Medicare Advantage – Great Insurance If You Are Healthy

It is open enrollment period through December 7, 2019 for those of us 65 years of age and older who are supposed to sign on to www.medicare.gov to choose our 2020 prescription drug plan Part D. This is also the open enrollment period for insurance owned and operated by private managed care Medicare Advantage programs. These plans preceded ObamaCare, or the Affordable Care Act, and are private managed care plans. They were designed to save the government money but, in fact, year after year are more costly per patient than traditional Medicare.

Let me repeat that, according to government auditors, MEDICARE ADVANTAGE PLANS COST MORE PER PATIENT PER YEAR THAN TRADITIONAL MEDICARE! If you sign up for one you will need to abide by the managed care company’s contracted panel of doctors and facilities. You do not get to choose the best doctor or hospital for your problem – just the best on your contracted panel. These insurers tell you it’s the same as Medicare but it is not. They will provide you with an insurance ID card colored and lettered to mimic Medicare but it is not Medicare.

It is great for healthy patients until they get sick. There are few, if any, monthly costs to enrollees. Generic drugs, inexpensive vision care, inexpensive hearing and dental care are often included. If you develop a complicated health problem and want to see the best it is usually OUT OF NETWORK. If you get sick out of your home area you may well be OUT OF NETWORK. These plans are immensely profitable to insurers.

They are so profitable that seniors are bombarded with mail advertising, full page newspaper advertising and constant prime time TV advertising using celebrity spokespersons. The ads encourage seniors to travel and fund their grandchildren with the savings they will reap from joining their plan.

They don’t explain what happens when mom has a new lymphoma and cannot go to MD Anderson or Memorial Hospital or Dana Farber for diagnosis and cutting-edge care. They don’t tell you about the experience of your contracted panel doctor to treat Grandpa’s throbbing headache caused by a brain vascular malformation because the regional neuro vascular interventionalist of choice is not on grandpa’s panel.

I have an idea. How about putting the cost of all the expensive enrollment advertising done by these private Medicare Advantage plans in to better benefits for their clients?  We all know the answer to that.

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