These seem mainly “Part C” plans (Medicare Advantage) plans. Many are “dual” for people with Medicaid also.
The “dual” people pay zero (except some might have Medicare part A premiums taken out of their social scurity though, not sure), and could just have Medicare+Medicaid and always pay zero for their medical care and drugs. However the Medicare Advantage companies basically get about the same amount of money per patient that the feds think they pay out, and if they can lure patients into these part c dual plans, then the company gets to keep any money they do not spend. And they are good at not spending it.
In effect these companies are permittted to BRIBE potential patients by offering all kinds of other stuff, including over the counter stuff, dental, cheap glasses, rides, and even gift cards!
And the money they make comes from money they don’t spend. They of course try to cherry pick healthier people to join. They harrass and limit doctors and hospitals, have weird network requirements, etc. Patients create problems for themselves, to some extent, by picking what turn out to be bad plans for their real needs just to get some extended (and often cheap) product the plan offers, not realizing the limitations.
The non-dual patients who only have medicare (no medicaid) ARE paying premiums for both part A plus the non-covered 20% plus part d drug plans, so there are some premiums involved on those plans. The premiums are socialist in that not everyone pays the same, people with some incomes have to pay often a lot more.
However, even in that case, their profit comes from spending less that the services they provide. The companies are specialists in RATIONING to the patients. They will of course claim they lower their expenses by preventive efforts to keep their patients healthy, but studies show that prevention almost always costs more.
Prevention is valuable to people and worth paying for, but in the long run, in a population, it always costs more — sooner or later we all get hurt or sick anyway, it just created a new expense and kicked the can down the road that will still cost a little later. They just pay the lip service to prevention that the feds require.
The plans save money mainly by refusing services, limiting options, creating hoops to jump through that cause people to give up trying, etc. All this after they have lured in their pigeons and sheep.
At least that’s my take, sorry if any of the above is somehow a little off or misstated. I just do not like these companies tricking old and ill people into bad decisions that they are stuck with for a year all because they dangled a free ride to the doctor, so I hate seeing their smiley ads.
Thanks for the informative reply.
It is the result of no one actually knowing what the bill is. Some pay through the nose, some don’t pay at all and the care is not exactly comparable. But people are being charged twice that of the next country down the list in Europe per capita. We pay the gold standard for a crappy catastrophic plan that pays for all the little stuff and gouges for the things that cost.
It is the Medical Industrial Complex...to steal a phrase.
DK