More Than 500,000 Americans Set to Lose Their Medicare Advantage Plans

[dalton99a]

https://www.newsweek.com/more-500000-americans-set-lose-their-medicare-advantage-plans-1952164

More Than 500,000 Americans Set to Lose Their Medicare Advantage Plans
Published Sep 11, 2024 at 1:02 PM EDT
Updated Sep 13, 2024 at 2:05 PM EDT

More than 500,000 Americans are scheduled to lose their Medicare Advantage plans now that major insurer Humana is leaving 13 markets across the country.

The company's Chief Financial Officer Susan Diamond made the announcement during a Wells Fargo Healthcare Conference this month, saying roughly 560,000 members would need to find a new plan.

That impacts roughly 10 percent of its Medicare Advantage participants.

The specific markets Humana is exiting from are those that are not likely to be profitable, Diamond said during the conference.

...

[no_hypocrisy]

1. Does that mean that MA subscribers can return to traditional Medicare?

[Lonestarblue]

2. I sure hope they can. Another reason to choose original Medicare. You won't be cancelled.

Original Medicare doesn’t include eyeglasses and dental, but I’ve had it for 8 or so years and it has covered every test and treatment I’ve needed.

[anciano]

6. Agreed 👍

Also, with Original Medicare, you and the doctors of your choice are in charge of your health care.

[XanaDUer2]

24. I've gone traditional nt

[Jmb 4 Harris-Walz]

32. Original Medicare

I thought it only covered 80% and you have to pay the remaining 20% unless you have a medi-gap plan.

I’ll be 65 in January so I’ve been studying up on all things Medicare. Originally I was going to buy an Advantage plan with HealthPartners in Minnesota — I’ve been covered by them my entire working career in Federal Government. However, now I’m conflicted between staying with Original Medicare with a supplemental (medi-gap) plan which will NOT include eye exams or dental care. Supplemental plans are available without any medical qualifications when initially signing up at 65. However, when switching later from an Advantage Plan back to Original Medicare you need to be “accepted” by a medi-gap plan. They might require a review of your medical records or an exam prior to acceptance AND it’ll be more expensive. Basically, getting it immediately when eligible is best; acceptance is essentially automatic.

HealthPartners is based in Minnesota so I don’t really think I need to worry they will pull their service in my area. They have eye and dental care which is definitely a plus. They also cover the remaining 20% subject to deductibles or co-pays. So, needless to say, I am conflicted. 😐

Any advice would be welcome!

[Lonestarblue]

43. I can see the conflict because of your positive experience with HealthPartners.

I had a different situation and chose original Medicare with a medigap policy because I wanted the flexibility of moving from one state to another in the future. I did not have any serious medical issues that would cause me concern for future acceptability by an insurance company. For me, the decision was based on both affordability and supporting Medicare versus the insurance companies. The cost of eye and dental care was something I could handle so I opted for original Medicare. This was several years ago, and at the time the Advantage programs were not offering a huge financial benefit over Medicare. The Advantage insurers have gotten more aggressive with their pricing in an effort to take market share and eventually privatize all of Medicare. Fighting their goal of privatizing Medicare, at which point they can raise prices without constraints, is the big reason I support original Medicare.

At this age, you’re just bombarded with information about Advantage and Medicare, much of it thoroughly confusing. I hope that Medicare eventually covers eye and dental care, but there’s no guarantee that will ever happen. I don’t know that I’ve helped much, but I wish you luck with making your decision.

[Jmb 4 Harris-Walz]

48. Thanks much for your perspective. I'm leaning more toward Original Medicare in the hopes that Harris/Walz win and

improvements to Medicare include adding dental and/or eye care. Even one would be very helpful.

[Abnredleg]

3. They can get another Avantage plan

Assuming one is available. They could go on original Medicare if they can pass medical underwriting for a supplement plan.

[maxrandb]

9. Great! I'll get my 94 year old mother on the web, or phone to pick a new plan right away

[Desert grandma]

12. I do not think a Supplement Plan can make them go through underwriting

if they have to choose a new plan because their current plan is leaving the state. At least that is the way it was.

[Abnredleg]

16. We're talking Advantage plans, not supplements

No underwriting if a supplement plan leaves the state, but there is underwriting if you try to switch from Advantage to Original since you don’t already have a supplement.

[Jmb 4 Harris-Walz]

33. Ok...what about if an Advantage Plan leaves the state?

[Rebl2]

17. I think

that is correct.

[Desert grandma]

10. Yes.

They can return to Original Medicare and choose a supplement that cannot make them go through underwriting. They should choose the supplement carefully as many increase each year as the person ages. I would advise them to choose a plan that is "issue rated". That premium will ONLY increase due to medical inflation. Most supplemental policies are "age attained" and will increase BOTH on your birthday and for medical inflation. AARP is the only Community rated plan which charges the same premium for everyone. In any case, the advantage to this situation is that since it is the insurer pulling out, members can choose new plans with no penalties. It is a good opportunity for those that wish to get back on original Medicare to do that and compare supplemental policies without letting a supplemental insurance company make you go through an underwriting process where they can reject or increase premiums for pre-existing conditions. We have a Supplement that pays all of the the 20 % Medicare doesn't and is plan "G" on an issue rated policy. We only pay the part B Medicare deductible and our plan pays everything else.

[Wonder Why]

14. I have a Plan F Medigap through AARP. That is no longer available to new people. It covers deductible also.

[brer cat]

21. I have that plan also and wouldn't dream of changing.

I have had several surgeries plus some expensive treatments that more than off set the cost of the plan. I honestly don't know how people afford medical care without a good plan.

[Maeve]

26. Mom has that. Wasn't an option for me

I handle her finances and would have gone that way, too.

[llmart]

19. I have exactly what you have and I wouldn't have it any other way.

My deductible this year with AARP's United Health Care Plan G was only $240 this year. I meet that just with my annual visit with the retinal specialist in January. Anything else throughout the year is paid completely.

[Raven123]

27. That's exactly what happened to someone I know several years ago

They went with AARP. Worked out well.

[karynnj]

20. They can return to the basic traditional medicare and to any part D (the drug) part

The problem is that ONLY when you first are eligible can you get a Medigap plan without going through answering medical questions that will determine if they accept you .. and at what cost. So, if you are someone with no significant medical problems, you go through the underwriting and can choose a Medigap plan. If, however, you have major medical problems it will be hard to get a plan and you will pay a lot.

That said, you will not be uninsured. For instances, Medicare will pay a very significant amount of your cost, but for many things, you will pay 20% of the Medicare agreed on price.

[Joinfortmill]

28. Yes if your plan is no longer offered.

Happened to when I moved to a state that did not offer my plan.

[AZ8theist]

31. Depends on where you live.

There are only 5 states in the north east that will allow you back in to traditional Medicare WITHOUT medical underwriting.

In other words, in the other 45 states, if you've been on Advantage for awhile, you will need to be approved by answering 30-40 medical questions. If you're healthy it should be OK. But if you've had just about any chronic condition, you'll be rejected and have to find a different Advantage plan. The cost of those plans could be steep in 2025.

[likesmountains 52]

39. That was my experience in Colorado. I decided to change from United Health Advantage

to regular medicare with a supplement. The questionnaire was lengthy and detailed..then I had to verify my information on a recorded phone call with Cigna when i applied. I doubt that anyone with a preexisting condition could get approved at a very low rate...

[AZ8theist]

40. Exactly

That's part of the Medicare Advantage scam that people are not generally aware of............

[elocs]

37. I can't return to traditional Medicare--I never had it because I could never afford it.

Why is this such a difficult concept to grasp? So I'll stay with my MA plan since it costs me nothing.

[AZ8theist]

41. You still have to pay the Part B deductible of $240.....

....Plus whatever co-pays your plan may have. If you get sick or need an operation, your out of pocket could be anywhere from $7K to $15K or more, depending on the complexity of your health issue.

Here's hoping you stay healthy!!

[elocs]

46. Nope. Because I am on Medicaid my MA plan has dual care coverage with Medicare the first payer, then Medicaid

which also pays Part B. So I currently pay nothing, which is good since I'm already under the 100% Federal Poverty Level but in a year from now I will lose an annuity which is almost 20% of my income. My MA plan has worked out well for me and I've never been denied any tests including several c scans and an MRI.

Yes, at age 72 I am healthy although I did have a cold 16 years ago.

[AZ8theist]

47. Yes, I did not account for those on Medicaid...

I'm happy you've got a plan that works for you.

I just wanted to point out that, generally, Advantage plans are not what people think they are. Especially when it comes to out of pocket expenses since MA is a pay-as-you-go program.

Plus the burden on the American taxpayer as the government picks up a huge portion of the FOR PROFIT cost charged by private health insurers.

[Skittles]

44. it costs the taxpayers PLENTY

the money scammed via MA should be used to improve Medicare - the entire goal of MA is to eventually get RID of Medicare

[questionseverything]

4. Ma only wants patients they know they can make money off of

Once that time is over, they will 🥾 you to the curb

[dalton99a]

11. +1. This is what happens when Medicare is privatized and becomes profit-driven.

[questionseverything]

15. While we definitely need to control the price of medicare

Privatization is not the answer

[OldBaldy1701E]

45. This is what happens when anything is privatized.

It becomes about money. Not heath Not helping anyone Not being human.

Greed is the GOD of the country and we kneel at that alter every minute of every day.

[snowybirdie]

5. Those tempted to sign up

Should heed this. They can just drop you whenever they want. And if you're allowed to sign up to regular Medicare
( dont know if that's possible or not) the insurance companies can consider your pre existing conditions and charge accordingly.

[Wonder Why]

13. Not true. If you go back to regular Medicare, there are no insurance companies involved. However, if you

want to add a Medigap policy to cover the deductible portion of Medicare, then what you say is correct.

[questionseverything]

18. Getting that 20% covered is easiest when you're first signing up

[Wonder Why]

22. Right. And cheapest.

[CousinIT]

7. Wealthcare doesn't work. America ranks worst in the world for health care--despite spending trillions

https://fortune.com/well/article/us-health-care-system-ranks-worst-commonwealth-fund-survey/

The U.S. health care system is in a class all its own, according to a new analysis of health system performance in 10 high-income countries—but in a devastating way.

Americans live the sickest lives and die the youngest, per a report by the Commonwealth Fund, an independent health care research firm. Mirror, Mirror 2024: A Portrait of the Failing U.S. Health System was published Thursday.

. . .

The U.S. came in last in three of five categories—equity, health outcomes, and access to care—in addition to having the poorest overall ranking. The country performed slightly better in administrative efficiency, finishing ninth ahead of Switzerland. This, despite spending more than any other nation included in the assessment.

“The U.S. is failing one of its principal obligations as a nation: to protect the health and welfare of its people,” Dr. Joseph Betancourt, president of the Commonwealth Fund, said in a prepared statement. “The status quo—continually spending the most and getting the least for our health care dollars—is not sustainable. It isn’t about lack of resources—it’s clearly about how they are being spent.”

High-income countries with worst health care systems
6. Sweden (up from No. 7)
7. Canada (up from No. 10)
8. Switzerland (up from No. 9)
9. Germany (down from No. 5)
10. U.S. (technically up from No. 11 but still last place)

While differences in overall performance between most countries were relatively small, the report noted, the U.S. was the sole outlier with “dramatically lower” performance.

Other health care rankings
Best access to care: Netherlands (same)
Worst access to care: U.S. (same)
Best administrative efficiency: U.K. (was Norway)
Worst administrative efficiency: Switzerland (was U.S.)
Best care process: New Zealand (same)
Worst care process: Sweden (same)
Best equity: Australia (same)
Worst equity: U.S. (same)
Best health outcomes: Australia (same)
Worst health outcomes: U.S. (same)

[groundloop]

34. Best care process: New Zealand ......

Speaking of New Zealand, I was there in February and in planning for my trip I discovered that visitors have access to free emergency health services. You pay a small fee while applying for your visa and part of that goes to cover your emergency health insurance while visiting.

[snowybirdie]

8. Those considering Advantage Plans

Should heed this. They can just drop you whenever they want. And if you're allowed to sign up to regular Medicare
( dont know if that's possible or not) the insurance companies can consider your pre existing conditions and charge accordingly.

[AZ8theist]

42. Advantage plans ARE NOT MEDICARE!!

It's private health insurance. Once you select an Advantage plan (Part C) you are opting OUT of Medicare.
Generally, the only way back in is to go through medical underwriting which puts you at the mercy of a private companys bean counters.

But you are 100% correct. Let the BUYER BEWARE!!!! Insurance agents make a ton of dough off of Advantage customers. Not nearly as much when selling Supplemental plans.

[Silent Type]

23. Fortunately, there is guaranteed issue for MediGap if the MA plan leaves your are.

When does federal law require guaranteed issue protections for Medigap?

"Federal law provides guaranteed issue protections for Medigap policies during a one-time, six-month Medigap open enrollment period for beneficiaries ages 65 and older when enrolling in Medicare Part B, and for certain qualifying events.

"These limited circumstances include instances when Medicare beneficiaries involuntarily lose supplemental coverage, such as when their Medicare Advantage plan discontinues coverage in their area, or when their employers cancel their retiree coverage. Beneficiaries who are in a Medicare Advantage plan also have federal guaranteed issue rights when they move to a new area and can no longer access coverage from their Medicare Advantage plan. In these qualifying events, people ages 65 and older in Medicare generally have 63 days to apply for a supplemental Medigap policy under these federal guaranteed issue protections. . . . . . "

https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/



https://boomerbenefits.com/medicare-supplement-guaranteed-issue/

https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy

It’s a hassle for sure.

[Skittles]

29. scammers not making enough PROFIT from your HEALTHCARE

[onecaliberal]

30. They can't profit from old sick people so of course it's time to throw them away.

This country is so fucked. They don't even try to hide it. Unbelievable.

[elocs]

38. Well, I'm old but not sick although I did have a cold 16 years ago.

My MA plan costs me nothing but gives me $174/month to buy healthy food. I can't even begin to afford traditional Medicare. I can't understand why this is such a difficult concept to grasp.

[groundloop]

35. While the ACA was a huge improvement, we desperately need much better.....

Thank you Joe Lieberman for fucking that up.

I'll probably never live to see it, but we NEED universal healthcare. The troglodytes on the right will never admit that it will actually lower their overall costs for healthcare.

[doc03]

36. Our union negotiates for Medicare Advantage every two years. We had Humana they always

tried to deny treatments. We currently have Blue Cross it seems better. We had UPMC years ago before I retired everyone said that was the best. That's University of Pittsburgh Medical Center.