We make no secret of our skepticism regarding Medicare Advantage. And it’s popular, including as it does things like gym memberships, dental care, and other ‘perks’. What could be wrong?
Well, Kaiser Health News a few months back published this story about how Advantage plans restrict coverage. This example is the plan dictating when a covered member is ready to leave rehabilitation. With traditional Medicare, it’s your health care team that makes those decisions. As it should be.
So caveat emptor big time here with Medicare Advantage.
Imagine: Black and Hispanic elders are more likely than white elders to receive in-home care from unpaid “informal caregivers,” according to this article in Home Care magazine.
It reports on a national survey of Medicare recipients by the Commonwealth Fund. The issues of concern, beyond the essential inequity, include an increased risk of inadequate care by untrained family members, and the burden imposed on those family members, who must take time off or even give up paid work to provide care.
Medicare does offer a home health benefit, although, unfortunately, it seems to be widely misunderstood. Our Cville Village will work with JABA to make sure members know what their benefits and rights are.
Medicare Advantage (MA) plans came about purportedly to save money on seniors’ health care. What has actually happened in the two decades since the current structure of MA was determined?
Suffice it to say that MA hasn’t solved our health care payment problems. In fact some providers of MA plans seem to be busy overcharging Medicare. Here’s today’s NPR story about fraud in MA plans.
Insurers that sell MA plans tout their additional benefits, low cost, and one-stop shopping. In fact, because of the payment structure, they are incentivized to deny care, and the beneficiary (that’s you) loses choice of provider and hospital. And if you change your mind and want to switch to Original Medicare, you may not be able to do so.
Open enrollment is done for this coming year, but everyone should examine their coverage every year in the fall to see if it still meets their needs. If you need help with this, contact the folks at JABA.