Gary, you are so right about this, I can't believe how many people I talk to, from patients to friends and family members, who don't understand the difference. I've been trying to inform people I know about this for years, but I feel like a tiny salmon swimming upstream against the enormous current of the private insurers' advertising campaigns to promote their MA plans!
I am so glad that I chose traditional Medicare plus a robust supplemental policy when I retired 10 years ago. Except for physical therapy, I’ve never had to get a referral for anything and everything, including a hip replacement and two visits to ER, one in an ambulance (a botched chiropractor visit) have been paid 100%. Compared to my husband’s Advantage plan which he chose because his pension pays a portion of it, with its long waits for referrals, “generous” co-pays, etc., if I’d been covered under his policy, my expenses would have been much more than what I pay for Medicare and the supplemental policy each year.
It’s quite obvious that Oz and the GOP would like to privatize health care and Medicare Advantage does just that. At a time when government wants to cut budgets, don’t people wonder why they are paying billions more to private insurers and hospitals for Medicare Advantage? Seniors love the “free eyeglasses” and “teeth cleaning” but don’t realize they are sacrificing choice and pre authorization denials for care. It’s fine until you need a service. Medical group CEOs like MA because they can partner with hospitals and also cash in on some of the extra billions. Large hospital systems also push patients into MA so they can upcode and rake in more $$. But ask any doctor if they would do straight Medicare or MA for themselves and you have your answer.
Bill, to your question, both have restrictive provider networks, require prior authorization and have high out-of-pocket maximums but non-profit include extras like dental, vision and hearing, etc. For an honest yet humorous take on Medicare Advantage, view over the Internet John Oliver's, "Last Week Tonight" expose of Medicare Advantage. It not only will answer your question straight up but draw your interest to replay. Be aware that a doctor can sign-up for only Original Medicare to exclusion accepting Medicare Advantage. Further, despite going out-of-network paying higher deductible, doctor may not have contract with company thus absolutely no coverage.
I am still confused. I have had Medicare Advantage plans through UCare (now gone) and Blue Cross of Minnesota and absolutely love the coverage. Is there a huge difference between the not-for profit and for-profit Medicare Advantage plans?
Bill - As a starting point, read the New York Times story that I included in this post. And also the three bulleted articles that I wrote that I linked to toward the end of the article.
A Federal Circuit decision in 2024 permits VA to adjudicate compensation claims for service injury going forward independent of court review unless if otherwise established within 38 CFR for some conditions. Loss is not inconsequential, i.e. free air ambulance. So for older vet your argument IS the issue especially in light of a lack of OPEN, honest discussion with brokers and non-profit advisory groups, alike, on merit of networks and quality of providers. This lack of real interest of either party made more important recently with exodus of Mayo Clinic. Will Rogers once said, "After eating an entire bull, a mountain lion felt so good he started roaring. He kept it up until a hunter came along and shot him. The moral: When you're full of bull, keep your mouth shut." For UnitedHealth, in large the small print!
I agree with you that it is a distinction with the difference that should be made; however, I must tell you that I recently enrolled in Medicare Advantage, and it has not been bad from a patient experience perspective.
Gary, you are so right about this, I can't believe how many people I talk to, from patients to friends and family members, who don't understand the difference. I've been trying to inform people I know about this for years, but I feel like a tiny salmon swimming upstream against the enormous current of the private insurers' advertising campaigns to promote their MA plans!
I am so glad that I chose traditional Medicare plus a robust supplemental policy when I retired 10 years ago. Except for physical therapy, I’ve never had to get a referral for anything and everything, including a hip replacement and two visits to ER, one in an ambulance (a botched chiropractor visit) have been paid 100%. Compared to my husband’s Advantage plan which he chose because his pension pays a portion of it, with its long waits for referrals, “generous” co-pays, etc., if I’d been covered under his policy, my expenses would have been much more than what I pay for Medicare and the supplemental policy each year.
It’s quite obvious that Oz and the GOP would like to privatize health care and Medicare Advantage does just that. At a time when government wants to cut budgets, don’t people wonder why they are paying billions more to private insurers and hospitals for Medicare Advantage? Seniors love the “free eyeglasses” and “teeth cleaning” but don’t realize they are sacrificing choice and pre authorization denials for care. It’s fine until you need a service. Medical group CEOs like MA because they can partner with hospitals and also cash in on some of the extra billions. Large hospital systems also push patients into MA so they can upcode and rake in more $$. But ask any doctor if they would do straight Medicare or MA for themselves and you have your answer.
Bill, to your question, both have restrictive provider networks, require prior authorization and have high out-of-pocket maximums but non-profit include extras like dental, vision and hearing, etc. For an honest yet humorous take on Medicare Advantage, view over the Internet John Oliver's, "Last Week Tonight" expose of Medicare Advantage. It not only will answer your question straight up but draw your interest to replay. Be aware that a doctor can sign-up for only Original Medicare to exclusion accepting Medicare Advantage. Further, despite going out-of-network paying higher deductible, doctor may not have contract with company thus absolutely no coverage.
I am still confused. I have had Medicare Advantage plans through UCare (now gone) and Blue Cross of Minnesota and absolutely love the coverage. Is there a huge difference between the not-for profit and for-profit Medicare Advantage plans?
Bill - As a starting point, read the New York Times story that I included in this post. And also the three bulleted articles that I wrote that I linked to toward the end of the article.
A Federal Circuit decision in 2024 permits VA to adjudicate compensation claims for service injury going forward independent of court review unless if otherwise established within 38 CFR for some conditions. Loss is not inconsequential, i.e. free air ambulance. So for older vet your argument IS the issue especially in light of a lack of OPEN, honest discussion with brokers and non-profit advisory groups, alike, on merit of networks and quality of providers. This lack of real interest of either party made more important recently with exodus of Mayo Clinic. Will Rogers once said, "After eating an entire bull, a mountain lion felt so good he started roaring. He kept it up until a hunter came along and shot him. The moral: When you're full of bull, keep your mouth shut." For UnitedHealth, in large the small print!
I agree with you that it is a distinction with the difference that should be made; however, I must tell you that I recently enrolled in Medicare Advantage, and it has not been bad from a patient experience perspective.
It’s good until you need a service that is denied.