counter health-related products. But that benefit is restricted to name brand items, not store-label items which usually are priced well below the name brand. Meaning that paltry five bucks a month goes half as far...so, gotta ask the question - who's getting kickbacks? Bet it's shared between the "internet bank" and the few retailers admitted to the program. Laughable. And disgusting!
Medicare Advantage is not Medicare. It is a private insurance plan. They restrict care by denying your doctor's requests for tests, referrals and some treatments. They are also making a substantial profit by offering these plans. Be careful what you sign up for
Now UnitedHealthgroup is going after people that are bilingual enticing them to buy dis advantage plans by opening private locations i.e. Suvida in Tucson AZ.
Interesting and predictable given the predatory (scurrilous and dishonest) business model that is Medicare Advantage; however, what people are not paying much attention to is that when Social Security benefits are halted so also will Medicare effectively halt for millions. Most Social Security beneficiaries have Medicare Part B premiums automatically deducted from their SS benefit. When Social Security stops, so will Medicare Part B premium payments - for millions. Then this will happen: as MA is paid by Medicare, if payment from Medicare stops, MA will bill people directly for any premiums -- and so also will Medicare bill people directly for the Part B premiums. People who can afford it will have to pay their Part B (and MA premiums, if any) out of pocket. But for those who cannot afford to pay the Medicare Part B premiums, the money flow from CMS to MA plans will also stop so people will be kicked off their MA plans. Thereby effectively halting ANY ability to access Medicare at any level. Add to that the fact that so many health care providers, increasingly wary about ever actually getting paid by Medicare (they already experienced MA payments being elusive and long-delayed), are simply refusing to accept Medicare patients at all.
Great article. Medicare Advantage cares more about its stock holders than it does about its patients. It is only getting worse.
Let’s move back to traditional Medicare Where patients’ needs come first and the money goes largely for better health.
And let’s make it available to all, from the cradle to the grave.
Further. Look at the extremely generous compensation, percs, bonuses paid to MA executives. I would posit that the MA insurance companies care, alright - but that caring is not exactly directed toward shareholders; the care is instead lavished financially upon the upper echelon management.
A well researched article and focus on a much needed topic.
Providers too are made to *Fight* to be paid, and being that they are either Small groups or Singular Practices imagine the *Negative* time and money investment they have to put in to get the Denials approved.
These need addressing and high time they are looked into.
I worked part-time after retiring from full time work (no thanks to you, Covid). This was archiving legacy files and doing patient intake in an ophthalmology clinic specializing treating vision disturbances such the (often horrific) problems from brain traumas like from car accidents. This clinic was doing amazing work in restoring at least some vision capability. I remember one very elderly woman in tears thanking the doctor because she could actually see her new grandbaby's face. The clinic eventually had to employ a full-time billing staffer specifically to do that "fighting." She eventually confided in me that the clinic had to stop taking Medicare Advantage patients because the clinic simply was never paid. [edited for typo]
Medicare advantage took over my insurance without me authorizing it I've hated them for years and found out they inserted themselves into my insurance and knocked out my original Medicare. I started getting letters from doctors in the hospital about bills due and went to bcrc and complained and they got rid of Medicare advantage in 72 hours. Check and make sure which is your original Medicare on the Medicare site it'll tell you that they're first or not. I found out when the hospital sent me a bill saying that Medicare original is not my first insurance. Make sure you protect yourself.
Thank you for writing about this.
Medicare Advantage is a scam. They offer freebies to mask their unfair practices of denying coverage, even to cancer patients,making people’s health records seem sicker than they are to maximize profits, and delay, delay, delay. If we are forced into this program, many people will die unnecessarily.
Freebies? Lol. I just have to laugh at Regence Blue Cross (for just one pathetic example) "freebie" -- the so-called "flex card." Which is administered by an internet-based entity calling itself a "bank." A whole $15 per quarter - not month - of alleged benefit for purchasing over-the-counter health-related products. But that benefit is restricted to name brand items, not store-label items which usually are priced well below the name brand. Meaning that paltry five bucks a month goes half as far...so, gotta ask the question - who's getting kickbacks? Bet it's shared between the "internet bank" and the few retailers admitted to the program. Laughable. And disgusting!
Medicare Advantage is not Medicare. It is a private insurance plan. They restrict care by denying your doctor's requests for tests, referrals and some treatments. They are also making a substantial profit by offering these plans. Be careful what you sign up for
In some instances the doctors are incentivized financially to participate in denial of access to care.
Now UnitedHealthgroup is going after people that are bilingual enticing them to buy dis advantage plans by opening private locations i.e. Suvida in Tucson AZ.
Talk about Ponzi schemes and oligarchs.
"Save a CEO, Support Medicare for All"
--Luigi Lobby
Interesting and predictable given the predatory (scurrilous and dishonest) business model that is Medicare Advantage; however, what people are not paying much attention to is that when Social Security benefits are halted so also will Medicare effectively halt for millions. Most Social Security beneficiaries have Medicare Part B premiums automatically deducted from their SS benefit. When Social Security stops, so will Medicare Part B premium payments - for millions. Then this will happen: as MA is paid by Medicare, if payment from Medicare stops, MA will bill people directly for any premiums -- and so also will Medicare bill people directly for the Part B premiums. People who can afford it will have to pay their Part B (and MA premiums, if any) out of pocket. But for those who cannot afford to pay the Medicare Part B premiums, the money flow from CMS to MA plans will also stop so people will be kicked off their MA plans. Thereby effectively halting ANY ability to access Medicare at any level. Add to that the fact that so many health care providers, increasingly wary about ever actually getting paid by Medicare (they already experienced MA payments being elusive and long-delayed), are simply refusing to accept Medicare patients at all.