Key Takeaways:
– The enrollment period for Medicare Advantage plans ends December 7th. If you opt for this, you’re committed till the next year.
– Medicare Advantage, created in 2003, is not real Medicare. The plans are private health insurance provided by corporations.
– Medicare Advantage plans can involve hurdles such as pre-approvals and can result in a denial of claims, leaving policyholders to pay out-of-pocket.
– Medicare Advantage plans often include additional benefits like dental and hearing care; however, the funds for these are often underutilized.
– Medicare Advantage plans may seem enticing, but the reality is often more complex and challenging than anticipated.
What’s Medicare Advantage All About?
Medicare Advantage was birthed in 2003 by George W. Bush and his colleagues. These plans are not real Medicare. Instead, they’re private health insurance provided by private corporations. These companies are paid by the Medicare trust fund, whether or not customers use their insurance.
The big difference? With real Medicare, you get medical services as prescribed by your doctor and the bill is directly paid by Medicare. On the other hand, Medicare Advantage plans involve a “pre-clearance” process. This means that the insurance company must pre-approve the medical help you need.
Understanding the Challenges with Medicare Advantage
Medicare Advantage often has a darker side. Companies deny claims — almost 18 percent — resulting in policyholders choosing to forego necessary procedures or pay for them out-of-pocket. These numbers reveal a rough reality for those expecting smooth coverage.
To compete with real Medicare, Congress enabled Medicare Advantage plans to offer additional benefits. These could include free or discounted dental, hearing, eyeglasses, gym memberships, groceries, rides to the doctor, and even cash rebates.
Transparency Issues with Medicare Advantage
The downside is that Medicare Advantage plans leave an enormous amount of unused funds. For instance, only 11 percent of policyholders who had plans offering dental care actually used that benefit. Many freebies offered to policyholders go unused leading to billions left unspent every month.
The coverup? Companies won’t disclose to the government how much of the reimbursed money they’ve spent. Thus, it remains unclear where these funds are really going.
The Big Picture for the Future
Internal debates propose that if the Medicare Advantage scam didn’t exist, real Medicare could be expanded to cover dental, vision, and hearing, negating the necessity for Medigap plans. However, for now, the wheel of privatization continues to spin.
Advice for Medicare Advantage Policy-holders
If you were persuaded by the appealing ads for Medicare Advantage, you have three more days to reconsider and revert back to real Medicare. Remember, once you opt for a Medicare Advantage plan, you’re locked in until the next year. It’s important to assess your needs, examine the pros and cons, and make an informed decision for your healthcare coverage.
The Bottom Line
While enticing ads may draw you towards the perceived benefits of Medicare Advantage, it’s necessary to look beyond the surface. Remember, Medicare Advantage is private insurance with its own set of rules. Opting for real Medicare might provide a smoother, more straightforward avenue for healthcare services.
Choosing healthcare coverage is a significant decision. Make sure to take your time and do your research. Weigh all your options before taking the leap. Your health and peace of mind depend on it.