Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News Editorials & Other Articles General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search
 

Hoyt

(54,770 posts)
5. Most importantly, they cap the out-of-pocket costs beneficiaries are subject to. Next, they provide
Fri Aug 8, 2014, 01:52 PM
Aug 2014

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.

Recommendations

0 members have recommended this reply (displayed in chronological order):

Truthfully, traditional Medicare ain't treating patients well. Co-pays, no out-of-pocket cap, Hoyt Aug 2014 #1
So what do Medicare Advantage plans do to deserve getting paid an extra 14% eridani Aug 2014 #2
donate bribes...errr campaign contributions to dems and repubs alike who allow this? nt msongs Aug 2014 #3
I'm shocked! SHOCKED!!! that you would say such a cruel thing! eridani Aug 2014 #4
You don't think your doctor, hospital, chiropractor, etc., is ontributing either directly and/or Hoyt Aug 2014 #6
Most importantly, they cap the out-of-pocket costs beneficiaries are subject to. Next, they provide Hoyt Aug 2014 #5
Lucky you if you can get Kaiser because most providers won't take advantage plans. Cleita Aug 2014 #8
How do you determine who is a good doc -- they have a pretty office, drive a nice car, have certain Hoyt Aug 2014 #12
I'm all for stopping it and using the money to fully fund Medicare so we old farts don't Cleita Aug 2014 #7
Problem is, the government isn't going to take that money and "fully fund Medicare." Hoyt Aug 2014 #9
Advantage programs, which privatize a single payer system, suck. Cleita Aug 2014 #10
The "right Congress" can do a lot of things. But, "right Congress" ain't close despite our efforts. Hoyt Aug 2014 #11
If you have to travel interstate like my DH and I did, the MA's will mostly not Cleita Aug 2014 #16
Very sorry you had such a bad experience. You can have it with traditional Medicare too. Hoyt Aug 2014 #17
I really can't afford it because I'm only on SS but I do without other Cleita Aug 2014 #18
+1! SammyWinstonJack Aug 2014 #13
The real reason for Medicare Advantage meow2u3 Aug 2014 #14
Yeah, those 15.5 million that choose it year-after-year are all suckers. Hoyt Aug 2014 #15
Yes, they are. With health care you don't find out that you are screwn until eridani Aug 2014 #19
Get expensively sick on traditional Medicare and you better have an expensive supplemental policy. Hoyt Aug 2014 #20
Latest Discussions»General Discussion»Medicare Advantage contin...»Reply #5