Government is beginning to crack down on Medicare Advantage fraud

[groundloop]

Over the last few years insurance companies have gotten more and more misleading in their marketing of Medicare Advantage plans. The administration is going to crack down on this. For example, ads for the Medicare Advantage plan pushed by Joe Namath are very misleading and things like this will be stopped. It's believed that forcing companies to advertise honestly will put many of these companies out of business.

https://www.healthcarefinancenews.com/news/cms-cracks-down-misleading-medicare-advantage-marketing



Here's a video explaining this (there's a short advertisement in the video for the advisory firm putting out this video).

[PoindexterOglethorpe]

1. I do not have the patience to watch 20 minutes plus.

But I will say that I have an Advantage Plan, and despite the claims I see here, my Advantage Plan has done well by me. I had a heart attack nearly two years ago, had a stent put in, three days in hospital a bill of nearly $80,000. I paid less than $1,000. So exactly how am I being taken advantage of?

If I were simply on original Medicare, I'd have been responsible for 20% of that bill. You can do the math.

[groundloop]

3. With Original Medicare plus Medigap Plan G you'd have been responsible for $233

But it sounds like you were able to find an Advantage plan that works well for you.

The problem is wading through all the marketing hype and lies to figure out what the truth is. There's a reason insurance companies go to all that trouble to lure customers, and that reason is profits. At least now they'll have to be more honest.

[PoindexterOglethorpe]

4. Yes, figuring out exactly what a Medicare person should sign up

for is hideously complicated. This year, as every year since I went on Medicare, I am getting a lot of mail, trying to persuade me to switch to another plan. It really should be a lot simpler.

But I'm heartily sick of those here who simply trash all Advantage Plans without seeing what they actually offer. My plan doesn't cost me anything extra, and I've found it to be better than any health care plan I ever had prior to Medicare. Again, I point to my heart attack nearly two years ago, and the small amount I paid out of pocket for my stent and hospitilazation. If I'd simply been on original Medicare I'd have paid vastly thousands more.

The reality is that in this country health care is needlessly and unendingly complicated. Unlike almost everywhere else. A huge problem is that those in Congress, and even those who simply work for the federal government, have excellent coverage and assume everyone else has the same. Alas, we don't.

[PoindexterOglethorpe]

6. $233 is a lot less than the 20% of my bill.

Explain to me how the Medicap Plan G was so much less.

[dpibel]

8. But you'd have been paying $200+ per month

Medigap isn't free, after all.

It doesn't take very many months of Medigap premiums to make up the difference between $233 and $1,000. At least according to my math.

[Sibelius Fan]

11. My wife and I have a Kaiser MA plan. Costs us $0 extra in monthly premiums.

I think it’s fantastic. I’ve had a number of surgeries and hospitalizations over the past 4 years and my out of pocket has been next to nothing, like $90 for a $12,000 bill.

[dweller]

2. About damn time

Notice that now that real Medicare sign up period has begun, the MA ads are announcing just that - it’s Medicare sign up time - and then giving a phone # for MA companies …

It’s a scam. It needs to end


On edit: I watched the whole clip … and stand by my claim
Medicare advantage is a scam


✌🏻

[PoindexterOglethorpe]

5. A scam that allowed me to pay a fraction of what I would have

had I had only Medicare when I had a heart attack two years ago. Gosh. What a terrible thing.

Are you on Medicare? What plan do you have for the things that basic Medicare doesn't cover? Really? Now you know why I have and Advantage Plan.

[dweller]

7. Yes, I'm on Medicare

And due to pre-existing conditions I can’t afford a plan B or D
I live on SS and plan D would cost almost 1/2 of my income …

So I live w/out health insurance … sux to be me

But at least I’ve not been scammed by insurance company fraud


YMMV


✌🏻

[PoindexterOglethorpe]

9. So, a plan that costs nothing extra,

as I have, is somehow worse than an a plan that would cost you 1/2 of your income?

What am I missing here? What exactly is the insurance company fraud?

[SheltieLover]

10. I had dr. Appt yesterday. BIG notices up "If you have Medicare Advantage"

Contact us to see if your plan is accepted.

Never been to this doc before & will not be going back (nightmare), but notices appeared to be new compared to some of the others affixed to the door.

That said, Advantage is a PPO. But maybe something has changed in the system to have prompted this notice.

[Demobrat]

12. Advantage plans are all about the network

If the doctors/hospitals you need and want are in your network you’re golden.
If you need specialized care that’s not available in your network you’re out of luck. If it’s 100 miles away that’s where you go. The networks are in constant flux so you have to keep up with who’s in and who’s out.
With traditional Medicare with a supplement you can go anywhere Medicare is accepted. But you pay a higher premium for that flexibility.

There’s no one right answer. It all depends on what facilities are in what networks in your area.

[PoindexterOglethorpe]

13. Many health care plans are likewise all about the network.

Several decades ago, the company my husband worked for switched to a different plan that did not include the doctor we'd been seeing for several years. So we switched to a different one. At the time we had little kids who needed the kind of care little kids typically need.

While the new doctor was quite nice, we were very grateful when the company went back to the old plan and we could go back to the old doctor.

My point is this: many, many health care plans set what doctors, hospitals, specialized services that you can use. Medicare Advantage is no different from those.

In reality, all health care plans should cover all health care wherever you are. Sadly, in this country, that's never the case.