Jayne Kleinman is bombarded with Medicare Advantage promotions every open enrollment period — even though she has no interest in leaving traditional Medicare, which allows seniors to choose their doctors and get the care they want without interference from multi-billion-dollar insurance companies.
Great article. As a NYC retiree, I know exactly what they’re talking about. They City and our former unions are trying to force us into a MAP. We know what cash cows they are for insurance companies. They need to level the playing field and make traditional Medicare premiums cheaper and offer some of the audio, vision and prescription benefits MAPs include (although most are minimal in MAPs).
Thank you, Mr. Potter, for all you have done to spread the truth. I was privileged to hear you testify last year at the City Council hearing in NYC. Thanks, too, to Matthew Cunningham-Cook who has done so much terrific reporting on this important issue.
I am utterly utterly disappointed with my Kaiser Permanente Medicare (dis)Advantage, I pay an added premium but receive denied coverage for in hospital skilled nursing for post-surgery recovery leading to physical therapy due to an exclusion that in the case of Out Patient surgical procedures, unless hospitalized for 2 nights access to skilled nursing and acute care is denied. This applies to ankle replacements, knees replacements, and hip replacements. There is no consideration about one’s home situation. They try to buy you off by offering a lousy transportation to appointments benefit (32 hours one-way trips) and even worse is access to skilled nursing and non medical in-home nursing care amounting to only 24 hours divided into 35 minute sessions. I will be immobile for 6 weeks. I simply cannot depend on my wife and family for 24/7 assistance. I filed a grievance and appeal to no avail. The planning for surgery is left up to the patient and there is next to no communication among surgeon pre-op and post-op recovery and rehabilitation. I have been dealing with serious pain. Medicare Advantage is all about making money on the backs of US taxpayers’ and patients.
Moreover, there are delays in scheduling appointments with specialists leading to worsening of patient condition and nonpayment for treatment is not infrequent.
Finally ,where is the dignity for older Americans (middle age - senior citizens) who never were diagnosed duringchildhood with neurological disorders like Autism Spectrum Disorder. I was finally properly diagnosed at 65 years old and there is no support for adults with this disorder. This is a life long affliction and a disability, but we are treated as an afterthought with little to zero benefits for us under the current Medicare (dis) Advantage Policy. I have paid everything out of pocket. I would rather be on Traditional Medicare. Medicare (dis) Advantage clearly proves that competition does not correlate with lower costs and better quality of care. I’m totally in favor of a single payer system.
This essay makes a strong case for universal healthcare (what used to be called by the AMA as evil socialized medicine). I am one of the few American citizens who actually enjoy universal healthcare. I am a retied disabled veteran. I can choose my physician. Any expense that Medicare does not cover, DOD Tricare for life pays. Even mot of my medication is free.
Unlike the propaganda that universal healthcare will create interminable waits in doctor offices, or deprive you of choosing your healthcare providers and hospitals is gaslight. Due to an incompetent surgeon I had to get repaired at Mayo Clinic. The cost was gas for the 2-hour drive up and back. Five years ago, and arthritis flare-up required 14 months on a drug costing and obscene $7,500/month. I had to pay for shipping the pricey epipens.
We could start the transition to people over 60, and slowly allow everyone to join in until we had a national healthcare system. A Blue wave could make it happen - maybe.
This article is excellent. Thanks to Nancy Smyth for flagging it, and I hope it will be widely read. Here’s an excerpt:
“I have been aware for a long time of basically fraudulent advertising in the MA insurance industry,” Toubman told HEALTH CARE un-covered. “There’s an overriding misrepresentation — they tell you how great Medicare Advantage is, and never the downsides.
“There are two big downsides of going out of traditional Medicare: They don't tell you that you give up the broad Medicare provider network, which has nearly every doctor. And should you need expensive medical care in Medicare Advantage, you will learn there are prior authorization requirements. Traditional Medicare does almost no prior authorization, so you don't have that obstacle. They don't ever tell you any of that,” he said.”
Great article. As a NYC retiree, I know exactly what they’re talking about. They City and our former unions are trying to force us into a MAP. We know what cash cows they are for insurance companies. They need to level the playing field and make traditional Medicare premiums cheaper and offer some of the audio, vision and prescription benefits MAPs include (although most are minimal in MAPs).
Thank you, Mr. Potter, for all you have done to spread the truth. I was privileged to hear you testify last year at the City Council hearing in NYC. Thanks, too, to Matthew Cunningham-Cook who has done so much terrific reporting on this important issue.
Please send this to Bernie Sanders, Kamala Harris and President Biden.
So true. I won't give up my straight Medicare!
I share Jayne's feelings about the obnoxious Medicare Advantage TV advertising. It is a good thing that I can mute them on my TV remote control.
I keep saying, if it is too good to be true, then it isn't true.
I am utterly utterly disappointed with my Kaiser Permanente Medicare (dis)Advantage, I pay an added premium but receive denied coverage for in hospital skilled nursing for post-surgery recovery leading to physical therapy due to an exclusion that in the case of Out Patient surgical procedures, unless hospitalized for 2 nights access to skilled nursing and acute care is denied. This applies to ankle replacements, knees replacements, and hip replacements. There is no consideration about one’s home situation. They try to buy you off by offering a lousy transportation to appointments benefit (32 hours one-way trips) and even worse is access to skilled nursing and non medical in-home nursing care amounting to only 24 hours divided into 35 minute sessions. I will be immobile for 6 weeks. I simply cannot depend on my wife and family for 24/7 assistance. I filed a grievance and appeal to no avail. The planning for surgery is left up to the patient and there is next to no communication among surgeon pre-op and post-op recovery and rehabilitation. I have been dealing with serious pain. Medicare Advantage is all about making money on the backs of US taxpayers’ and patients.
Moreover, there are delays in scheduling appointments with specialists leading to worsening of patient condition and nonpayment for treatment is not infrequent.
Finally ,where is the dignity for older Americans (middle age - senior citizens) who never were diagnosed duringchildhood with neurological disorders like Autism Spectrum Disorder. I was finally properly diagnosed at 65 years old and there is no support for adults with this disorder. This is a life long affliction and a disability, but we are treated as an afterthought with little to zero benefits for us under the current Medicare (dis) Advantage Policy. I have paid everything out of pocket. I would rather be on Traditional Medicare. Medicare (dis) Advantage clearly proves that competition does not correlate with lower costs and better quality of care. I’m totally in favor of a single payer system.
This essay makes a strong case for universal healthcare (what used to be called by the AMA as evil socialized medicine). I am one of the few American citizens who actually enjoy universal healthcare. I am a retied disabled veteran. I can choose my physician. Any expense that Medicare does not cover, DOD Tricare for life pays. Even mot of my medication is free.
Unlike the propaganda that universal healthcare will create interminable waits in doctor offices, or deprive you of choosing your healthcare providers and hospitals is gaslight. Due to an incompetent surgeon I had to get repaired at Mayo Clinic. The cost was gas for the 2-hour drive up and back. Five years ago, and arthritis flare-up required 14 months on a drug costing and obscene $7,500/month. I had to pay for shipping the pricey epipens.
We could start the transition to people over 60, and slowly allow everyone to join in until we had a national healthcare system. A Blue wave could make it happen - maybe.
So purchase a supplemental PPO policy, problem solved.
This article is excellent. Thanks to Nancy Smyth for flagging it, and I hope it will be widely read. Here’s an excerpt:
“I have been aware for a long time of basically fraudulent advertising in the MA insurance industry,” Toubman told HEALTH CARE un-covered. “There’s an overriding misrepresentation — they tell you how great Medicare Advantage is, and never the downsides.
“There are two big downsides of going out of traditional Medicare: They don't tell you that you give up the broad Medicare provider network, which has nearly every doctor. And should you need expensive medical care in Medicare Advantage, you will learn there are prior authorization requirements. Traditional Medicare does almost no prior authorization, so you don't have that obstacle. They don't ever tell you any of that,” he said.”