About 8000 seniors may lose Medicare coverage in one county. Not just Florida this time.

[madfloridian]

This is truly tragic.

Medicare Advantage plans have been allowed to bombard seniors who don't know what is going on. They are in addition to the traditional Medicare program. The ads are so pervasive and intrusive that many seniors think they must pick one. Here is the link to explain.

http://www.medicare.gov/Choices/Overview.asp

The mails and ads are apparently non-stop, and it often looks like seniors may be forced to change. It is scary to some.

These plans are so easy to get involved in. But there is so much risk. The marketing is brilliant and non-stop. Our county has about 8,000 patients who will lose medical care from major providers here come June. It was just announced that one of the largest clinics around here will not accept Universal Health Care Medicare patients.

Hard Sell Cited as Insurers Push Plans to Elderly

WASHINGTON, May 6 — Insurance companies have used improper hard-sell tactics to persuade Medicare recipients to sign up for private health plans that cost the government far more than the traditional Medicare program, federal and state officials and consumer advocates say.

Insurance agents, spurred in some cases by incentives like trips to Las Vegas, have aggressively marketed the private plans, known as Medicare Advantage plans. Enrollment in them has skyrocketed in the last year, and Medicare officials foresee continued rapid growth in the next decade.

....."But Dr. Barbara L. McAneny, a cancer specialist in Albuquerque, said that many of her patients who signed up for such plans “suddenly found that they had huge new co-payments — $1,250 every three weeks for a combination of five intravenous chemotherapy drugs.”

In Florida and seven other states, the Universal Health Care Insurance Company offers a private fee-for-service plan that promises “the ultimate freedom to see any doctor, any time, anywhere.” This product — the Any, Any, Any plan — got off to a fast start, enrolling 85,000 people. But it “temporarily postponed new enrollments as of Feb. 14” because of a dispute with the Florida insurance commissioner, Kevin M. McCarty, who said the company did not have adequate cash reserves to comply with state law.

And now the ones signed up with Universal are learning there will be no help from the federal government, even though the company failed to provide as promised. This is scary stuff for seniors.

Universal Users Stuck With It for Now

LAKELAND - Polk County residents enrolled in Universal Health Care's Medicare Advantage plans can't expect any extra help from the federal government as they deal with a dwindling number of local physicians who accept the Universal plans.

The federal government isn't ready to schedule a special enrollment period for Polk residents who want to leave Universal, but officials continue to monitor the situation, a representative for the Centers for Medicare and Medicaid Services (CMS) said Monday.

U.S. Rep. Adam Putnam's office got the message from CMS and passed it to Central Florida Physicians Alliance, which represents 190 physicians who contracted with Universal through the alliance. That contract is being terminated at the end of May, which will force some Polk residents to find different doctors.

More than 8,000 Polk County residents are enrolled in Universal programs, company spokesman Bob O'Malley said.

These people should be allowed to get right back into regular Medicare. They have been paying premiums just like others on Medicare. One of the people working with them said they were getting calls from people just in tears with nowhere to turn.

And the latest news on this. One of the largest will stop taking payment from this group. Soon I expect many doctors at this clinic not to take Medicare patients at all.

Lakeland Medical Group Will Stop Taking Universal Insurance

Clark & Daughtrey Medical Group will stop accepting Universal Health Care insurance after June 30.

That change affects about 2,500 patients whose doctors are at the Lakeland-based medical group. Clark & Daughtrey had taken Universal insurance under a contract between Universal and Central Florida Physicians Alliance, a group representing almost 200 doctors. Clark & Daughtrey is an alliance member.

The contract between the alliance and Universal is scheduled to end May 31. Clark & Daughtrey got a one-month extension as its officials tried to work out a longer arrangement with Universal.

But their talks fell through. Clark & Daughtrey, after sending letters to its patients, announced Wednesday that the arrangement will expire June 30

What this government has done to seniors in this country, confusing them and upsetting them, is unforgiveable. Maybe Moore's film will get someone's attention. Our congress recently failed to get through a bill requiring competitive bidding on drugs for Medicare D. That's our Democratic congress, need I mention. That was part of their promise to seniors. And no moves toward health care yet.

I see a Senate panel is investigating these plans. They should allow seniors to go right back on regular Medicare if a company bails out.

Senate Panel Hears Testimony On Medicare Advantage Marketing Practices

State insurance regulators from Georgia, Oklahoma and Wisconsin on Wednesday testified before the Senate Special Committee on Aging about unethical or illegal practices that sales agents allegedly have used in their states to enroll Medicare beneficiaries in private Medicare Advantage plans, the Raleigh News & Observer reports (Goldsmith, Raleigh News & Observer, 5/17). In advance of the hearing, Senate investigators released to Congress interviews and documents that indicate sales agents in at least 39 states have used unethical or illegal practices (Kaiser Daily Health Policy Report, 5/16).

No excuses for our country to allow this. Howard Dean talked about the Medicare Advantage plan on the Aaron Harber show recently. Harber asked him about it and said the Republicans seemed proud of it. Dean laughed and said of course they liked it, they put it together in partnership with the drug companies. They did not have the patients in mind.

The video covers that and more:
http://www.harbertv.com/index2.htm

[Viva_La_Revolution]

1. kick!

get this out there.

[TahitiNut]

2. As Adam Putnam just acts as a field rep for the corporate crooks.

:grr: :puke:

Universal Health Care is a big GOP contributor,

DESAI, AKSHAY
SAINT PETERSBURG,FL 33704
UNIVERSAL HEALTH CARE/PHYSICIAN/EXE
2/13/2006
$25,000
National Republican Senatorial Cmte

DESAI, AKSHAY
SAINT PETERSBURG,FL 33704
UNIVERSAL HEALTH CARE
6/10/2005
$25,000
National Republican Senatorial Cmte

... and lots more

http://www.opensecrets.org/indivs/search.asp?key=SSVBV&txtState=(all%20states)&txtEmploy=Universal%20Health%20Care&txtAll=Y&Order=N

[Tanuki]

3. This is appalling. Thanks for possting it. k&r, nt

[madfloridian]

4. Don't you love all the national news coverage this has gotten?

:sarcasm:

[Telly Savalas]

5. The media is probably so overwhelmed by the powerful and immediate response

by the Congressional Democrats, that they don't really know where to begin in covering this story.

[madfloridian]

6. Yep. I am sure they were stunned.

There is an article in the NYT I think tonight about how Bush is strutting around so proudly.

[acmavm]

7. This is just stupifying. The Federal Government refusing to allow old

people who have been victimized to recover their Medicare benefits. WHAT THE HELL IS A GOVERNMENT FOR IF NOT TO RIGHT THE WRONGS DONE TO ITS PEOPLE?

Oh wait, the 'evil-does' are republican benefactors. Silly me. I understand now.

[madfloridian]

9. There should someone warning people about this, not just ignoring it.

Many of the seniors who are signed up for various of these Medicare Advantage plans simply thought they had to do it. One mailing after another goes out, and it sounds like something you must do....which is exactly what the intent was....to get seniors off traditional Medicare and privatize it.

If you do a news search at Google, then sort by date, you see that a lot of politicians are aware it is a serious problem. Why the heck aren't they out on the air talking about it?

And people here who have parents on Medicare should check out what program they are on. Be aware of it.

Here's a link to the Google News search by date:

http://news.google.com/news?hl=en&ned=us&q=%22medicare+advantage%22&ie=UTF-8&scoring=d

[madfloridian]

8. Everything costs more than on the traditional Medicare plan.

Those companies got to make their money on the backs of the old folks.

Seniors find little advantage to plan

When two insurance salespeople showed up at Emma Williams' home in Atkinson and said they'd been referred to her by a neighbor, the 78-year-old widow didn't think twice about letting them in.

They were clean cut and friendly, and because Williams trusted her neighbor's judgment, she invited the couple in and listened to their sales pitch. An hour later, she'd signed up for private Medicare coverage - a Private Fee for Service (PFFS) plan - that would only lead to worry and expense.

Shortly after enrolling, Williams went to her doctor and was billed $20 for a procedure that used to be covered completely by Medicare and her supplemental insurance. Another shock came at the pharmacist, where a prescription that used to cost $5 dollars now cost $35.

When I asked why, my doctor's receptionist told me it was because Medicare didn't cover me anymore." Williams said.

"I'm on a fixed income, and now I have to pay when I go to the doctor. And I still have to pay for my telephone, gas and taxes. They're after me like a hound dog. I don't know what I'm going to do."

This is a national tragedy, and that Senate hearing is not proceeding fast enough.

Where are you, Bill Nelson? Mel Martinez? Opie Putnam? Why are you having to be begged to speak up.

All those drug companies got you under their control, I guess.

This is how they are trying to get seniors off Medicare the hard way. What a cruel thing to do. But Little Boots got his 100 billion to kill Iraqis.

[demgrrrll]

10. There are loopholes to get out of these advantage policies.

The state insurance commisioners have the list and can let the policy holders know what may work for them. If the person is Medicaid eligible or becomes Medicaid eligble that is one loophole.. etc and many seniors on a fixed income are eligible for Medicaid on a spend down basis. The people at the insurance company aren't necessarily forthcoming with this information.

I detest Medicare Advantage policies.

[madfloridian]

11. But no help for those not on Medicaid. Just Medicare there seems to be nothing.

At least that is my understanding.

When was the HMO crisis in Florida? Remember that? Seems like it was all ages involved then. HMOs ran out of Florida with their tails between their legs, and many Floridians were hurt.

[xxqqqzme]

12. so if a person signs up w/ an 'advantage' plan

their monthly medicare portion of their Social Security check goes straight to the 'advantage' holder. By transferring that portion, the advantage holder becomes the health care provider?

Am I reading that right? I know my HMO was very upfront about these advantage plans. The info I received said straight out it would cancel my medicare coverage. As a disabled SSI recipient, I don't mess around w/ the coverage I have, as slight as it is.

[mcking]

14. It's actually even worse

The federal government actually gives these "private fee for service" plans MORE than it would cost to just cover someone on plain vanilla Medicare. Then those companies turn around and provide the same or WORSE coverage (it varies from company to company) and pocket the difference.

These are not necessarily drug companies -- they have their own Part D plans blessed by the Bush administration. These are insurance companies, although in many cases they're not "real" insurance companies but have been slapped together by sharp operators who have seen the potential for huge, easy profits written right into the regulations.

Why would the feds do this, you ask? Well, the law and regs were designed to give incentive to companies to provide Medicare coverage in rural areas where Medicare replacement (managed care) plans just aren't available. Problem is, they're growing exponentially in areas like Florida where Medicare managed care plans (which have been around for many years and generally provide decent services) are plentiful.

The "private fee for service" plans are a boondoggle, plain and simple. Even if you're not a Medicare recipient, it's costing you money that could be better spent directly on care for the elderly. I'm blaming the Republicans at the moment, but if the Democrats don't do something about the situation PDQ, they'll be just as responsible in my book.

[madfloridian]

15. I agree, Our party MUST do something. I hope the hearings go well.

It is easy for seniors to get confused over all these ads they are bombarded with...and there is no one around to explain it who is neutral. AARP has an ugly history in being neutral on stuff like this, yet seniors trust them.

Local groups I have tried to ask about it don't seem to have a clue about how to advise seniors.

It was meant to be confusing to get them off traditional Medicare and onto the private plans.

[daveskilt]

13. I don't take UHC at my hospital - wish none of these plans existed

Medicare Part A = good
HMO and advantage plans = bad

easy equation I explain twenty times daily to seniors who all go ahead and sign away their benefits. On medA they get 100 days acute and 100 days SNF coverage. the plans all claim to give 'up to' 150 days - sounds better? under medA the doctor says how much time you need and what services you need. under the plans - the office decides how much they want to pay for.

average length of stay in a snf on medicare A for a broken hip (80 yr old) - 68 days. on an HMO 8 days. on the HMO I WILL see them come through the ER again within 2 weeks with more injuries - sent home too soon to save a buck for the HMO.

[madfloridian]

16. Interesting post.

That is a huge difference in the recovery time allowed for the broken hip.

I am afraid that those ads that go to homes that are so colorful and compelling are making them think they don't a choice.

This bunch of "conservatives" would unravel every safety net for seniors and the poor in a heartbeat and not look back.

I think young people who are not paying attention will end up with huge responsiblities for aging parents who were misled on purpose.

[demgrrrll]

17. Have you read the stories about UHC being charged for racketeering

By NYC Hospitals? That is a story I would like to know more about.