Posted on 11/24/2023 10:47:42 AM PST by buckalfa
Hospital just confirmed a Zero balance as of Monday.
Good for you, congratulations.
Systemically, however, MA programs are causing catastrophic harm and they should be discontinued soon.
Of course, every tweak to Federal and State health programs which envision public-private partnerships flooding Congress with bribes makes things worse, Medicare Advantage is no exception.
Funny...the hospital where I get my care,a very famous one,just started offering its own Medicare Advantage plan.
“That’s not a bug, that’s a feature.”
The rates for Advantage plans during this last year crashed— and result being they were not accepted very long.
Result— 2024 plans increased by more than 25%/monthly premium. So likely to actually pay hospitals and not get dumped. If they don’t people are really going to be ticked.
Do you know how many dollars were actually paid?
I signed up for standard Medicare.
It was not an easy thing to do.
I’m on Medicare A & B. Provider is Kaiser. Isn’t everything taken care of?
I keep getting hit on for C & D. No comprende. Healthy Harry here.
I no comprende your question. Are you saying you are being asked to pay co-pays and deductibles?
Medicare Advantage provides health coverage to more than half of the nation's seniors, but a growing number of hospitals and health systems nationwide
are pushing back and dropping some or all contracts with the private plans altogether."
"Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers.
Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government
and are being probed by lawmakers over their high denial rates."
"It's become a game of delay, deny and not pay,'' Chris Van Gorder, president and CEO of San Diego-based Scripps Health, told Becker's.(Emphasis mine)
"Providers are going to have to get out of full-risk capitation because it just doesn't work — we're the bottom of the food chain, and the food chain is not being fed."
"In late September, Scripps began notifying patients that it is terminating Medicare Advantage contracts for its integrated medical groups,
a move that will affect more than 30,000 seniors in the region.
The medical groups, Scripps Clinic and Scripps Coastal, employ more than 1,000 physicians, including advanced practitioners."
"Mr. Van Gorder said the health system is facing a loss of $75 million this year on the MA contracts, which will end Dec. 31 for patients covered by UnitedHealthcare,
Anthem Blue Cross, Blue Shield of California, Centene's Health Net and a few more smaller carriers.
The system will remain in network for about 13,000 MA enrollees who receive care through Scripps' individual physician associations."
"If other organizations are experiencing what we are, it's going to be a short period of time before they start floundering or they get out of Medicare Advantage," he said.
"I think we will see this trend continue and accelerate unless something changes."
Ooops! I realize you mean Medicare part C and D.... forgive me.
I’ve had Medicare Advantage plans for years including hospital procedures and I have had no problems so far. But I do know others that have had problems. From what I can gather it seems to be related to the serving area.
Who remembers when Medicare was sold to us as free health care after we turn 70?
Or 65
Back when I got old, I did lots of research and ended up with a Medigap plan and a drug plan. I’ve had one claim. I paid nothing, but the plan only paid 10% of the billed charges. What Medicare alone would have paid, I do not know.
It’s a mess.
The problem for MA subscribers is that to change to a better plan it is more expensive but worse than that, you will have to qualify, being accepted into a non-MA plan is not automatic.
Odd though, going the other way from Part G or similar to MA is automatic. I wonder why? The answer is money and rationing.
All you really need to know is that MA is an Obamacare program.
stay away from “Advantage Plans” like the plague... get the supplemental
Lots of people are going to die because of these decisions.
standard Medicare.
—
Only covers 80% at best, with a lot of gaps. You could easily get struck with Hospital bills of $100K after standard Medicare.
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