General Discussion
In reply to the discussion: Medicare Advantage continues to steal from taxpayers [View all]Hoyt
(54,770 posts)services traditional Medicare does not. Next, they provide supplemental coverage as part of their plan. Next, they provide some drug coverage, traditional Medicare does not. Perhaps most importantly, they provide some coordination of care that traditional Medicare does not.
For example, if I go traditional Medicare, I will pay $110 to the government per month for Part B coverage (I'll also pay that if I select Advantage).
Next, if I want supplemental coverage to pay coinsurance, deductibles, drug, provide a cap on out-of-pocket, perhaps a few more days of nursing home care in addition to the limited amount Medicare covers before you qualify for Medicaid after becoming essentially destitute, etc., that'll cost me at least an additional $200.
Again, most importantly if I go to an Advantage plan like non-profit Kaiser, I'm going to get coordination of care among health care providers. Or, I can take traditional Medicare, hope I can find providers who will accept me. Then, I can hope all the providers I select actually work with each -- like read/review what the other one is doing when you are in the hospital or being treated for a serious chronic condition. And, I get all that hassle and have to pay $200 or so a month extra to get supplemental and drug coverage.
Also, I can compare the quality ratings of Medicare Advantage plans. I can't do that easily when I'm choosing from thousands of doctors, hospitals, diagnostic test providers, DME providers, etc., many of whom are in it only for the money.
Truthfully, if the government is paying 14% more, it's worth it for the reasons above. But, I don't believe they are paying that much more because the law stipulates they pay these plans a few percentage points more that traditional Medicare would have paid (they handle registration, coordination of care, quality reporting, pay claims, etc.). If the plans are inflating the severity of the patient population, that's an easy fix.
The fact that 30% of beneficiaries are selecting Advantage plans tells me they like it. It's relatively new, a lot of people don't know it exists, etc. -- so they must like it. The ACA includes incentives for providers to form what are essentially Medicare Advantage plans. Until they do so, I think smart Medicare beneficiaries know what they are getting.
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