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Any Advantage to Medicare Advantage?
Vidcast: https://youtu.be/T2TNGuTrYTM
You’ve seen them on TV offering you an unbelievable option to conventional Medicare. Some of your favorite public figures are pitching this stuff. (Broadway Joe,vComedian Jimmy Walker, and Star Trek’s favorite commander Bill Shatner). They’re talking about Medicare Part C which is another name for a Medicare Advantage Plan. Is there really an advantage or are there hidden disadvantages?
Joe, Jimmy, and Bill paint a rosy picture. You get all the advantages of traditional Medicare including doctor’s visits, hospital care, and surgery but also the promise of additional coverage for dental services, eyeglasses, hearing aids, prescription drugs, fitness workouts, and more all without the need for a separate prescription drug plan or Medicare supplementary policies, so-called Medigap plans. The best news: in many cases you play nothing and enjoy a reduction or elimination of what you’re currently paying for traditional Medicare and a Medicare supplementary policy. Too good to be true? You bet.
What is this really? The US government pays private health insurance companies, your best friends….right, the money that would normally go to providing medical care for you via traditional Medicare.d These companies then provide that care. It's a tremendously profitable business for these companies. They make twice the profit for each person covered under Medicare Advantage that they make covering younger individuals.
The ways they made these profits is the dirty little secret they don’t want you to know. Let’s shine a light on this now so that you do know.
Many plans saddle you with costly out-of-pocket expenses including copays and deductibles when you require covered services. The insurer only pays the entire bill when you reach a maximal out-of-pocket ceiling which can be quite high.
The other huge savings for them and disadvantage for you is choice. With a Medicare Advantage Plan you are limited to the insurer’s network of providers and hospitals and often only where you live. Your own medical team and preferred hospital may not be on that list.
The insurance companies reap more profits by forcing these contracted doctors and hospitals to accept less for their services. Then too, they often deny recommended services during the cumbersome preauthorization process forcing you to file grievances and appeal, appeal, and appeal.
The bottom line: Medicare Advantage is a great option if you are willing to have a limited choice of doctors and hospitals and are prepared for hefty co-pay expenses should you become ill. It’s a great choice if you are a member of the walking well and never require other than routine healthcare services.
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By Howard G. Smith MD, AM
Vidcast: https://youtu.be/T2TNGuTrYTM
You’ve seen them on TV offering you an unbelievable option to conventional Medicare. Some of your favorite public figures are pitching this stuff. (Broadway Joe,vComedian Jimmy Walker, and Star Trek’s favorite commander Bill Shatner). They’re talking about Medicare Part C which is another name for a Medicare Advantage Plan. Is there really an advantage or are there hidden disadvantages?
Joe, Jimmy, and Bill paint a rosy picture. You get all the advantages of traditional Medicare including doctor’s visits, hospital care, and surgery but also the promise of additional coverage for dental services, eyeglasses, hearing aids, prescription drugs, fitness workouts, and more all without the need for a separate prescription drug plan or Medicare supplementary policies, so-called Medigap plans. The best news: in many cases you play nothing and enjoy a reduction or elimination of what you’re currently paying for traditional Medicare and a Medicare supplementary policy. Too good to be true? You bet.
What is this really? The US government pays private health insurance companies, your best friends….right, the money that would normally go to providing medical care for you via traditional Medicare.d These companies then provide that care. It's a tremendously profitable business for these companies. They make twice the profit for each person covered under Medicare Advantage that they make covering younger individuals.
The ways they made these profits is the dirty little secret they don’t want you to know. Let’s shine a light on this now so that you do know.
Many plans saddle you with costly out-of-pocket expenses including copays and deductibles when you require covered services. The insurer only pays the entire bill when you reach a maximal out-of-pocket ceiling which can be quite high.
The other huge savings for them and disadvantage for you is choice. With a Medicare Advantage Plan you are limited to the insurer’s network of providers and hospitals and often only where you live. Your own medical team and preferred hospital may not be on that list.
The insurance companies reap more profits by forcing these contracted doctors and hospitals to accept less for their services. Then too, they often deny recommended services during the cumbersome preauthorization process forcing you to file grievances and appeal, appeal, and appeal.
The bottom line: Medicare Advantage is a great option if you are willing to have a limited choice of doctors and hospitals and are prepared for hefty co-pay expenses should you become ill. It’s a great choice if you are a member of the walking well and never require other than routine healthcare services.