Why Are Medicare Advantage Plans Being Rejected? Hospitals, physician groups, and other healthcare providers across the country are growing increasingly frustrated with Medicare Advantage plans offered by major insurers like UnitedHealthcare and Humana. As author Jae Oh explained in an interview, the healthcare system involves many complex stakeholders, and Medicare Advantage plans must negotiate details of healthcare services and prices with providers on one hand while also setting co-pays and co-insurance costs for consumers on the other. Watch more free videos about Medicare on finStream TV at this link: https://www.finstream.tv/videos/medicare/ . Interested in Jae Oh’s book, Maximize Your Medicare? Find it here: https://maximizeyourmedicare.com/
Featuring: Jae Oh
Categories: Medicare
It is easy to say that I am just among the privileged and dismiss my comments. But in this matter, privilege is the just the ability to understand and the determination to act accordingly.
Now age 81, at age 65 I purchased Medicare Supplement Plan J in Florida (an Issue Age state, thus slowing premium growth). It covers the Parts A and B deductibles, excess doctor charges, ER care, and has saved considerable medical expenses, avoided delays, allayed worries, and allowed peace of mind regarding medical treatment. At any hospital or doctor, I just show my medigap card and there are no questions. The medigap plan then handles all rest. (True, Plan J was discontinued two years after I purchased, though grandfathered for those who have it; however the current medigap plans N and G are quite good.)
More to the point, based on my experiences, half or more seniors on Medicare Advantage simply undervalue their own health. To put is bluntly, they do have the resources for a Supplemental, but they prefer things that offer immediate consumer, creature, and familial, and peer satisfaction.
THIS TOO–The older you get, the harder it is to recover from illness. And the added stress of finding the means of paying the medical cost (and the stresses of MA restrictions and denials) can prolong the illness. So having a good medigap plan will alleviate the stress and promote healing. Thus in a subtle way, in part, medigap helps pays for itself.
My wife and I gladly pay for Medigap and maintain a modest yet confident retirement. We don’t travel, nor go out dining, nor own a car, nor lavish our grandchildren, nor wear designer jeans, but neither did we pay a dime for her two knee replacements nor my dislocated shoulder, nor the nursing, nor the therapy, and with surgeons of our choosing.
My advice: force yourself to get medigap Plan G on your 65th birthday when you enroll in Medicare , and don’t lose it. Moreover, if you do this within 6 months of your 65th birthday (so called “Open Enrollment”) by law the medigap provider (eg. Aetna, Humana, etc) must accept you. Whereas, after 6 months the provider will require medical underwriting (medical records), which might reveal a medical precondition that the provider will not accept and thus deny you, which happens all too often.
Notwithstanding, our Medicare Supplements are through AARP/Unitedhealth. As for their Medicare Advantage partnership, let me express displeasure with the many ways AARP and Unitedhealth work hand-in-glove to drain Medicare and reap huge profits. United Health even pays AARP a nice “Royalty” for the AARP imprimatur. Their concerted determination to entrench Medicare Advantage is appalling.