The Great Big Medicare Rip-Off [Medicare Advantage]

[goillini52]

My comments are just a general observation with no desire to debate the pros and cons of MAPD. Overall, that kind of debate on this forum quickly dissolves into ad hominem attacks without substance.

As for the Emanuel article (and others posted/linked by @goillini52) I have read a number of reports and treatises over the years to know that many of the authors completely miss the "real world" view of the topics.

FWIW, I found the 50%/99% reference interesting in that, it shows there are a number of buyers who want nothing to do with managed care. Perhaps they are tired of being jerked around by managed care plans in their pre-T65 life.

I find that to be the case with the majority of folks who contact me for advice and direction for Medicare options.

Scott posted the link to the article. Adjusterjack said he couldn't access the article through the link and asked if somebody could post the article, so I did.

I thought he made some good points.

Medicare is taken advantage of by the doctors and hospitals. Medicare Advantage is taken advantage by the insurance companies.

 

[scagnt83]

But there are various "levels" of managed care within MAPD, correct? HMO, PPO, etc.

Its really no different than the private insurance plan they had prior to becoming Medicare eligible.... correct?

So why is the "managed care" aspect of a MAPD such a bad thing?

Especially if it creates better health outcomes for the patient??

What are the pros/cons of having traditional coverage with gap insurance vs. mapd?

 

[LostDollar]

So why is the "managed care" aspect of a MAPD such a bad thing?

Especially if it creates better health outcomes for the patient??

Caveat, not an agent.

Note: Dec 28, 2022 forum membership at >84.5K members. Active posters a very small portion of that.

Better health outcome or worse health outcome -- a point of dissension in many threads over the 6 years I've been a forum member. And I figure posters for both sides probably represent a large number of agents who do not speak via posts.

Agents have stories about the successes or failures of MAPD's to bolster their particular positions.

In the final analysis a Medicare Beneficiary just has to make a choice. Financial constraints will force some to MAPD's, others with financial resources can choose.

 

[Bevo]

"Democrats and Republicans might disagree on how to spend the savings,...[If a crackdown on MA waste happens]"

Oh, I'm sure they have the check written out to Ukraine already.

 

[goillini52]

"Democrats and Republicans might disagree on how to spend the savings,...[If a crackdown on MA waste happens]"

Oh, I'm sure they have the check written out to Ukraine already.

I'm a Republican, but it's getting hard to tell the difference between Republicans and Democrats in D.C. Too many RINO's. Too many crooks.....on both sides.

 

[scagnt83]

In the final analysis a Medicare Beneficiary just has to make a choice. Financial constraints will force some to MAPD's, others with financial resources can choose.

So essentially a MAPD allows a consumer to get a high deductible type plan that is lower cost than traditional medicare?

 

[Bevo]

I'm a Republican, but it's getting hard to tell the difference between Republicans and Democrats in D.C. Too many RINO's. Too many crooks.....on both sides.

The swamp...it runs deep and on both sides.

 

[ICACharleston]

So essentially a MAPD allows a consumer to get a high deductible type plan that is lower cost than traditional medicare?

No, it's first dollar coverage with no deductible for medical but a small Rx deductible and a high out-of pocket limit. I like to say "MAPD is pay as you go, medsup is pay whether or not you go".

If you are getting something for nothing, you are not the client but the product. The MAPD client is the gummint.

 

[somarco]

Its really no different than the private insurance plan they had prior to becoming Medicare eligible.... correct?

No different, from a functional perspective you are correct.

However the differences in understanding and application are quite noticeable.

Roughly 70% of folks under 65 have EGHP . . . they don't have to understand how it works, and since it is "given" to them, they just accept the function/dysfunction as that is the way it is and move on.

Many times they only learn the pitfalls of managed care when they have a large claim . . . then they pay as billed (after the insurance pays) and rarely dispute the adjudication process.

Folks under 65 with some form of public health insurance do not have a non-managed care option. When they become eligible for Medicare they have a choice between original Medicare (no networks, not managed care) and MAPD.

 

[Allen Trent]

dissolves into ad hominem attacks without substance.

I am going to ad hominem attack you right now by calling out that you are making an ad hominem attack against forum members by saying this dissolved into an ad hominem attack without substance. ............................LOL

PS-- if it does indeed dissolve into an ad hominem attack, how would we know if it had already dissolved?