Medicare Advantage Plans Disadvantage Many Elderly and Disabled People

[Ms. Toad]

5. Not everyone can pay thousands of dollars to worry about it later.

(just like under traditional insurance, if you go to a doctor without pre-auhorization, none of the care by that doctor is covered - so it won't be just the initial visit that is not covered, but likely all of the care provided by them that together handed to later or with about later.) And it happens so frequently that it is exemplary, not cherry picking.

You've seen the data before, and choose to ignore it because you haven't (yet) experienced it. Under traditional Medicare, you don't have that dilemma - you just go and it is paid for.

As for upcoding, the problem is significantly worse in MA plans. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/

The study generally limits all Medicare together, but separate them in figure 3, and the discussion indicates

In 2018, the National Bureau of Economic Research reported that specific diagnoses were considered more profitable, and hospitals responded by suggesting types of admission and treatment plans that have increased these diagnoses. In 2014, Geruso and Layton examined that upcoding had cost Medicare $10.5 billion, or $640 per Medicare Advantage enrollee; but since the deflator was applied uniformly, upcoders retained a large share of their charge.