Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News Editorials & Other Articles General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search

groundloop

(12,334 posts)
Thu Nov 3, 2022, 09:03 PM Nov 2022

Government is beginning to crack down on Medicare Advantage fraud

Over the last few years insurance companies have gotten more and more misleading in their marketing of Medicare Advantage plans. The administration is going to crack down on this. For example, ads for the Medicare Advantage plan pushed by Joe Namath are very misleading and things like this will be stopped. It's believed that forcing companies to advertise honestly will put many of these companies out of business.

https://www.healthcarefinancenews.com/news/cms-cracks-down-misleading-medicare-advantage-marketing



Here's a video explaining this (there's a short advertisement in the video for the advisory firm putting out this video).


13 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Government is beginning to crack down on Medicare Advantage fraud (Original Post) groundloop Nov 2022 OP
I do not have the patience to watch 20 minutes plus. PoindexterOglethorpe Nov 2022 #1
With Original Medicare plus Medigap Plan G you'd have been responsible for $233 groundloop Nov 2022 #3
Yes, figuring out exactly what a Medicare person should sign up PoindexterOglethorpe Nov 2022 #4
$233 is a lot less than the 20% of my bill. PoindexterOglethorpe Nov 2022 #6
But you'd have been paying $200+ per month dpibel Nov 2022 #8
My wife and I have a Kaiser MA plan. Costs us $0 extra in monthly premiums. Sibelius Fan Nov 2022 #11
About damn time dweller Nov 2022 #2
A scam that allowed me to pay a fraction of what I would have PoindexterOglethorpe Nov 2022 #5
Yes, I'm on Medicare dweller Nov 2022 #7
So, a plan that costs nothing extra, PoindexterOglethorpe Nov 2022 #9
I had dr. Appt yesterday. BIG notices up "If you have Medicare Advantage" SheltieLover Nov 2022 #10
Advantage plans are all about the network Demobrat Dec 2022 #12
Many health care plans are likewise all about the network. PoindexterOglethorpe Dec 2022 #13

PoindexterOglethorpe

(26,771 posts)
1. I do not have the patience to watch 20 minutes plus.
Thu Nov 3, 2022, 09:08 PM
Nov 2022

But I will say that I have an Advantage Plan, and despite the claims I see here, my Advantage Plan has done well by me. I had a heart attack nearly two years ago, had a stent put in, three days in hospital a bill of nearly $80,000. I paid less than $1,000. So exactly how am I being taken advantage of?

If I were simply on original Medicare, I'd have been responsible for 20% of that bill. You can do the math.

groundloop

(12,334 posts)
3. With Original Medicare plus Medigap Plan G you'd have been responsible for $233
Thu Nov 3, 2022, 09:31 PM
Nov 2022

But it sounds like you were able to find an Advantage plan that works well for you.

The problem is wading through all the marketing hype and lies to figure out what the truth is. There's a reason insurance companies go to all that trouble to lure customers, and that reason is profits. At least now they'll have to be more honest.

PoindexterOglethorpe

(26,771 posts)
4. Yes, figuring out exactly what a Medicare person should sign up
Thu Nov 3, 2022, 10:26 PM
Nov 2022

for is hideously complicated. This year, as every year since I went on Medicare, I am getting a lot of mail, trying to persuade me to switch to another plan. It really should be a lot simpler.

But I'm heartily sick of those here who simply trash all Advantage Plans without seeing what they actually offer. My plan doesn't cost me anything extra, and I've found it to be better than any health care plan I ever had prior to Medicare. Again, I point to my heart attack nearly two years ago, and the small amount I paid out of pocket for my stent and hospitilazation. If I'd simply been on original Medicare I'd have paid vastly thousands more.

The reality is that in this country health care is needlessly and unendingly complicated. Unlike almost everywhere else. A huge problem is that those in Congress, and even those who simply work for the federal government, have excellent coverage and assume everyone else has the same. Alas, we don't.

dpibel

(3,393 posts)
8. But you'd have been paying $200+ per month
Thu Nov 3, 2022, 11:08 PM
Nov 2022

Medigap isn't free, after all.

It doesn't take very many months of Medigap premiums to make up the difference between $233 and $1,000. At least according to my math.

Sibelius Fan

(24,631 posts)
11. My wife and I have a Kaiser MA plan. Costs us $0 extra in monthly premiums.
Fri Nov 4, 2022, 11:49 AM
Nov 2022

I think it’s fantastic. I’ve had a number of surgeries and hospitalizations over the past 4 years and my out of pocket has been next to nothing, like $90 for a $12,000 bill.

dweller

(25,145 posts)
2. About damn time
Thu Nov 3, 2022, 09:08 PM
Nov 2022

Notice that now that real Medicare sign up period has begun, the MA ads are announcing just that - it’s Medicare sign up time - and then giving a phone # for MA companies …

It’s a scam. It needs to end


On edit: I watched the whole clip … and stand by my claim
Medicare advantage is a scam


✌🏻

PoindexterOglethorpe

(26,771 posts)
5. A scam that allowed me to pay a fraction of what I would have
Thu Nov 3, 2022, 10:28 PM
Nov 2022

had I had only Medicare when I had a heart attack two years ago. Gosh. What a terrible thing.

Are you on Medicare? What plan do you have for the things that basic Medicare doesn't cover? Really? Now you know why I have and Advantage Plan.

dweller

(25,145 posts)
7. Yes, I'm on Medicare
Thu Nov 3, 2022, 10:37 PM
Nov 2022

And due to pre-existing conditions I can’t afford a plan B or D
I live on SS and plan D would cost almost 1/2 of my income …

So I live w/out health insurance … sux to be me

But at least I’ve not been scammed by insurance company fraud


YMMV


✌🏻

PoindexterOglethorpe

(26,771 posts)
9. So, a plan that costs nothing extra,
Fri Nov 4, 2022, 01:00 AM
Nov 2022

as I have, is somehow worse than an a plan that would cost you 1/2 of your income?

What am I missing here? What exactly is the insurance company fraud?

SheltieLover

(59,811 posts)
10. I had dr. Appt yesterday. BIG notices up "If you have Medicare Advantage"
Fri Nov 4, 2022, 02:20 AM
Nov 2022

Contact us to see if your plan is accepted.

Never been to this doc before & will not be going back (nightmare), but notices appeared to be new compared to some of the others affixed to the door.

That said, Advantage is a PPO. But maybe something has changed in the system to have prompted this notice.

Demobrat

(9,921 posts)
12. Advantage plans are all about the network
Sat Dec 17, 2022, 02:34 AM
Dec 2022

If the doctors/hospitals you need and want are in your network you’re golden.
If you need specialized care that’s not available in your network you’re out of luck. If it’s 100 miles away that’s where you go. The networks are in constant flux so you have to keep up with who’s in and who’s out.
With traditional Medicare with a supplement you can go anywhere Medicare is accepted. But you pay a higher premium for that flexibility.

There’s no one right answer. It all depends on what facilities are in what networks in your area.


PoindexterOglethorpe

(26,771 posts)
13. Many health care plans are likewise all about the network.
Sat Dec 31, 2022, 03:31 AM
Dec 2022

Several decades ago, the company my husband worked for switched to a different plan that did not include the doctor we'd been seeing for several years. So we switched to a different one. At the time we had little kids who needed the kind of care little kids typically need.

While the new doctor was quite nice, we were very grateful when the company went back to the old plan and we could go back to the old doctor.

My point is this: many, many health care plans set what doctors, hospitals, specialized services that you can use. Medicare Advantage is no different from those.

In reality, all health care plans should cover all health care wherever you are. Sadly, in this country, that's never the case.

Latest Discussions»Issue Forums»Social Security & Medicare»Government is beginning t...