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In reply to the discussion: New Medicare Program: Full List of Services That Will Need Prior Approval [View all]Ms. Toad
(38,109 posts)69. No. They said they should be banned from using "Medicare" in their names.
Advantage plans are private insurance, and they should be banned from using " Medicare" in their name.
That was the basis of my reaction. They use "Medicare" in their names because they are part of Medicare.
I agree Medicare should not have authorized such plans, but that ship has sailed. Because they are part of the statutory Medicare scheme, the use of the name is proper.
As for being non-profit, the supplement portion of original Medicare is also run by for-profit insurance companies. It's not as obvious because they aren't advertised much because they don't make much profit for the companies offering them (since the insurance companies don't have a lot of control over what is covered.)
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New Medicare Program: Full List of Services That Will Need Prior Approval [View all]
BumRushDaShow
23 hrs ago
OP
They really went after nerves. Is salvation through pain part of the plan?
bucolic_frolic
23 hrs ago
#1
I get steroid shots in my scaphoid joint for arthritis. The list specifies that steroid shots in joints are not included
Martin68
1 hr ago
#70
Medicare Advantage is already set up to be able to deny claims for things that Medicare would automatically cover.
thesquanderer
22 hrs ago
#8
Advantage plans are private insurance, and they should be banned from using " Medicare" in their name.
OMGWTF
21 hrs ago
#18
I agree. Unless maybe they more honestly called it something like "Medicare Alternative" or "Medicare Private Option."
thesquanderer
21 hrs ago
#25
They are literally Medicare plans, Authorized under the Medicare Part C statutes
Ms. Toad
20 hrs ago
#31
The person you're replying to said Advantage plans should not have been allowed as Medicare plans.
pnwmom
9 hrs ago
#63
But one of the main reasons to choose standard Medicare over a Medicare Advantage plan is to minimize a third party
Ms. Toad
20 hrs ago
#38
So? People pay MORE to join Traditional Medicare so that they can choose their own doctors
pnwmom
18 hrs ago
#48
Yes, they do, in order to get Parts A and B, which covers both hospitalization
pnwmom
16 hrs ago
#56
i've had the cellular. tissue application for foot wounds that would not heal
rampartd
22 hrs ago
#7
neck surgeries, knee surgeries, incontinence control, pain relief -- how very cruel, how very predictable
0rganism
22 hrs ago
#9
Our doc told us pre-approval is needed for what was our usual blood test
AverageOldGuy
21 hrs ago
#14
But this experiment is being done with Traditional Medicare patients, which doesn't require prior authorization.
pnwmom
18 hrs ago
#49
But private companies WILL provide the AI services performing prior authorizations for Traditional Medicare.
pnwmom
7 hrs ago
#66
The whole reason Iʻm paying extra for supplemental ins is to keep the imperfect gem, traditional medicare, where
mahina
21 hrs ago
#19
"Just reading our DUers here and the impacts this would make to their lives is powerful."
BumRushDaShow
21 hrs ago
#24
It is not just AI needs to be destroyed - but the insertion of third party judgment (of any kind)
Ms. Toad
20 hrs ago
#40
I expect this is being pilot-tested to eventually become a permanent change (with more procedures needing prepproval)
BumRushDaShow
19 hrs ago
#45
I know for those of us feds who planned to maintain their FEHB insurance plans when Medicare-eligible
BumRushDaShow
17 hrs ago
#51
When I had a cancer diagnosis, I was in surgery 2 days after getting the diagnosis,
pnwmom
9 hrs ago
#65
That's the general basis for my personal concern with the skin and tissue substitutes
Ms. Toad
3 hrs ago
#68