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eridani

(51,907 posts)
Fri Apr 19, 2013, 04:54 AM Apr 2013

Wendell Potter: Medicare Advantage – or DISAdvantage?


http://www.healthinsurance.org/blog/2013/04/18/medicare-advantage-or-disadvantage/

If you’re being courted by a private insurance company to enroll in one of its Medicare Advantage plans, don’t sign on the bottom line until you’ve read a recent report by a researcher at the Center for Medicare and Medicaid Services (CMS). The real bottom line you need to understand is that the insurer might want to keep you enrolled only as long as you’re relatively healthy. When that changes, you just might find that you’re no longer considered a valued member and that the traditional Medicare program is a much better deal for you.

The study, published recently in the Medicare and Medicaid Research Review, confirmed what some who are familiar with the Medicare Advantage program, including me, have suspected: when people enrolled in MA plans become critically ill, many realize that the only way they will get coverage for the care they need – and at a facility of their choice – is to return to the traditional Medicare program.

Former health insurance industry exec Wendell Potter says he believes his mother Pearl, left, is alive today because she was disenrolled from a Medicare Advantage plan that would have failed to cover costs of care that Traditional Medicare covers.

It may come as a surprise, but one of the reasons the Medicare program costs taxpayers more than it should is that the federal government has for years been overpaying insurance companies to participate in the Medicare Advantage program. (Medicare Advantage plans – typically HMOs and PPOs – are private alternatives to traditional Medicare.) Congress created the program after private insurers insisted that not only could they meet the medical needs of senior citizens and the disabled more cost effectively than the government, they could do so and still make a profit.

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Wendell Potter: Medicare Advantage – or DISAdvantage? (Original Post) eridani Apr 2013 OP
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