Something strange happened on the way to health insurance nirvana. Hospitals are dumping some Medicare Advantage plans. Such a move would have been unthinkable a year ago when Advantage plans were the high flyers of the insurance business raking in money by signing up new recruits, a substantial number of them with little or no understanding of the trade-offs involved in what they were buying.
Unfortunately, there are no clean hands here. Providers & insurers are fighting over the same $ stream. The only question is who will get more - not how to improve patient health. The only real solution is having a national system where Americans are collectively self-insuring. We cut out that layer of non-productive & cost-generating middlemen (insurance) & negotiate directly with providers.
We’re already spending the $. It’s just going to corporate profits instead of care.
Even knowing about the big insurers' practices, when I turned 65 this year, I signed up for an Advantage Plan. It seemed wonderful because it cost me nothing out of pocket, paid for routine care, and gave me a free gym membership. However, as I learned more about how MA plans kick hospitals out of network, deny care, and otherwise do all they can to bilk taxpayers and deliver value only to shareholders and executives, I simply could not continue to live with my decision. Instead, I used Open Enrollment to switch to Traditional Medicare. Yes, it now costs me about $185 per month for supplemental insurance (I went with a member-owned mutual company), vision, dental, and prescription coverage. But no longer supporting MA immediately improved my HEALTH because I SLEEP better at night knowing I am no longer colluding this scam to ripoff American taxpayers. It's worth it!
That was my plan, to switch to Traditional Medicare but I needed health coverage for my dependent granddaughter who would have been dropped from my employer paid retirement benefit. It's all ridiculously complicated and needlessly so! Single payer now!
Be a Hero has been fighting MA plans for two years to atually do what they advertise but with little success because there is no enforcement mechanism. We are now meeting with our legislators to obtain their support for an executive order to force the Centers fo Medicare and Medicaid to enforce the laws or drop companies from the insurance market. Today the Biden adimistration issued a lot of new rules, to crack down on their most harmful practices, so maybe that day will come when the laws are enforced. Join us and work for quality health care for all.
The agent we consulted when signing up for Medicare a few years ago literally didn’t know the difference between traditional Medicare and Medicare Advantage…in his words, “I don’t know why you wouldn’t want to choose this”, citing the lack of premium and additional various benefits. Paying additional premiums monthly for both of us to have adequate traditional Medicare coverage would have been a hard sell from that perspective. It’s only recently become easier to get real information in the midst of the Advantage hype…
That said, I’ve begun to dread finding out the weaknesses in the MA system when we need it most.
Since "MA plans “pay less, don’t follow medical policy, coverage, billing, and payment rules and procedures" then isn't that false advertising in that MA is NOT an advantage to medicare? Medicare original with its 80/20 payout is so outdated we do need a way to protect our life savings from a fiscal cliff. The harassment we all live through under our annual open enrollment's constant marketing and calls is reason enough for me to dream of the day we can enjoy the freedom under a single payer health care. Sooner rather than later please! Still trying to figure why we float the extremely expensive health insurance industry when they provide absolutely NO health care to anyone but deny and constrain care to just about everyone.
Visit www.Medicarenewswatch.com to view the 2024 CostShare Reports posted by HealthMetrix Research president Alan Mittermaier for over 100 markets. Consumers can easily identify which $0 premium plans are most and least favorable to members based on their health status.
Stealth privatization in progress. By the time enough people are wise to "advantage" plans being a death trap, current CEOs of these companies will have their winnings and be moving on. These plans are so entrenched, I'd be surprised if they're ever outlawed and everyone brought back into traditional Medicare. One can hope, I guess. Or perhaps we can just get dental and vision in traditional Medicare. Talk about an easy win.
Having worked in a hospital dealing with Medicare Advantage denials, it was an easy choice when it came time to sign up. Regular Medicare and a G supplement, no restrictive provider panels, no pre authorization. After the annual deductible (about 220.00), the rest is covered.
If you want to learn more about what Be a Hero is doing and has done this past year and would like to talk about what Ady Barkan has meant to you, join our Grassroots Gathering on Dec. 14 at 8 pm ET. We are focusing on people who have worked with us before, but we welcome your attendance too. Just go to heroes.win/RSVP to sign up. Then if you can't make it, you will get a full recording of the call the net day to listen to when you can. There have been some positive changes recently to help control the Medicare (Dis)Avantage plans including action taken by the Biden administration.
Unfortunately, there are no clean hands here. Providers & insurers are fighting over the same $ stream. The only question is who will get more - not how to improve patient health. The only real solution is having a national system where Americans are collectively self-insuring. We cut out that layer of non-productive & cost-generating middlemen (insurance) & negotiate directly with providers.
We’re already spending the $. It’s just going to corporate profits instead of care.
Even knowing about the big insurers' practices, when I turned 65 this year, I signed up for an Advantage Plan. It seemed wonderful because it cost me nothing out of pocket, paid for routine care, and gave me a free gym membership. However, as I learned more about how MA plans kick hospitals out of network, deny care, and otherwise do all they can to bilk taxpayers and deliver value only to shareholders and executives, I simply could not continue to live with my decision. Instead, I used Open Enrollment to switch to Traditional Medicare. Yes, it now costs me about $185 per month for supplemental insurance (I went with a member-owned mutual company), vision, dental, and prescription coverage. But no longer supporting MA immediately improved my HEALTH because I SLEEP better at night knowing I am no longer colluding this scam to ripoff American taxpayers. It's worth it!
That was my plan, to switch to Traditional Medicare but I needed health coverage for my dependent granddaughter who would have been dropped from my employer paid retirement benefit. It's all ridiculously complicated and needlessly so! Single payer now!
I'm sorry about your situation, @Cheryl, and agree--single payer now!
Be a Hero has been fighting MA plans for two years to atually do what they advertise but with little success because there is no enforcement mechanism. We are now meeting with our legislators to obtain their support for an executive order to force the Centers fo Medicare and Medicaid to enforce the laws or drop companies from the insurance market. Today the Biden adimistration issued a lot of new rules, to crack down on their most harmful practices, so maybe that day will come when the laws are enforced. Join us and work for quality health care for all.
The agent we consulted when signing up for Medicare a few years ago literally didn’t know the difference between traditional Medicare and Medicare Advantage…in his words, “I don’t know why you wouldn’t want to choose this”, citing the lack of premium and additional various benefits. Paying additional premiums monthly for both of us to have adequate traditional Medicare coverage would have been a hard sell from that perspective. It’s only recently become easier to get real information in the midst of the Advantage hype…
That said, I’ve begun to dread finding out the weaknesses in the MA system when we need it most.
Since "MA plans “pay less, don’t follow medical policy, coverage, billing, and payment rules and procedures" then isn't that false advertising in that MA is NOT an advantage to medicare? Medicare original with its 80/20 payout is so outdated we do need a way to protect our life savings from a fiscal cliff. The harassment we all live through under our annual open enrollment's constant marketing and calls is reason enough for me to dream of the day we can enjoy the freedom under a single payer health care. Sooner rather than later please! Still trying to figure why we float the extremely expensive health insurance industry when they provide absolutely NO health care to anyone but deny and constrain care to just about everyone.
Visit www.Medicarenewswatch.com to view the 2024 CostShare Reports posted by HealthMetrix Research president Alan Mittermaier for over 100 markets. Consumers can easily identify which $0 premium plans are most and least favorable to members based on their health status.
Stealth privatization in progress. By the time enough people are wise to "advantage" plans being a death trap, current CEOs of these companies will have their winnings and be moving on. These plans are so entrenched, I'd be surprised if they're ever outlawed and everyone brought back into traditional Medicare. One can hope, I guess. Or perhaps we can just get dental and vision in traditional Medicare. Talk about an easy win.
Having worked in a hospital dealing with Medicare Advantage denials, it was an easy choice when it came time to sign up. Regular Medicare and a G supplement, no restrictive provider panels, no pre authorization. After the annual deductible (about 220.00), the rest is covered.
If you want to learn more about what Be a Hero is doing and has done this past year and would like to talk about what Ady Barkan has meant to you, join our Grassroots Gathering on Dec. 14 at 8 pm ET. We are focusing on people who have worked with us before, but we welcome your attendance too. Just go to heroes.win/RSVP to sign up. Then if you can't make it, you will get a full recording of the call the net day to listen to when you can. There have been some positive changes recently to help control the Medicare (Dis)Avantage plans including action taken by the Biden administration.