1 min read
10 Sep

The AHA is comprised of over 5000 hospitals, 270,000 physicians, over 2,000,000 nurses and over 40,000 other health care workers. Recently they wrote a letter to CMS (Centers of Medicare and Medicaid) that uses some pretty strong and definitive language about their experience with Medicare Advantage.  

Medicare Advantage is private health insurance contracted with the government to manage your care instead of original Medicare. To the consumer who has never encountered difficulty or who has not done research, these plans can be very appealing because of celebrity endorsement (false or misleading at best) and attractive "zero dollar" premiums.  In fact according to some commercials, these companies will actually pay someone to be on their plan. 

The cost of the free plan is surrendering original/traditional Medicare coverage. Original Medicare no longer pays claims for someone who chooses Medicare Advantage while they have it. This loss equals a minimum of about 22,000 hours of work that have resulted in contributions to Medicare. Part of Premiums paid for part B (yes they have to pay for the premium even though part b no longer covers them) are used to help subsidize the private health insurance managing their care instead of Original Medicare. 

It sounds like a bargain price for "a, b, and d" in one low or no premium... What that means is the right to choose their own prescription drug coverage as with original medicare is also surrendered. Everyone on that HMO or modified regional PPO has the same drug coverage. Part of the cost appeal in premium is a smoke screen for giving up the right to buy a medigap also called medicare supplement to pick up gaps of coverage. 

"Free insurance" costs surrendering your right to guaranteed renewable coverage that results in out of pocket expenses coming out of the patient's pocket. 

You can find the letter here or download a beautiful PDF. This is not the opinion of one doctor or one beneficiary... it is the collective passionate appeal of a vast network of health care providers across from all over the country. 


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