Large Hospital Groups Cancelling Contracts with Medicare "Advantage" Carriers

[Otto_Harper]

https://www.youtube.com/live/LNu_i5bJjiA?si=bUmBis50foop9iJX

Why anyone would use such abominable plans is beyond me.

[Silent Type]

1. People use those plans because they can't afford traditional Medicare, a supplement, and Part D.

Have traditional Medicare now, but the day will likely come when MA is all I can afford.

[JohnSJ]

3. You're right. I am paying about 800 dollars a month for 2 with part D, but no dental.

[area51]

12. Medicare desperately needs fixing.

The Medicare for All mentioned in my sigline is proposing to fix the current issues with Medicare. Soon I'll be 65 and I hope to avoid MA if at all possible.

[Silent Type]

14. All for MFA, but the chances now are zero.

[XanaDUer2]

2. I chose traditional Medicare

2 drs warned me off MA. Wish the trillions going to MA were going to lower Medicare.

I predict once a ton of ppl are on MA, traditional Medicare will be ended, and benefits of MA will be reduced. My 2 cents

[Evolve Dammit]

15. That's what I' feeling too, if that's any consolation.

[Skittles]

25. that's obviously the end result - to get rid of Medicare

obvious to anyone with critical thinking skills

[lostnfound]

48. Absolutely. That's the GOP plan. Nt

[sinkingfeeling]

4. MA is the only way to get my retiree 'benefits'.

Corporation forced all retirees to a single MA plan or we would lose other benefits.

[Deuxcents]

5. Mine did, too. I still opted out for original Medicare.

Too many red flags for MA and my healthcare was the only benefit from my retirement as I moved my IRA many years ago..been retired since ‘95 so..

[phylny]

11. My husband's as well.

We did not have a real choice.

[pnwmom]

22. What other benefits could you lose? That doesn't even sound legal.

Boeing is pushing their retirees into a MA plan, but the only thing retirees would lose is, if they turn down the plan, is whatever contribution Boeing's been making into their current supplement.

[Josiesdad]

6. Here is a no-video link to a similar article

https://www.beckershospitalreview.com/finance/hospitals-are-dropping-medicare-advantage-left-and-right.html

[PortTack]

7. The Medicare advantage plans have been over charging and seriously draining Medicare coffers

So good!

[enough]

9. My husband and I chose MA 15 years ago when we were 65.

This was not because of advertising. I spent a LOT of time reading and comparing plans. At this point we pay 100 a month each. Including drug plan, dental plan, eyes, and hearing aids.

During those 15 years I have had both knees replaced and been diagnosed with atrial fibrillation. The care has been excellent. However I do know that at 80 we have not yet had to deal with the really complicated heath issues.

Since we signed up 15 years ago, we have learned about the nefarious social cost of Medicare Advantage. And we have been hoping to switch to Medicare for that reason. The system makes it difficult and expensive to make that switch, which is outrageous. But we have stayed with MA for that reason.

Whenever I mention on DU that we have had good medical care on MA, I always get a lot of angry response. To me at this point the outrage is the fact that it is so difficult to switch.

[dpibel]

13. Where are all the people being taken advantage of?

This is the twice or thrice weekly thread warning that the end of the world is Medicare Advantage, and that the big problem is Advantage plans provide almost no meaningful coverage.

Yet, in every such thread, there's someone like you, who's had MA for years and says it's done them right.

If MA is so damned bad, I'd expect many people on each thread telling their tales of woe.

And I have yet to see such. I'm sure there have been a few people who detailed complaints.

But really: Every thread should be all about "Yeah. MA screwed me, too."

And they aren't.

[MOMFUDSKI]

17. Have MA and perfectly fine with it.

Why pay $400/mo and have to get a separate drug plan and have no dental, eye care, etc? Is having traditional Medicare a status symbol now to let people know you are able to spend a lot on health care each month? Jeesh

[WhiteTara]

41. do you have a 20% copay?

[unc70]

45. No, Do not have a 20% copay

Last edited Thu Nov 2, 2023, 02:01 PM - Edit history (1)

Might have an occasional $20 copay for an out-of-network or specialist copay. I can't remember the last time that happened. Have spent under $50 this year for Rx and out of pocket; eyes and dental with crown covered 100%. $0 premium per month. Includes many of the miscellaneous benefits like Silver Sneakers.

Could I possibly have some combination of medical charges that would cost me several thousand dollars in a year? Theoretically, yes. But with a tradition Medicare set of plans, my premiums each year would equal or exceed that risk. And would still need dental, hearing, eye, etc.

[Skittles]

20. THE TAXPAYERS, THAT'S WHO

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.

[dpibel]

26. DAYUM!

I just spent the better part of a half hour responding to the post you self-deleted! And my stately and measured essay is apparently gone forever. Jeez.

If you read the article upon which this OP is based, you will discover that this wholesale rejection of Medicare Advantage is not, perhaps, quite the universal contagion it's being represented as.

For instance, a number of the cited hospital systems are canceling their contracts with some, but not all, MA providers.

That suggests to me that there may well be problems with cheaters (if you believe that has never happened with traditional Medicare, please look into the history of Sen. Rick Scott) but that does not actually mean there's an inherent problem with MA.

Again I ask: Here's a political discussion board that skews elder. If these problems are so rampant--especially denial of benefits--why am I not reading accounts of that in all these "Look Out! MA Will Kill You" threads? What I read are posts from people who say, "I have MA, and I'm doing just fine, thank you."

How's that work? It's horrible coverage, but we have no complainers? You know that people who are unhappy are more likely to post reviews than satisfied customers--by orders of magnitude--right?d

[Skittles]

37. the ultimate goal is to get rid of Medicare

increasingly looks like it's being handed over to the vultures bit by bit

[dpibel]

43. I understand that's what Thom says

I have yet to see any convincing explanation of how it works.

Medicare Advantage gives broader coverage, so it will kill Medicare.

Hard to see how that quite works.

Can you tell me, please, how people who get dental coverage for nothing are being cheated and they are, therefore, killing Medicare?

[ArkansasDemocrat1]

33. I've had MA since becoming eligible

My choices when I was disabled in the midst of my career were Traditional MC without meds and me having to pay 20% of every bill including surprise bills while my only income was the pittance that is SSDI OR with MA meds are included and affordable copays for those meds and dr visits. I couldn't afford a Part D supplement and a gap supplement plan. Some MA providers are better than others, avoid the ones who advertise a lot, but compare the plans with this guide

https://www.medicare.gov/plan-compare/#/?year=2024&lang=en

[Joinfortmill]

49. Have had MA for 10 years.

No issues and very affordable. Some very serious health issues, including brain aneurysm stenting. Always choose a national PPO plan.

[LetMyPeopleVote]

10. I get several calls a day trying to sell me one of these plans

[orleans]

16. medicare will be taking 18% out of my SS

i don't have a medigap plan in place -- i doubt i can afford it!

this is my first year for this so i thought i'd just do medicare and see what happens but jesus! i can't afford fucking medicare!

[MOMFUDSKI]

18. And how do you think you arrived at

this place?

[orleans]

21. i lived too fucking long

[pnwmom]

23. Medigap policies are worth the expense, if you can at all afford it.

I was just looking at a relative's statement from their Medigap policy. Almost $20,000 in treatments for the cancer patient and the cost to the patient was only $174.

[orleans]

24. wow -- which ins. company -- sounds like a good one nt

[pnwmom]

27. Premera Blue Cross Blue Shield of Illinois. It's a Boeing policy and that's where Boeing

is headquartered now.

[progree]

38. Be sure to sign up for a Medigap aka a Medicare Supplement program within the designated 6 month period

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.

Or you can't get a Medigap policy at all.

https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

[dpibel]

28. But what would it be with M. Advantage?

Unless you know what the same treatment would have cost under MA coverage, this means nothing.

My brother-in-law, with Advantage, had a stroke with tens of thousands of dollars of hospital bills. He paid a couple hundred.

So: Same story, with about the same evidentiary value.

[pnwmom]

46. It wouldn't matter to me because the bottom line was $174. Maybe Medicare Advantage

could beat that, but I wouldn't care. I don't want an insurer interfering in treatment decisions. That doesn't happen with Medicare supplements/Medigap. They pay for whatever treatment a doctor and patient decide on. With Advantage policies, your doctor has to get your treatment plan approved, and hope they don't deny it.

My relative has a very unusual cancer, and it's hard enough for doctors at UW to decide on the best course of treatment, without having an insurer sticking its greedy nose in, looking for ways to keep its profits up.

[MOMFUDSKI]

31. I asked my Agent when one should get original

Medicare and he said when one is quite sick such as ongoing cancer or that type of situation.

[Demobrat]

34. But at that point you can be turned down for a supplement because of the pre-existing condition

So you could end up paying 20% of the cost of the treatment. Better an advantage plan with an out of pocket limit than that.

[Demobrat]

29. Based on these threads that pop up every so often,

it seems like everyone on Medicare is happy with their plan.

The Medicare Advantage people are ecstatic, and the ones who go with OM with a supplement are perfectly satisfied.

Personally I would never choose MA because of past experience with the whole private insurance HMO/PPO network/referral/approval system. It’s a blessing to know I’ll never go through that again. And I like knowing I have coverage wherever I am. But that’s just me.

If your MA network works for you, enjoy the perks. Good health to everyone.

[MOMFUDSKI]

32. There are many that just can't pay for what

Traditional Medicare costs per month. They don’t have that choice. That is on our politicians. Fix this shitty conundrum!

[ArkansasDemocrat1]

35. I'm one of them

I once asked someone running for office a question about this. Since Medicare pays 80%, why not raise the percentage deducted for FICA that 20% and charge those on SS 20% more on the medicare premium and then cover everything? He said it was a good idea. I don't think he won.

[Demobrat]

36. Yes. MA is definitely better than OM alone.

For avoiding bankruptcy.

[Demobrat]

42. There is really no right answer for everyone.

There’s only the least horrible choice for you.

[dchill]

30. High-paid celebricon endorsers, high rates of claim...

...denials, a plethora of scare-mongering boob-tube commercials - what's not to love about Medicare Advantage? I wouldn't go near it for anything. Bad enough I have to pick a privatized Medicare prescription plan.

If you have MA and are happy with it, well, good for you. To me, it Smells Like Rick Scott Spirit.

[dpibel]

44. Nice slogans

Do you have any facts at hand to support what you say?

I mean, really. You believe that people who have Advantage are just too stupid to realize how they're being ripped off?

Cuz, like, Rick Scott spirit?

You do realize, don't you, that Rick Scott ripped off traditional Medicare?

Not, maybe, the best example of the horrors of Advantage.

[dchill]

47. Not stupid. Just gullible.

Medicare Advantage programs were shoehorned into the Medicare program as a tap-in point for business appointments interests to make money. Like all privatization, it's a rip-off. Rick Scott did indeed rip off Medicare. And got away with it, evidently. Medicare Advantage is perfectly legal.

[Freddie]

39. My daughter is a home-care RN Case Manager

She HATES the Advantage plans. Bean-counters always trying to limit care, second-guessing doctors and nurses. She has to fight them to get patients - mostly elderly, just discharged from the hospital- the number of home care visits they need. Says Traditional Medicare never does. We took her advice and signed up for Traditional with an AARP supplement. So far so good.

[chowmama]

40. I could have stayed on my work insurance

But chose to go on Medicare when the time came, knowing I'd need a supplement for Part D. My work insurance had double-digit increases in paycheck contributions every single year, for years, with a larger co-pay to boot and sometimes less coverage. My co-workers who made claims from time to time always were denied first and had to contest the first decision to get any coverage at all. It was supposed to be a non-profit company in our state, although they're for-profit in some others. No way was I staying.

I looked at my current year's contribution (knowing it would be larger in a month or two) and used that to see what I could get for the same money, Medicare and supplement counted together. I also wanted a real non-profit company based in my state (Minnesota). And an Advantage plan was not of any interest for reasons I'll state below.

For no more than my work insurance co-pay, counting both Medicare and my non-Advantage supplement, I have better coverage than I had with the work plan. Now, I realize I can afford it because I'm still working, so I'm lucky that way. When I start collecting Social Security in 2 months, I'll still be able to afford it even after I retire. But I've watched my co-workers deal with the plans getting switched around and around, and just continuing to get worse and worse. I'm well out of it. And yet I've had right wingers ask me and DH, "So, Medicare is a good thing?". They listen to Faux News and RW talk radio; they can't and won't believe it. Advantage is marketed to them.

Advantage is a suckers' game, IMO. It was invented to kill Medicare. I don't care how cheap the coverage is now - what do you think it'll be when Medicare no longer exists? When they win, there's no competition, and you have no choice but to buy their product? If possible, they'll lobby to still force people to buy something and they're the only something available.

I'm guessing those great rates will spiral upwards like a tornado, and the coverage will essentially disappear. Get sick enough, they'll find a way to drop you entirely. An entire country with all the sick people on what used to be called 'Sign of the Cross' insurance - none at all. And the healthy people paying through the nose for little to nothing, one big bill away from being in the same boat.

I don't think they can kill it before I die, so if I was selfish, I wouldn't care. But I don't want my kids, grandkids, or anybody's kids to have to live like that. This is still a civilized society, not the permanent feudal state the corporate interests dream of.

The makers of Medicare Advantage are not our friends. We don't have to help them.