Posted on 11/08/2013 6:43:37 PM PST by markomalley
Retired chemist Edward Schokowitz was incredulous when he received a letter from Horizon Blue Cross Blue Shield of New Jersey early last month saying his Medicare Advantage Plan, which had no premium, would be eliminated next year.
“They took all the senior citizens and threw us out of the plan. They now want to give us the same plan for $153 [per month],” he told the Daily Caller. “The President said you can’t be kicked out of your plan. He lies.”
Schokowitz is one of many Medicare beneficiaries now learning that — like Americans who buy insurance on the individual market — they are losing their insurance, and in some cases their doctors, under Obamacare.
Private insurance companies that cover patients with government funds under the Medicare Advantage program have quietly started to dump doctors and patients because of Obamacare budget cuts.
Schkowitz, 75, who lives in a senior citizen complex near Atlantic City, would also pay more for prescription drugs under the new plan. The co-pay for a three-month supply of one of his medications increases next year from $7.50 to $54.00.
Thousands of New Jersey residents are suffering the same fate . Currently, 74,000 Garden State residents are enrolled in Blue Cross Blue Shield Medicare Advantage. Nearly half have zero-premium plans.
But in 2014, New Jersey Horizon Blue Cross Blue Shield is eliminating all zero-premium plans with prescription drug coverage and all but two of its other plans with monthly fees.
New Jersey Horizon Blue Cross Blue Shield spokesman Tom Vincz tells the Daily Caller that “due to rising health care costs and cuts to Medicare Advantage we had to make these product changes.”
The company is asking elected officials to avoid further cuts to the program, “We’ve been lobbying Congress to help insure that Medicare Advantage is appropriately funded to avoid further increases in premiums and changes in the product,” Vincz told TheDC. “We are hoping to make this a one time experience.”
Federal payments to Medicare Advantage HMOs will decrease seven to eight percent in 2014, according to one prominent health care industry analyst.
Overall, the Affordable Care Act slashes Medicare Advantage funding by $156 in ten years, a reduction that Democrats and many journalists long insisted would not harm patients. Republicans, however, have continually warned of dire consequences.
Now, insurance companies, feeling squeezed, are nixing doctor contracts and patient plans to save money. Medicare Advantage plans are being dropped all over the country.
Nearly 4,000 UnitedHealthCare Medical Advantage members in Hawaii will have their plan terminated next year, according to the Honololu Star-Advertiser.
UnitedHealthCare Medical Advantage is also eliminating two plans in Broward County, Florida.
In Portland, Oregon, Providence and Humana are nixing their PPO plans, which allow patients to see any Medicare doctor. HMO plans, on the other hand, give patients access to only doctors in the network.
UnitedHeatlhCare is also dropping two of the plans it offers Western Pennsylvania residents.
Avalere Health, a consulting group, said in a little-noticed report this September that patient access to Medicare Advantage Plans will decline next year because of the Obamacare cuts.
Relying on data provided by the Center for Medicare and Medicaid Services (CMS), Alvalere concluded, “A majority of the counties across the country will see a decrease in the number of MA plans available from 2013 to 2014.
“Approximately 80 percent of counties in the South and Midwest will see a reduction in MA plan options, while slightly more than half of the counties in the Northeast and West will have fewer plan options.”
Avalere said the total number of plans will decrease by 5.3 percent. Before Obamacare the number of plans was increasing.
Medicare Advantage patients accustomed to seeing any Medicare doctor they wish are going to be particularly hard-hit under further Obamacare budget cuts.
Avalere chief executive officer Dan Mendelson tells the Daily Caller, “There are going to be fewer PPOs in the program. That product is difficult to maintain.”
Even when insurance companies continue to offer the same Medicare Advantage plans some are increasing prices.
Plan pricing varies by locality, right down to the zip code.
The Aetna Medicare Advantage Standard HMO plan for West Philadelphia residents in the 19104 zip code now costs $39 per month. In 2014, the premium increases to $75.50. Another plan will increase from $140 to $172.
As prices increase for some Medicare Advantage patients their access to doctors withers.
Medicare Advantage HMOs last month started to inform doctors nationwide that their contracts will not be renewed.
Noted Obamacare critic Betsy McCaughey tells the Daily Caller that the cancellation of contracts decreases costs for Medicare Advantage HMOs by reducing doctor utilization. Fewer doctors available will make it harder for patients to get appointments.
“This is happening all over the country,” McCaughey said.
Lazlo Weiss, a Brooklyn ophthalmologist, learned early last month that his Medicare Advantage contract with Empire Blue Cross Blue Shield is being canceled. “You have patients that you have a relationship with some over many years and you know their problems and they know you and then all of a sudden they are no longer your patients,” he told the Daily Caller. “I hope something can be done before there is more harm to these people.”
New York State Medical Society president Sam Unterricht said that United Health Care Medical Advantage is canceling the contracts of 2,100 New York providers. Emblem Health is also axing doctors but Unterrich has no exact figures.
“We think [Congress] should investigate to see if anything can be done,” Unterrich said. “This affects a lot of patients and physicians adversely.”
Unterricht says the New York State Medical Society has written the entire New York Congressional delegation asking for help. The office of Democratic Sen. Charles Schumer of New York told Unterricht’s staff members that they will look into the matter.
In Ohio, UnitedHealthCare Medicare Advantage it is cutting doctors loose because of Obamacare.
UnitedHealthCare spokesman Kevin Shermach told the Springfield News Sun that the company is “dealing with the financial pressures created by severe cutbacks in Medicare Advantage funding.”
Shermach did not respond to repeated requests for comment.
It is unclear how many doctors are being axed. But Ohio State Medical society official Todd Baker told the Daily Caller it is happening across all specialties.
SAS Surgery and Vein Specialists, a four physician practice in Springfield, Ohio, just had its UnitedHealthCare Medicare Advantage contract canceled, leaving more than 400 of its patients in the lurch. Some had been under the care of their doctors for decades.
Becky Browning, the office manager for the practice, tells TheDC, “Patients have expressed concern and fear about losing the doctor they are comfortable with. The senior citizens don’t understand why this is happening.”
UnitedHealthcare Medical Advantage has also terminated the contracts of doctors in Connecticut, Florida and New Jersey. Exact numbers could not be determined for those stats.
But Rhode Island Medical Society spokesman Steve DeToy says UnitedHealthCare informed him that the group is cutting 20 percent of its Medicare Advantage doctors.
DeToy told the Daily Caller that dermatologists, rheumatologists and endocronologists who remain in the program are worried they will not be able to handle anymore patients.
“This is creating tremendous havoc,” he said.
Democrats and many journalists have long insisted that Obamacare cuts to Medicare would not harm patients and dismissed Republican objects as partisan grandstanding.
The Affordable Care Act cuts $717 billion from Medicare–$156 from Medicare Advantage–over ten years. Obamacare supporters claimed the government pays more to insure seniors under Medicre Advantage than it does under traditional Medicre so the cuts were justified.
The Romney presidential campaign last year repeatedly attacked Obama for taking the axe to Medicare. But journalists sided with Obama.
Last year, Time magazine staff writer Kate Pickert said the Romney campaign assertions were patently false. Her October 12, 2012 “Fact Check” post for the magazine’s Swampland blog said the notion “that the Affordable Care Act struck a dangerous blow to Medicare that will change the program in fundamental ways is untrue.”
Pickert insisted that the Medicare Advantage cuts were a prudent cost-saving measure.
Mitt Romney also charged during the campaign that Obama was “destroying the Medicare Advantage program.”
Traditional Medicare covers 80 percent of the fees for any doctor that accepts Medicare. Patients buy “Medigap” insurance to cover the rest. They must also obtain separate prescription drug coverage.
Medicare Advantage HMO plans cover 100 percent of the cost for in-network providers only and generally include drug coverage. Medicare Advantage PPOs allow patients to visit any doctor who accepts Medicare but they pay out of pocket and then get partially reimbursed.
Zero-premium plans sound free but they are not. The government deducts $104.90 from the monthly social security payments to everyone enrolled in both Medicare Advantage and traditional Medicare
28% of all Medicare beneficiaries receive coverage through Medicare Advantage.
One of them is the mother of Florida Republican Sen. Marco Rubio.
In August Rubio, who frequently expresses concern that his mother will suffer under Obamacare, said that “the chances are that soon seniors will open up the mail to the bad news that your Medicare Advantage…has been changed in negative ways because of Obamacare.”
Time magazine’s Pickert last month likened Rubio and other Republican critics of the Medicare cuts to chicken littles.
“Back in 2009 and 2010, one of the harshest criticisms of President Obama’s health care law was that it would hurt seniors,” she opined on October 14. “Four years later, with the ACA in place, it appears that worries about the future of Medicare Advantage have not come to fruition — at least not yet.
“But Republicans have not given up. Some still say the program is in jeopardy thanks to Obamacare.”
But warnings about Obamacare’s threat to seniors were not just coming from politicians.
According to Forbes magazine, Citi health industry analyst Carl McDonald told clients on February 18 that he expected 7 to 8 percent cuts to the Medicare Advntage program in 2014.
He said the funding reductions would be “enormously disruptive to Medicare Advantage, likely forcing a number of smaller plans out of business and creating disarray for many seniors.”
MIT professor Jonathan Gruber, architecht of the Massachuseets health insurance law that was the model for Obamacare, told the Daily Caller that seniors who stand to lose their doctors and Medicare Advantage plans must be sacrificed for the greater good.
“It is a tiny effect compared to the benefits of this law. There is small fraction of Americans who might need to change doctors or plans because of the law.”
Medicare Advantage covers 14.4 million people.
Asked if Obama had betrayed seniors with his famous promise to Americans that they could keep their doctor and health plan Gruber insisted that, “He was not really talking about seniors.” But in fact, the president’s promise, in dozens of televised speeches was all-inclusive and unqualified. (Related: Obama denies ‘you can keep it’ videotaped promises)
Pressed further, Gruber, who is normally quite expansive with journalists, said, “I have to go” and hung up the phone. (Related: Media skip disclosure of paid Obamacare shill)
Robert Zirkelbach, spokesman for America’s Health Insurance Plans, said another aspect of the Affordable Care Act has also sparked changes to doctor networks and Medicare Advantage policies. The new health insurance tax is “extremely disruptive” to the industry, forcing companies to find new ways to cut costs, he contended.
Whatever maggot-infested natural calamity befalls scum-of-the-earth Jonathan Gruber (and his employer) can't be too undeserved.
“One pays a severe price sometimes for being ignorant.”
How do you figure? I’ve been a conservative all of my 73 years, and I’ve had my Medicare HMO cancelled. I hate to break it to you, but with respect to seniors, I will bet you that a large percentage of seniors are also conservative and are suffering along with the libs. The only difference is that we didn’t vote for the idiots who “designed” FUBOCare.
I can’t wait for them to Rostenkowski his ass. Obama will rue the day he messed with the old folks.
Every dead senior is 3 more Rat votes.
You probably aren’t old enough to have even tasted my mothers cooking punk, she was murdered in 1996 at the age of 87.
Until the non-stop robocalls "inform" them that it was really the dirty rotten Pubs that did this to them.
Not to worry, I’ve heard that Obama is going to give people allowances against purchases of dog food.
>>MIT professor Jonathan Gruber, architecht of the Massachusetts health insurance law that was the model for Obamacare, told the Daily Caller that seniors who stand to lose their doctors and Medicare Advantage plans must be sacrificed for the greater good.
“It is a tiny effect compared to the benefits of this law. There is small fraction of Americans who might need to change doctors or plans because of the law.”??
Spoken like a true Communist.
The script is already written:
1. The web site will be deemed operational by the 10th of December....although there’s a lack of security with ID fraud noticed, and it will still tank out because it just can’t handle hundreds of thousands logging in at the same time.
2. January will come with shock. They just didn’t get the numbers of young people they expected, and the WH huddles quietly and wondering just how big a deal this is.
3. By March of 2014, folks are falling into deductible shock. They were used to 1,500-to-3,000 dollar deductibles. This new game of $5,000-to-$7,500 deductibles....invites savings they don’t have. One brief emergency room visit in March....suddenly turns into a $5,200 bill that the citizen has to pay...not the insurance company. No one has cash laying around to fit into the new deductible deal. The low-wage idiots who got the subsidy stuff? Well...subsidy isn’t there to help with the deductible business, and they are stuck with bills that they cannot ever pay.
4. July and August come. The insurance companies have crunched the numbers and pump up rates for 2015. You guessed it....everyone has double the rate of the 2014. It’s mostly because younger people didn’t flock to the system. But there’s this discovery of another ten million people who had health insurance in 2013, but now have none because of the cost factor and confusion.
5. The election of 2014 is all about costs of health care. Democrats can’t explain nothing, and act confused because they don’t understand what they voted for. Republicans end up with 52 senate seats. The President sits there in a daze in Dec of 2014...wondering how you move ahead for the remaining two years.
6. Massive complaints are lodged on the national scale over healthcare. Everyone now agrees....single payer must occur. The health industry, the doctors, and the hospitals...absolutely don’t want it and lobby against it. Single payer arrives somewhere after the 2016 election and is the carrier of the new President (whether Republican or Democrat).
7. Single payer requires limits on cost, and mandates what doctors or hospitals can charge. Single payer also kicks in personal limits. You got cancer, smoke, and over sixty-five? They won’t provide any treatment, and you die. You weigh 280 lbs and need a hip replacement....forget it unless you lose eighty pounds. Lawyers step in and start to sue. Per day....at least 1,500 cases are posted in court over single payer and the limits. Millions are paid weekly by the government for damages. Single payer bankrupts the system in less than four years, and is considered a complete failure.
There’s no script beyond that point because there’s simply no solution beyond single payer. No other plan B. No way out of the pit.
It’s going to make for a great movie.
I am sorry to hear that she was murdered.
Bump
One of the premier marxist slogans for more than a century.
Right up there with "from each according to his ability, to each according to his need".....(Karl Marx, 1875).
Not to mention right up there with "We are 5 days away from fundamentally changing the United States of America"......(Obammie the Commie, 2008)
Leni
You missed my reference. It was to the gentleman referenced at the beginning of the story. It was suggested that because he was a New Jersey resident there was a good chance that he voted for Obama and other Democrats.
Interesting article describing how Obamacare policies are impacting Medicare/Medicare Advantage.
Several months ago, several talkshow hosts and guest commentators on news programs would say that Medicare was going to be severely impacted when Obamacare actually starts. However, none of them ever went into any details. Most of their commentaries involved what they expected to happen to non-Medicare young individuals and middle class, middle age families.
==
Medicare Advantage has always been rather fluid since it began about 6 years ago.
In my state, there were originally about 8 different companies offering a total of some 40 different plans. At the end of each year, some plans/companies dropped out for the next year, and some new companies/plans were added. The net total seemed to be a few less companies/plans each new year.
For 2013, we had about 6 companies with various plans. Due to local medical refusing some and allowing others, the ‘real’ choices were limited to about 4 companies and a couple of plans from each.
For 2014, the company I used for the previous 3 years dropped out completely. Thus, I have to change to some other plan/company or return to regular Medicare. Looking at the options available, what plans had my regular doctor on its provider list, and what plans/companies the local doctor/hospital would accept, I was limited to 3 choices.
One choice had medical and drug coverage, but it had a $150/year deductible on drugs. My 4 prescriptions are generic, so I would barely reach the $150. Thus, most of my drugs would be out-of-pocket, even with drug coverage.
Another choice did not cover drugs, so I would have to have a separate drug policy which would be an additional premium cost each month. Medicare makes it mandatory to have approved drug coverage, either in a Medicare Advantage plan or in a separate drug plan.
Luckily, after checking with my doctor and local hospital, they were now accepting plans from a company they would not accept for the previous 4 years. One plan covers drugs without deductibles (medical nor drugs) and without additional premium cost over the regular mandatory Medicare Part B premium.
I fully expect for 2015, either Medicare Advantage will be gone or the premiums will be significantly more. We won’t know until the ‘Medicare and You 2015’ information is released in mid-September 2014.
Exactly! A tradition of evil.
MIT professor Jonathan Gruber, architecht of the Massachuseets health insurance law that was the model for Obamacare, told the Daily Caller that seniors who stand to lose their doctors and Medicare Advantage plans must be sacrificed for the greater good.
I asked, "well what is going to happen to those people we can't
reeducate, that are diehard capitalists?" and the reply was that
they'd have to be eliminated.
And when I pursued this further, they estimated they would have to
eliminate 25 million people in these reeducation centers.
And when I say "eliminate," I mean "kill."
Twenty-five million people.
I want you to imagine sitting in a room with 25 people, most of which
have graduate degrees, from Columbia and other well-known educational
centers, and hear them figuring out the logistics for the elimination
of 25 million people.
And they were dead serious.
“It was suggested that because he was a New Jersey resident there was a good chance that he voted for Obama and other Democrats.”
I got that. But you don’t know he’s a liberal for a fact ( he’s a retired chemist so maybe he was a Republican) and the sad fact of the matter is that this law hurts people without regard to political affiliation. That we have roughly half the population that are Gibbsmedats, is a sad commentary on us as a country, but maybe the worm will turn as these “who expect others to take care of them” being to really find out that there is no free lunch.
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