Great article Wendell Potter!! I see a trend of many patients going back to traditional Medicare and adding a supplement for Part D. The thieving vertically integrated big insurers/PBMs did NOT find their big pot of gold at the end of the MA rainbow.
I applaud your experience and wisdom and keep up the great work! I repost every one of your articles on LinkedIn along with some of my own comments. Thanks!
That is not as easy as you think. Medicare advantage patients who have been in the advantage program over one year cannot just switch back to Traditional Medicare unless they undergo an underwriting process by the private insurers who run the Medigap program, which covers 20% of part part B Medicare outpatient care. That means patients may be rated and charged higher premiums because of underlying medical problems. That 20% part B is either covered by patients private funds or Medigap program or by the state through Medicaid.
A few brief years ago I was working for a large Managed Care insurance company, I was specifically against them getting heavily involved into Medicare Advantage and I wore them it was going to be the financial downfall well this is one of the few times in my life that I can easily say I told you
I worked in the insurance healthcare industry for almost 30 years - specifically in provider contracting for most of that time. The changes I saw over the years was incredible.
I became disenchanted when I finally came to realize that my sole JOB (and the staff that worked for me) was to steal good, hard earned $$ from the small practices and hand it over to the corporate machine ~ and for what? Million dollar bonuses for people who had no clue?? And for profit.
Then came the denials based on a procedure being “medically necessary”. A bunch of old, washed up doctors and people in suits making those decisions.
So I quit. Healthcare insurance should NEVER be for profit.
These idiot MBAs must be stopped. Their avarice is quite literally killing people. There can't be a single payer, but there should be someone who can automate this whole insurance process, and charge a small subscription fee to manage the data, like Amazon. They don't make the products they sell, they just manage data, for a little over $10/month. Oh wait. There is. Sentia Health with the blog right here: https://sentiahealth.substack.com
The first Medicare managed care contract went into effect in 1973 (Kaiser) as part of Nixon’s HMO Act. Medicare managed care has gone through 51 years of iterations, name changes, adjustments by HHS, CMS, presidents and Congress. It is now freely chosen for healthcare coverage by over 34 million Americans & consistently enjoys support by over 80% of congressional members. It’s not going anywhere. May as well get used to it.
Great article Wendell Potter!! I see a trend of many patients going back to traditional Medicare and adding a supplement for Part D. The thieving vertically integrated big insurers/PBMs did NOT find their big pot of gold at the end of the MA rainbow.
I applaud your experience and wisdom and keep up the great work! I repost every one of your articles on LinkedIn along with some of my own comments. Thanks!
That is not as easy as you think. Medicare advantage patients who have been in the advantage program over one year cannot just switch back to Traditional Medicare unless they undergo an underwriting process by the private insurers who run the Medigap program, which covers 20% of part part B Medicare outpatient care. That means patients may be rated and charged higher premiums because of underlying medical problems. That 20% part B is either covered by patients private funds or Medigap program or by the state through Medicaid.
Unless you live in one of 4 States which has no underwriting. New York is one of them .
A few brief years ago I was working for a large Managed Care insurance company, I was specifically against them getting heavily involved into Medicare Advantage and I wore them it was going to be the financial downfall well this is one of the few times in my life that I can easily say I told you
I worked in the insurance healthcare industry for almost 30 years - specifically in provider contracting for most of that time. The changes I saw over the years was incredible.
I became disenchanted when I finally came to realize that my sole JOB (and the staff that worked for me) was to steal good, hard earned $$ from the small practices and hand it over to the corporate machine ~ and for what? Million dollar bonuses for people who had no clue?? And for profit.
Then came the denials based on a procedure being “medically necessary”. A bunch of old, washed up doctors and people in suits making those decisions.
So I quit. Healthcare insurance should NEVER be for profit.
These idiot MBAs must be stopped. Their avarice is quite literally killing people. There can't be a single payer, but there should be someone who can automate this whole insurance process, and charge a small subscription fee to manage the data, like Amazon. They don't make the products they sell, they just manage data, for a little over $10/month. Oh wait. There is. Sentia Health with the blog right here: https://sentiahealth.substack.com
The first Medicare managed care contract went into effect in 1973 (Kaiser) as part of Nixon’s HMO Act. Medicare managed care has gone through 51 years of iterations, name changes, adjustments by HHS, CMS, presidents and Congress. It is now freely chosen for healthcare coverage by over 34 million Americans & consistently enjoys support by over 80% of congressional members. It’s not going anywhere. May as well get used to it.
Thanks for all your work on this issue Check this out: https://replica.startribune.com/html5/reader/production/default.aspx?pubname=&edid=75a55f3e-1163-4825-8bc4-174c2175b4ac Tom Emmer ad in today's Minnesota Tribune, "End the Biden-Harris Raid on Medicare" "Diverted over $260 Billion to pay for LIberals' Green Energy Spending" Page A10