Posted on 04/01/2023 9:04:40 PM PDT by SeekAndFind
We’ve written about the hypocritical nature of Joe Biden’s attacks on the Republicans over Social Security and Medicare, with the Biden administration targeting Medicare Advantage. Almost 50 percent of the people eligible for Medicare opt for Medicare Advantage, so anything that would affect the program could affect a lot of people.
We reported back in February about how Biden got fact-checked by Twitter that month for lying about the Republicans. But that was particularly disgraceful, when he was proposing moves that could result in cuts to payments to Medicare Advantage insurers.
The 2024 Medicare Advantage and Part D Advance Notice, released in February, proposed a 1.03 percent average Medicare Advantage revenue increase driven by a 2.09 percent growth rate, but insurers have argued that because of other changes, it would represent a 3.7 percent cut.
As I wrote at the time:
House Republican Study Committee (RSC) Chairman Kevin Hern (R-OK) sounded an alarm about what the Biden administration was doing. Hern warned where Biden was going with this, “Biden just cut nearly $5 billion in funding for Medicare Advantage, and this is just his first step. The end goal is to get everyone – not just seniors – onto government-controlled, Medicare-for-All plans.”
That probably explains why Sen. Elizabeth Warren (D-MA) has been one of the biggest proponents for these Biden moves. Medicare Advantage represents a public-private company program that people like with good services and broad support. But that stands in the way of Medicare for All, and some on the left don’t like that.
However, Medicare Advantage has had bipartisan support, and people on both sides of the aisle have called on the administration to sustain it. It’s supported by a bipartisan majority of the Senate including Sens. Catherine Cortez Masto, Kyrsten Sinema (I-AZ), Jon Tester (D-MT), Joe Manchin (D-WV), and Amy Klobuchar (D-MN). The bipartisan group wrote a letter imploring CMS to “continue to sustain and strengthen Medicare Advantage.”
Even the Governor of Puerto Rico, Pedro Pierluisi, a member of the New Progressives, was very upset. Pierluisi told the Biden administration that the preliminary plan to regulate 2024 Medicare Advantage reimbursements, which could lead to a reduction of $800 million annually in payments to these health plans on the island, would represent “the biggest cut in federal funds for health care in Puerto Rico’s history.” Pierluisi called on Secretary Xavier Becerra to stop the changes in Medicare Advantage plan reimbursements.
However, now they’ve finalized the Medicare Advantage rates for 2024, according to Bloomberg, and they would reportedly result in a 1.12 percent cut for plans, after stripping out the expected impact of how plans report patient illnesses. The rate wasn’t as much as the Biden administration had intended, after a lot of backlash on the issue about what had originally been proposed.
But they’re also going to phase in some of the changes that determine payments based on the severity of patients’ health problems, having them take effect over three years instead of immediately over one year. That’s why there’s going to be a smaller-than-anticipated drop in the first year. So, it’s a bit of smoke and mirrors here, yet they’re still going down the same problematic road.
Bloomberg notes, insurers “will now have to determine whether to maintain generous benefits that help attract customers, such as zero premiums” or fall back on “more costly plans.” Either way, it is not going to be good for the 30 million Medicare Advantage consumers, and that’s going to be right at the foot of the hypocritical Biden administration.
Isn’t Medicare Advantage kind of a scam?
My mom has it, and I am impressed with the level of care she gets.
I nearly died a few years ago..in and out of hospital from July through November..had various procedures and ended with successful surgery. Everything was paid.
He’ll do everything he can to project the blame on Republicans. Everything Biden touches turns to sh— because that’s what he is.
I’m glad you recovered, and that they covered it. I’ve heard quite a few stories that that didn’t happen.
Isn’t Medicare Advantage kind of a scam?
I live in Oregon, and started Medicae Advantage this year. The reason is that with traditional medicare, plus the various drug, dental and optical add-ons, I was looking at a $350 deductible for drugs, and another $350 for dental, and about $125 for optical. I also had a $230 premium to pay for the Medicare 20% co-pay, plus $60 dental premium and $23 drug plan premium and $13 vision premium.
With the Advantage plan, I pay a $61 drug premium and $13 for vision coverage, which doubles my vision coverage beyond the Advantage plan. I also pay $20 - $25 to see specialists, and I have to pay 20% co-pay on durable medical equipment. I pay nothing else.
My monthly expenses are nearly eliminated, which allows me to save up for any medical expenses I may incur beyond what is already budgeted for.
I should have added that the Advantage premiums are monthly, and the others are co-pays.
The insurance companies push it like crazy. They really really want you to sign up for Medicare advantage. I have resisted because it sounds like a typical HMO were you have to have a primary care physician who controls your healthcare. I’m not sure if that’s correct or not.
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No. I prefer it
Going to have to let Jimmy JJ Walker go...along with Joe Namath. Cut some celebrity costs. ;-) Advantage plans can be OK if you are lower income and want a “free” plan and don’t mind complying with HMO or PPO doctor networks...some areas of the country are better for decent “Plan C”/Advantage doctor/hospital networks...usually “non-rural”. There are also co-pays with AP’s. Traditional Medicare with a supplemental policy/plan like “Plan G” or “Plan N” allow about any doctor or hospital in the country and co-pays are paid by the supplemental plan. Also AP’s can change the doctor/hospital network and co-pay “rules” yearly while once on Medicare with a supp. the “rules” never change for life. So basically “pay me now or pay me later”.
Not a scam, but it can restrict your choices in the future if your needs change. I prefer Medicare Supplements over Advantage. But I know many people who are quite happy with their MA plans.
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Joe Biden is a Scam.
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The insurance companies push it like crazy. They really really want you to sign up for Medicare advantage. I have resisted because it sounds like a typical HMO were you have to have a primary care physician who controls your healthcare. I’m not sure if that’s correct or not.
No seek-and-find, that is not correct. Medicare Advantage insurance providers generally have both a HMO and. PPO plan. The nation’s biggest provider company, United, has a great PPO plan that does not require referrals and “management by a primary care physician” allowing the patient to see the provider of choice as long as the physician accepts medicare. The co-pays are somewhat higher if they are not “on the plan” but that amount is really minimal. Medicare advantage programs generally are at no additional cost to the patient other than maintaining Medicare Part B costs (unlike the Supplement plans of regular Medicare i.e. part G, N, etc.)
The advantage programs offer enhanced benefits such as dental coverages, vision and eyeglass benefits, and hearing aide coverage not available under traditional Medicare Part B with an expensive Part B supplement. Most plans include membership in various health clubs and a quarterly set amount to spend at pharmacies for OTC products (such as pain relievers, allergy medication, toothpaste, female products etc.). As an example, Aetna Advantage allows $90/quarter and United allows $40/quarter with some additional for completing some “health objectives.”
So NO, Advantage programs are not a SCAM, they are a different Government program created to allow the insurance companies to manage care - likely more efficiently than federally employed administrators can manage.
I could go on....but you get my drift.
Beware of insurance salesmen. Most are working on commission and often have the ethics of a used car salesman. Do not expect non biased advice.
If you worked for a company large enough to have corporate medical insurance and such, they probably have a retiree benefits group. Even if you haven't worked for that company for years, you can probably still tap into their retiree services.
I have Medicare supplemental insurance through the insurance broker retained through a former employer for their retirees. 30K plus employees. The broker's agents are salaried, not commissioned. The broker is not wed to one or two insurance providers. For example, I have three different insurance companies that in combination provide the maximum range of medical, hospitalization and assisted care. Once a year during open enrollment, I review things with the broker and occasionally will tweak some details.
Pro tips…. If your health insurance is through a retiree benefit program…. ALWAYS keep the company benefits department and social security up to date with your current address and contact information. Periodically, the company will download to the insurance broker an update on all retiree's address, etc. The broker then updates this information to the individual insurance companies. If you moved 6 months ago without updating the former employer's benefits data, you could end up with a mess to untangle via temporary denied coverage or even temporary cancellation. There's a also 60 day window IIRC to notify social security (via their website) of a move. Get outside this window and you could end up with a penalty that increases the cost of Medicare.
My opinions…
In our area, the only Advantage plan is run by Blue Cross. And it would not allow us to see our doctor but we would have to travel twice as far to a new doctor and neither of us have our own teeth but wear dentures so the dental is not needed. We only have Medicare but that has worked for us so far.
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