Older Americans say they feel trapped in Medicare Advantage plans (www.kpbs.org)

submitted 8 months ago by MicroWave@lemmy.world to c/health@lemmy.world

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Enrollment in Medicare Advantage plans has grown substantially in the past few decades, enticing more than half of eligible people, primarily those 65 or older, with low premium costs and perks like dental and vision insurance. And as the private plans' share of the Medicare patient pie has ballooned to 30.8 million people, so too have concerns about the insurers' aggressive sales tactics and misleading coverage claims.

Enrollees, like Timmins, who sign on when they are healthy can find themselves trapped as they grow older and sicker.

"It's one of those things that people might like them on the front end because of their low to zero premiums and if they are getting a couple of these extra benefits — the vision, dental, that kind of thing," says Christine Huberty, a lead benefit specialist supervising attorney for the Greater Wisconsin Agency on Aging Resources.

"But it's when they actually need to use it for these bigger issues," Huberty says, "that's when people realize, 'Oh no, this isn't going to help me at all.'"

Medicare pays private insurers a fixed amount per Medicare Advantage enrollee and in many cases also pays out bonuses, which the insurers can use to provide supplemental benefits. Huberty says those extra benefits work as an incentive to "get people to join the plan" but that the plans then "restrict the access to so many services and coverage for the bigger stuff."

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[-] reddig33@lemmy.world 34 points 8 months ago

So tired of this country piecemealing out healthcare and inserting added cost bureaucracy and middle men throughout it all.

[-] Rolando@lemmy.world 28 points 8 months ago

My elderly aunt wanted help signing up for a Medicare Advantage plan because she'd seen a bunch of ads. I had no idea what any of this was about so I looked up some info on Investopedia.

Man, talk about byzantine. Elderly Americans are expected to learn a bunch of billing-related terms, estimate what kind of health problems they'll have in the future, guess how the treatments for those problems will be billed, and then determine how those bills will play out in terms of the various possible plans. Naturally, the result is companies playing tricks and customers getting screwed as described in OP's article.

[-] Pollo_Jack@lemmy.world 15 points 8 months ago

If only there was something old people could do to help dictate how healthcare works.

[-] kalkulat@lemmy.world 14 points 8 months ago* (last edited 8 months ago)

This is spot on. "Richard Timmins went to a free informational seminar to learn more about Medicare coverage. 'I listened to the insurance agent, and basically, he really promoted Medicare Advantage.'".

Bait ('free' information warmup ) and hook (tell you about the improved benefits. '12 free doctor trips! $50 free groceries!' ). The US government pays these vultures, and so do victims. AND the vultures limit health 'networks' AND they gain the right to decide whether to approve your treatment. (Not a problem for regular Medicare.)

Anyone considering investment Part C for themselves (or with parents considering) knows how very complicated Medicare (and its numerous rules and ins and outs) can be to understand. Unless there's a rush, there's plenty of 'free' info online without a foot holding the door open.

[-] Chuymatt@kbin.social 4 points 8 months ago

This is a feature, not a bug.

this post was submitted on 07 Jan 2024

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