Finally! Democrats should have made this happen last year or earlier *Easier to cancel subscriptions*

[fskimospy]

Good read, thanks.
It appears to me that Medicare needs to alter it's payment adjustments, though paying a bit more for plans that get 5 star ratings doesn't seem out of line to me. Regardless of that, it's still done as an open bid and Medicare decides what the criteria and adjustments will be. The issue is on the Medicare side, not the PPO or HMO.

My experience in government contracting is that it's often far to convoluted. Back in the late 90's I won a million dollar project by exploiting an undefined assumption in the requirements, I was by far the highest bid. The funny part of that story was at the bid opening, the fellow reading the bids read mine and said "this is bullshit". I still got the job.

Yes, the insurance companies are operating in the environment the MA program set up for them (absent the fraud, that is). In my opinion it's a wasteful program that should be eliminated though - a few percentage points doesn't sound like a lot but when you're talking health care spending it can quickly turn into enormous sums of money. MA plans also don't provide meaningfully better outcomes on the whole: https://www.kff.org/medicare/report...ditional-medicare-a-review-of-the-literature/

So basically it's more money for the same results, which isn't great. It's not the biggest problem out there but people always talk about cutting spending and eliminating wasteful programs. Well, here's one!

 

[Greenman]

Until they decide to clean up their bid process, I'm going to stick with a plan that's worked out well for me and my MIL (wife isn't old enough for Medicare, I robbed a cradle).

 

[fskimospy]

Until they decide to clean up their bid process, I'm going to stick with a plan that's worked out well for me and my MIL (wife isn't old enough for Medicare, I robbed a cradle).

You should stick with whatever you think works best for you.

My point is the program should be eliminated entirely as it is wasteful and ineffective but until that happens you do you!

 

[SteveGrabowski]

That's fine as a general industry opinion, but not particularly informative. I've been in an advantage PPO for just short of two years and so far I'm very happy with it. The coverage, service, and deductibles are far and away better than the insurance plan that cost me $2000 a month before I was eligible for Medicare.
I did a comparison before I joined the advantage plan and it netted me better benefits at the same cost. So far I haven't seen a down side to the plan, but if there is a benefit to dumping it I'd do it this afternoon.

Not how Medicare works. It's easy to go from real Medicare to scam privatized Medicare but try going back to the real thing and now you're subject to underwriting based on medical history when you select a Part G plan to pay the 20% Part B doesn't cover. Only way you're getting on a Part G plan without underwriting is if your carrier stops offering coverage in your area. Then you get a new initial enrollment window where you can select a Part G plan without them being able to jack up your premium based on previous medical history. It's a nice trap the private insurers have set, especially since advantage looks better when you turn 65 if you haven't had any serious medical episodes yet.

 

[hal2kilo]

The insurance companies loot peoples' Medicare benefits to give them a shitty HMO in return.

I know United Health sucks ass, but what about the other advantage plans like Kaiser. Yea, they gate keep, so does everybody in the business.

 

[Greenman]

Not how Medicare works. It's easy to go from real Medicare to scam privatized Medicare but try going back to the real thing and now you're subject to underwriting based on medical history when you select a Part G plan to pay the 20% Part B doesn't cover. Only way you're getting on a Part G plan without underwriting is if your carrier stops offering coverage in your area. Then you get a new initial enrollment window where you can select a Part G plan without them being able to jack up your premium based on previous medical history. It's a nice trap the private insurers have set, especially since advantage looks better when you turn 65 if you haven't had any serious medical episodes yet.

So your objection is centered on enrolment in a part G plan if you leave the advantage plan, because part G is also a private carrier that subjects you to underwriting. Is that an accurate summary? If so, how is that a reflection on the advantage plans?
I'm not arguing with you, I'm trying to understand your objections so I can review and possibly alter my current coverage.

 

[SteveGrabowski]

So your objection is centered on enrolment in a part G plan if you leave the advantage plan, because part G is also a private carrier that subjects you to underwriting. Is that an accurate summary? If so, how is that a reflection on the advantage plans?
I'm not arguing with you, I'm trying to understand your objections so I can review and possibly alter my current coverage.

Part G subjects you to underwriting if you sign up anywhere outside of the initial enrollment period the first six months you're Medicare eligible. If you sign up in the initial enrollment period the carrier can't look at your medical records and can only charge a flat fee based on your age and location. It's why you're screwed if you ever decide you're better off with regular Medicare after being in an Advantage plan since most likely you're doing it because your medical expenses look daunting and now that's a pre-existing condition. Or if you only take Part A+B and possibly D but wait past your initial enrollment window to get Part G coverage for the 20% of insurance Part B doesn't cover. It's a good trap the healthcare industry set to make traditional Medicare worse if you start out in Advantage and have thus lost your ability to sign up for Part G in an initial enrollment window.

 

[MrSquished]

The only party doing anything to protect consumers are the Democrats. The Republicans do the opposite. This is the case for virtually anything that has economic impact on those who are not wealthy.

But a lot of dumb fucks are racist sexist bigoty and just general pieces of shit.

 

[BoomerD]

LOL you bought into the Medicare Advantage scam. LOL simping for scumbag insurance companies.

I’ve had MA plans since 2018. (First time one became available in the county where we lived…Humana) At the time,$17/mo premium on top of my Medicare part B premium, no dental, but prescriptions by mail at no cost for most drugs, and optical. The next year, premiums dropped to $0.00
Then we moved to a county that had zero MA options. One of the Humana reps recommended I get a post office box in my previous county and use that as my “home” address. Did that for over a year, but it was a PITA to drive the 125 miles each way to pick up prescriptions and see the doctor. Then, Regence (BCBS) offered options here. Back to paying premiums $25/mo or $40 with dental. Last year, premiums went to $38 for everyone, but included dental.
For 2025, Regence is pulling all their Medicare Advantage plans from Washington…so I have to change…again. Looks like I have ONE company gain. A subsidiary of Mutual of Omaha. $0/mo. premium, includes vision, dental, $0 prescriptions buy mail, $5900 max out of pocket…OR $96/mo with $2000 max out of pocket. After my wife’s stroke last year, we got hit with medical bills for the first time ever…yet, with around $75,000 in bills, we paid less than $2000.

 

[Greenman]

Part G subjects you to underwriting if you sign up anywhere outside of the initial enrollment period the first six months you're Medicare eligible. If you sign up in the initial enrollment period the carrier can't look at your medical records and can only charge a flat fee based on your age and location. It's why you're screwed if you ever decide you're better off with regular Medicare after being in an Advantage plan since most likely you're doing it because your medical expenses look daunting and now that's a pre-existing condition. Or if you only take Part A+B and possibly D but wait past your initial enrollment window to get Part G coverage for the 20% of insurance Part B doesn't cover. It's a good trap the healthcare industry set to make traditional Medicare worse if you start out in Advantage and have thus lost your ability to sign up for Part G in an initial enrollment window.

Thank you. Based on that, the best I can hope for at this point is that I don't somehow lose my advantage plan, which I'm pretty happy with. Though I also carry a supplemental long term care plan.

 

[SteveGrabowski]

I’ve had MA plans since 2018. (First time one became available in the county where we lived…Humana) At the time,$17/mo premium on top of my Medicare part B premium, no dental, but prescriptions by mail at no cost for most drugs, and optical. The next year, premiums dropped to $0.00
Then we moved to a county that had zero MA options. One of the Humana reps recommended I get a post office box in my previous county and use that as my “home” address. Did that for over a year, but it was a PITA to drive the 125 miles each way to pick up prescriptions and see the doctor. Then, Regence (BCBS) offered options here. Back to paying premiums $25/mo or $40 with dental. Last year, premiums went to $38 for everyone, but included dental.
For 2025, Regence is pulling all their Medicare Advantage plans from Washington…so I have to change…again. Looks like I have ONE company gain. A subsidiary of Mutual of Omaha. $0/mo. premium, includes vision, dental, $0 prescriptions buy mail, $5900 max out of pocket…OR $96/mo with $2000 max out of pocket. After my wife’s stroke last year, we got hit with medical bills for the first time ever…yet, with around $75,000 in bills, we paid less than $2000.

Ouch sorry to hear about your wife. Hope she's doing well. Had a friend get one five years ago but her husband noticed it immediately and got her to the hospital and she has been in pretty good shape since, just a little slower than before but still quite sharp. But then my friend's dad was who just ignored it for a day when he had one went blind.