Letter: The disadvantaged of Medicare Advantage

Published: 11/9/2022 7:00:40 AM
Modified: 11/9/2022 7:00:13 AM

In response to Mr. Savage’s My Turn (Monitor, 11/4), wherein he presents a glowing review of Medicare Advantage plans, I can only say that I am genuinely glad for him and his peers whose reasonably good health has thus far made his Medicare Advantage Plan a fair choice. Spurred on by the onslaught of D-list celebrity endorsements, seniors are signing up in droves for these plans, which promise reduced premiums and expanded benefits to include some dental, vision, and hearing costs. And, for Mr. Savage and friends, the plans work pretty well, until they don’t.

If you delight in denial of services, relish relinquishing choice of provider, and are keen to pay out of network costs, there’s an MA plan for you. Should you incur high medical costs which look to become chronic, MA plans will look for ways to dump you like a hot gallbladder, and barriers to re-enrollment in traditional Medicare can be daunting. According to the Inspector General, our major MA insurers (United Health, Human, Cigna, CVS Health, Elevance) have all hugely over-billed the federal government by upcoding severity of patient illness, or outright falsifying a diagnosis. In 2020, MA over-billing alone($12-25 billion) surpassed the budgets of several federal agencies, including the CHIP program for kids, NASA, and U.S. Customs and Border Protection. The chief beneficiaries of MA are insurance companies, large hospital/physician groups, private equity, and complicit politicians. So, be aware of who the advantaged and disadvantaged might be in this great scheme.

Robert Kiefner



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