Monday, October 21, 2013

Is America Waking Up To Medicare Advantage Plan Pitfalls?

America’s seniors are constantly bombarded by insurance company’s selling Medicare Advantage Plans to replace their current Medicare coverage.  These plans offer lower copayments and more services like free health club memberships.  Most of our senior’s live on a fixed income.  Their income has not kept up with real inflation.  The older and sicker Medicare beneficiaries spend a much higher percent of their income on health care.  This has attracted approximately 12.7 million Medicare beneficiaries to switch to Medicare Advantage Plans.  One study estimated the Medicare Advantage plans cost Medicare an extra $34.1 billion in 2012. 
It appears some of the people have finally noticed the problems with Medicare Advantage Plans.  The Attorney General for the state of Minnesota is asking the federal government to investigate Humana for denying legitimate claims.  They have been accused of pattern of denying claims and overcharging enrollees.  The Attorney General’s office compiled several hundred pages of affidavits that it presented to the federal government on Friday.  This proves Humana has been improperly handling insurance claims by dozens of Minnesotan enrolled in it's Medicare Advantage plans.
A United Healthcare Medicare Advantage plan that covers 35,000 beneficiaries in southwest Florida is dropping at least 300 doctors and hard-to-find medical specialists from its Southwest Florida network.  This will create problems for the beneficiaries to find physicians and healthcare providers. 
Home Health and Hospice providers have long known the problems of dealing with Medicare Advantage insurance companies.  They may require prior approval for services, limit the amount of services for seniors, delay payments, pay lower rates or require home health agencies and hospices to be members of their network. 
Home health agencies, hospices, other providers, suppliers and physicians should become advocates for their Medicare patients.  They should explain the limitations that will be imposed by Medicare Advantage Plans. They should join with other senior organizations and advocate for their patients.  We all need to pull together to stop this exploitation of our seniors. 
Medicare Advantage Plan Study Link

Minnesota Attorney General Article Link

United Healthcare Article Link

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