Friday, October 12, 2018

IBM Medicare Via Benefits OneExchange ExtendHealth Disadvantage of Medicare Advantage

In the last few months the Department of Health and Human Services became the advertising agency for Medicare Advantage plans.  This is supposed to be an unbiased organization that provides the oversight and administrative processing for Medicare recipients.  It is now the unabashed tool of private insurance companies.

Updated 6/11/19

It's disheartening because Medicare Advantage plans have a lot of downsides that are hidden in the details and the sweet smile of insurance agents. This link to a Reuters news report confirmed it has been happening for a while, but the current government administration is over the top:
https://www.reuters.com/article/us-column-miller-medicare/medicare-advantage-plans-get-unfair-push-from-u-s-government-critics-idUSKBN1O621T

Updated 12/5/18

A few days ago this report appeared in the New York Times about how the Department of Health is "advertising" Medicare Advantage plans and the lack of pros and cons:

 https://drive.google.com/file/d/1nOu51PEZhmaG9OUzDyblYQJSXIUVLUDM/view?usp=sharing

The best synopsis I have seen about that downside of Medicare Advantage plans is this description in Investopedia.  I encourage anyone considering a Medicare Advantage plan to first read this article:

https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp

Updated 10/15/18

The New York Times and a number of other publications recently did an article about Medicare Advantage Plans inappropriately denying claims such that 75 percent of appeals are successful at the first level of review.  That means insurance companies are exploiting customers who are too overwhelmed to appeal either because they do not realize they can appeal or they don't have the wherewithal to do it.  How ruthless!

Here is a link to a copy of the NYT article:

https://drive.google.com/file/d/1FUFTc8RhIvYkyhiS35jB_mSPPe1R8oJs/view?usp=sharing

If you want to read the full inspector general report here is a link to a copy of the report:

https://drive.google.com/file/d/1P0CUSXXlimKU3DlT4bVSCQ6EvNKYG-UX/view?usp=sharing

Updated 10/20/18

A couple of days ago I received and email from "Medicare" that was legitimately from the US government urging me to consider a Medicare Advantage Plan.  I was so irate that the federal government is pushing private insurance over the traditional Medicare insurance pool that I sent a copy of the email to my local congressional representative to complain.  This is beyond egregious.  The federal government has no business hyping private insurance plans and looks like a violation of federal government ethics rules (Employees shall act impartially and not give preferential treatment to any private organization or individual). 

Updated 10/30/18

I recently saw a program on PBS about how companies that offer Medicare Advantage plans have been pushing doctors in their networks to use more serious diagnosis codes so the insurance companies can increase the amount reimbursement they get from the federal government.  Companies like United Healthcare are now being sued by the government for BILLIONS of dollars in over-payment of claims.  Here is a link to the program:  https://www.pbs.org/video/medicare-advantage-taking-advantage-aldeae/

Updated 11/13/2018

I just found the following recent quotes from the heads of HHS and CMS:

"Medicare Part D and Medicare Advantage demonstrate the successes possible when we harness consumer choice and private-sector innovation to improve care and lower cost," said Alex Azar, secretary of the Department of Health and Human Services.   
CMS Administrator Seema Verma added: "The steps that the Trump Administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits, and lower costs for seniors."




No comments:

Post a Comment