Posted on 11/21/2022 9:37:15 PM PST by ConservativeMind
An analysis found that cancer patients with privatized, cost-saving Medicare Advantage were more likely than those with traditional Medicare to go to hospitals with physicians less experienced at performing complicated surgeries, and that they were more likely to die within the first 30 days after the removal of their stomach, pancreas or liver.
With traditional Medicare, beneficiaries typically may go to any doctor or hospital in the U.S. that takes Medicare, whereas in most cases, Medicare Advantage beneficiaries can see only doctors and providers who are in the plan's network and service area.
They found that cancer patients who had their stomach or liver removed and had Medicare Advantage were 1.5 times more likely to die within the first month after surgery compared to their peers with traditional Medicare. Similarly, Medicare Advantage beneficiaries who had oncologic surgery of the pancreas were twice as likely to die within the first month, the study showed.
People with traditional Medicare were more likely to be treated at a teaching hospital (23% vs. 8%), hospital accredited by the Commission on Cancer (57% vs. 33%) or National Cancer Institute-designated cancer center (15% vs. 3%). Traditional Medicare beneficiaries were also more likely to be treated at hospitals with a higher median number of total beds, ICU beds, operating rooms and annual inpatient surgical volume.
Medicare Advantage beneficiaries, on the other hand, experienced a delay of more than two weeks from diagnosis to first course of therapy. A reason for the delay could be the required prior authorization that Medicare Advantage beneficiaries with an HMO have to undergo. While this referral process is intended to limit unnecessary medical care, it can cause delays for Medicare Advantage beneficiaries who need specialized services, such as complex cancer surgery.
(Excerpt) Read more at medicalxpress.com ...
I have a separate prescription plan……also good and paid for by my former employer.
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We have to use Medicare’s Rx plan and the meds I am on are ridiculously expensive on it.
Mr. mm and I have found Good Rx to be more cost effective, but nowhere near what our prescription plan was before.
What this meant for me is dealing with specialized insurance pros that are not working on commission. Every single insurance provider is at their fingertips with no commission bias weighing into recommendations.
I strongly recommend that anyone in the Medicare world to go with this kind of retained insurance broker option. Heck, even if you've got a past employer you worked with some years ago in the past, I recommend calling that company's benefits department or person to get a referral to their retained retiree insurance broker - It might work and is worth looking into.
One hitch to this is that when you move to a different permanent address, you need to telephone the former employer benefits to update the new address. This is because their employee/retiree data base has to exactly match the address the insurance provider has. I had this problem once and found out the hard way when benefits were temporarily denied. What a hassle! Also, if there are any fundamental foul ups in employee records, this can through a wrench in things.
Example, the company's record for my birthday got fouled up. I would call former employer's benefits and “fix it”, fix it with the insurance broker and fix it with the insurance companies directly and still the error kept getting propagated through computers. Finally got fed up and worked up the corporate chain until getting to the corporate VP for HR (30k employees). This was during Covid crap and he was working at home, crying baby in the room and all. I kept on his case until he personally fixed the problem via his high level computer authorization. If he had copped out, my next call was to the President of the company.
It wasn't planning for this but by the luck of my birth year, I had 3 options for Medigap tiers - HMO, PPO and Cadillac. I opted for the Plan F Cadillac, which has since been discontinued by Medicare. However, I'm grandfathered in so all is good for me. I can always downgrade but can never go back up.
At the present time:
Transamerica for health
Aetna for prescription
Cigna for vision, hearing, dental
Overall, I’m satisfied with it, too. Regular Medicare and premium and I carried over my Anthem BCBS Plan F insurance into retirement and Medicare with it for the supplemental.
The two cover everything as long as whatever it is done (in a hospital) is coded medically necessary. I haven’t had to pay a dime for three times in the hospital - all ICU (with surgery on the last) in the last 5 years. Also, never get a bill or have a co pay with my doctors. My Plan F premium is high, but it’s a known quantity and well worth it IMO.
Exactly, if you like to be controlled, limited doctor choices, and pay more, you will love the advantage (for the insurance companies) plan…
I never seriously considered it after I saw how the game was played.
Typical Hit Piece Quietly Funded By WHO ?
These Obvious Smear Pieces Are Always Quietly Funded and the Source Never Divulged .
Yeah,my CM’are cardiac related, exercise and diet have helped tremendously. I have outlived my prognosis so all is good.
We researched Advantage vs Supplemental plans as I was turning 65.
We went with Supplemental Plan G, and believe we made the right choice. Ours is through Mutual Of Omaha.
A couple of my quilting friends were fine with Advantage UNTIL major health problems arose. One lady broke her back. Although there was a surgical procedure that could fix that certain problem, her plan refused to cover it. Solution was to lie on her back for a few months. It worked in the end but the surgery would have had her back on her feet after a couple weeks.
I’ve had cancer, mastectomy, hip replacement and a few other procedures and never paid a cent after relatively small deductible was satisfied. I chose my doctors.
The cost monthly is higher but in the long run we believe we come out ahead.
They’re both lousy choices.
Deep State doesn’t like competition.
“I am appealing this because Medicare should pay for cholesterol testing.”
Based on what I’ve learned, there’s not much to be gained from standard cholesterol testing in the first place. If it’s up to me, I won’t bother with it, since all it does is lead to being prescribed statins, which is something that I won’t get near, given my earlier experiences with it.
Seems misleading as when you go on Medicare and take an Advantage plan you have both plans.
You can chose an out of network doc for the Advantage, but pay more, or you can just omit telling them you have Advantage and just go on plain Part A, B, C, D xy. IMHO
And she just figured that out? Neither will Sloan Kettering. You take advantage planif you are cheap or have no other options. And I have wealthy cheap friends who have Advantage. Once my husband started talking about switching to save money and I told him he was crazy to consider it. He has chronic medical issues.
It seems to me that this might be a geography issue rather than an insurance issue...but I could be wrong.
I have such a plan (through Blue Cross) and I can see any doctor...or go to any hospital...that takes Medicare. That means 98% of doctors...and hospitals. That’s one of the main reasons I took the plan. If I develop some rare cancer I want to be able to go to Baltimore...or San Francisco...or Ottumwa,Iowa to see *the* world expert on that cancer.
I’m on Medicare and have Aetna as well. I’ve had very good experiences with Aetna and have no plans on changing. I had transplant surgery last year, and the total for my surgery was well over $400,000, with ongoing medical monitoring and my prescriptions.
My wife and I get bombarded with the Advantage plans as well. Sure, we can get one of those cheaper plans with low or no premiums, but in the long run, it’s better to stay with what works.
My best to you🙂
We have Aetna Medicare advantage and I have to say it is Cadillac insurance for the most part.
I think you're mistaken. Advantage takes the place of Medicare, you can't just run back to Medicare for coverage if you have an Advantage plan. During the annual enrollment period you can switch back to Medicare or vice-versa, but you're stuck with your choice until you change coverage.
True, doc tried to get me to take a statin and I said no.
How many living people do you know that have had their liver removed, no matter what insurance they have? I don’t know any.
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