Trapped in Medicare Advantage Plans

"Timmins, though, discovered that his enrollment in a Premera Blue Cross Medicare Advantage plan would mean a limited network of doctors and the potential need for preapproval, or prior authorization, from the insurer before getting care. The experience, he said, made getting care more difficult, and now he wants to switch back to traditional, government-administered Medicare.

But he can’t. And he’s not alone.

“I have very little control over my actual medical care,” he said, adding that he now advises friends not to sign up for the private plans. “I think that people are not understanding what Medicare Advantage is all about.” (...)

“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,” said 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 said, “that’s when people realize, ‘Oh no, this isn’t going to help me at all.’” (...)

David Meyers, assistant professor of health services, policy, and practice at the Brown University School of Public Health, analyzed a decade of Medicare Advantage enrollment and found that about 50% of beneficiaries — rural and urban — left their contract by the end of five years. Most of those enrollees switched to another Medicare Advantage plan rather than traditional Medicare. (...)

“The problem is that once you get into Medicare Advantage, if you have a couple of chronic conditions and you want to leave Medicare Advantage, even if Medicare Advantage isn’t meeting your needs, you might not have any ability to switch back to traditional Medicare,” Meyers said.

by Sarah Jane Tribble, KFF Health News | Read more:
Image: DigitalVision/Getty
[ed. I've mentioned these deceptive Medicare Advantage plans before (see: Only Medicare is Medicare) but it's worth re-stating: don't do it! The answer, Healthcare For All, and if not that, at least Medicare For All. And for all the whiners who cry about cost (and the waste of their precious taxpayer dollars), see this (Twitter/X), and here:]

 "Congress has just passed a $1.59T spending bill for 2024, with a significant $886B for defense. With non-defense at $704B, defense now dominates 56% of spending."

[ed. That's 3/4 of a trillion dollars. Every year. I don't know how they spend it fast enough. Must be a big problem.]