Why does Obama dislike Medicare Advantage Programs?

[napi21]

I just heard him say it again on FTN this AM. My husband & I just signed up for an Advantage Program because it was so much less expensive than a Supplement Program, and still limits our potential out of pocket costs.

[NeedleCast]

1. Write his campaign and ask

They've been pretty forthcoming from what I can tell when I've sent in questions to his campaign. It'll mostly likely get answered by a staffer, but at least you'll have something resembling an official answer.

[napi21]

2. OK. If I get an answer, I'll post it. n/t

[Bluenorthwest]

3. The Advantage programs do not replace the Supplements

You need to go back and re-read. They are two different things. Fully. If you are in need of services not covered under Medicare, in almost all cases those services will also not be covered under an Advantage Program. The Supplements are just that, and they add services that many people might need. If you need them, get a supplement.
Advantage programs are simply Medicare run by a HMO. The benefits are similar to the point of being identical. You are correct that the Advantage caps your out of pocket for covered services, but the services not covered are what the supplements are actually about.
They are not the same. Advantage is cheaper because it does not suppliment at all, to speak of. Now for many people, depending on needs and age and such, regular Medicare or Advantage are just fine, so I'm not saying you need to change. I'm saying make sure you have covered yourself.

[napi21]

5. We enroled in an Advantage PPO, not an HMO, and the only diff.

I found between the Advantage Plan that we enrolled in and the Supplement programs I was researching is that the copays are a bit higher. I have not found any services that are not covered. The plan we enrolled in is $68/mo per person and includes Part D coverage. The Supplemt programs I reviewed were $131/mo per person plus an additional $25/mo. for Part D. Although the Supplemt program had NO copay on Dr. visits and a very small copay for hospital services, I'm willing to rely on our past personal experiences and risk the copays v/s paying so much higher premiums each year.

[marmar]

4. Perhaps this is why:

from the NY Times:



The Medicare Privatization Scam


Published: April 21, 2007


If private health plans are supposedly so great at delivering high-quality care while holding down costs, why does the government have to keep subsidizing them so lavishly to participate in the Medicare program?

About a fifth of elderly Americans now belong to private Medicare Advantage plans, which — thanks to government subsidies — often charge less or offer more than traditional Medicare. As Congress struggles to find savings that could offset the costs of other important health programs, it should take a long and hard look at those subsidies.

The authoritative Medicare Payment Advisory Commission estimates that the government pays private plans 12 percent more, on average, than the same services would cost in the traditional Medicare fee-for-service program. The private plans use some of this money to make themselves more attractive to beneficiaries — by reducing premiums or adding benefits not covered by basic Medicare — and siphon off the rest to add to profits and help cover the plans’ high administrative costs.

Although the insurance industry insists that the subsidies are much lower and are warranted by the benefits provided, Thomas Scully, who headed the Medicare program for the Bush administration until 2003, told reporters recently that the subsidies were too large and ought to be reduced by Congress.

The largest private enrollment is in health maintenance organizations, which typically deliver care a bit more cheaply than standard Medicare and should not need their 10 percent subsidies, on average, to compete. The biggest subsidies — averaging 19 percent above cost — go to private fee-for-service plans, which are the fastest-growing part of the Medicare Advantage program. Unlike the H.M.O.’s, which at least manage a patient’s care and bargain hard with doctors and hospitals, these plans ride on the coattails of standard Medicare, typically providing access to the same doctors and paying them at the same rates. Thanks to the big subsidies they get, such plans are often a good deal for beneficiaries, charging less for the same benefits or adding benefits without raising prices. ......(more)

The complete piece is at: http://www.nytimes.com/2007/04/21/opinion/21sat1.html?ex=1334808000&en=e9fe0ffaa1eacec6&ei=5088&partner=rssnyt&emc=rss

[knitter4democracy]

6. I was thinking this, too.

People forget that Medicare has a 3% overhead (according to one figure I read) and private insurance has a 20-30% overhead (depending on the company). Private companies cost more. They also are a lot harder to deal with, both on the patient side and on the provider side.

[rurallib]

7. While making calls for a health care advocacy group this summer

Part of what we did was to engage the callers in discussion of their HC plans.
Folks who had regular old medicare + a supplement were usually very happy with their coverage.
Some of the most upset folks were people who had medicare advantage or whatever the medicare plus is called. They payed less premium, but each and every one was either fighting to get a bill paid or had been screwed on some coverage they thought they had. One woman was looking at a $50,000 bill they refused to pay.

[napi21]

9. I suspect that's because MOST Advantage Plans are HOM's. The

one we enrolled in is a PPO. It's a bit more expensive than the HOM's but only $20/mo. The one thing that everyone must be aware of is that it is your Drs. option to participate or not. The first thing I did was check with our Drs. office to make sure he and the local hospital system were participants.

There are SO MANY options to choose from, I think many people are overwhelmed and they think they have benefits and services they do not. I know during my research, I found out that there is NO CAP on your out of pocket costs with the BCBS Supplement Ins. I doubt most people would think to ask that question, but those who suddenly have to deal with some very serious illness and need something like Chemo, the copays can financially devastate them very quickly!

[madfloridian]

8. It's trying to privatize Medicare without saying so.

They are allowing all these companies access to seniors without telling the seniors what they are doing.

Many of them are scams or worse, though they sound good on the surface.

[Faygo Kid]

10. The Advantage programs cost considerably more than regular Medicare. Corporate $$$.

They are designed to privatize Medicare and put big dollars in the pockets of the insurance companies. They were supposed to introduce "competition" and lower costs; instead, they cost more than Medicare.

And they are subsidized by those who pay premiums for regular Medicare. It's another Bush ripoff.