A dying agents warning ‼️

[Yagents]

Yup....60 BILLION dollars, every single year, in Medicare fraud from original Medicare. And then we wonder why everyone's taxes and premiums are through the roof. Money don't grow on trees, folks. You cannot just have a system that questions almost nothing. Contrary to popular belief/narrative, there actually are some prior authorizations on original Medicare, but certainly not a lot. That is a LOT of our money.

The government is estimated to overpay Medicare Advantage plans by a significant amount, with estimates ranging from 22% to over $400 billion:

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• Center for American Progress: Estimates that Medicare Advantage plans are overpaid by 22–39%
  
  
  
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• MedPAC: Estimates that taxpayer overpayments to Medicare Advantage plans totaled more than $400 billion over the past decade

 

[InsuranceGuy29]

The government is estimated to overpay Medicare Advantage plans by a significant amount, with estimates ranging from 22% to over $400 billion:

• 
  
  
  
  
• Center for American Progress: Estimates that Medicare Advantage plans are overpaid by 22–39%
• MedPAC: Estimates that taxpayer overpayments to Medicare Advantage plans totaled more than $400 billion over the past decade

The term "overpayment" is highly subjective and very misleading. The insurance companies completely take the ENTIRE burden of ALL costs of care off of the Federal government/taxpayers, and puts it on themselves.

That is an IMMENSE savings for taxpayers/the government, overall. All for a payment of roughly $1,000 month. Many of these folks are extremely sick and cost the insurance companies millions of dollars a year in care for one person.

I'll put that in perspective....let's say a person is EXTREMELY sick and needing $1,000,000 dollars of care, per year. The Federal Government pays the insurance companies $12,000 a year and goes...."Here you go...this is now your problem." Sounds like a pretty damn good deal to me if I'm the government and taxpayers.

Do I believe there's no fraud and no "overpayments" on the Medicare Advantage side? Absolutely not. But the people that always bring the "overpayments" up are completely leaving this HUGE fact out.

On the original Medicare side, they are paying for 80% of these unbelievably high costs of healthcare, AND getting defrauded at a rate of over 60 billion dollars a year (and that's just what they know of), on top of that.

Even with "overpayments," the government and taxpayers are still coming out WAY ahead.

 

[Midlevel]

This begs the question . . . does this mean there is zero fraud on the managed care (MAPD) side? How about Medicaid?

How could there be? Everything is denied and then they die. lol

 

[goillini52]

So you are going to pay 95.00/month for a PDP bc wife has to switch Drs? Can’t believe people let a Dr (God in some people’s eyes) control them. Poor babies have to do a little more work to get their half a million dollars a year. Screw that.

$81, and I was saying that in my situation the PDP will pay better than the MAPD. Also, I don't like the uncertainty when doctors and hospitals can leave the network mid year with no warning. I want the security of a Med Supp. I want to be able to go where I want.

My wife asked me how much free toothpaste do we need?

 

[rmhaire]

That is an IMMENSE savings for taxpayers/the government, overall. All for a payment of roughly $1,000 month. Many of these folks are extremely sick and cost the insurance companies millions of dollars a year in care for one person.

Actually it's just the opposite. MA plans cost the government more than OM per beneficiary.

In 2019 it was roughly $300 more per year. And it's gone up every year since.

Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019 | KFF

The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis. The...

www.kff.org

 

[rmhaire]

My wife asked me how much free toothpaste do we need?

Don't forget those free Uber rides.

 

[Midlevel]

Actually it's just the opposite. MA plans cost the government more than OM per beneficiary.

In 2019 it was roughly $300 more per year. And it's gone up every year since.

Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019 | KFF

The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis. The...

www.kff.org

300.00 per year more vs the billions of fraud on OM. Come on buddy, I like you now but listen to yourself. lol

 

[rmhaire]

300.00 per year more vs the billions of fraud on OM. Come on buddy, I like you now but listen to yourself. lol

You're right. All of the fraud is on my side of the fence.

Oh well, I've got some up coding to do.

 

[Midlevel]

You're right. All of the fraud is on my side of the fence.

Oh well, I've got some up coding to do.

Guess most folks would rather have the Gov’t pay the 10000.00 for their healthcare rather than them paying 3-4000.00/year for their own and not having dental, vision, hearing and OTC. lol. Shocker. 55% and counting are choosing that way.

 

[InsuranceGuy29]

Actually it's just the opposite. MA plans cost the government more than OM per beneficiary.

In 2019 it was roughly $300 more per year. And it's gone up every year since.

Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019 | KFF

The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis. The...

www.kff.org

The Real Story on Medicare Advantage Costs and Spending - Better Medicare Alliance

by Mary Beth Donahue A recent Kaiser Health News article parroted a series of salacious claims on Medicare Advantage spending. “Critics have argued for

bettermedicarealliance.org

Now add in all of the fraud and also all of the unaccounted fraud from original Medicare. There is simply no way. Moreover, hypothetically, let's say it's true......seniors are still getting insanely better value with MA. The insurance companies provide so many extras that are not included on original Medicare.

Generally on most, there's no monthly premiums, no deductibles, RX plans included that entail better RX coverage, dental/vision included, care that's actually focused on prevention/keeping them healthy, and keeping more money in their pockets to live and survive. All of these extra services/benefits cost WAY more than that small $300 difference.

I know some agents in here scoff at those extra benefits, but take someone on a tighter budget that needs $3,500 worth of dental work, and that can be a catastrophic life event.

All of this has a positive domino effect on the economy and stimulates the economy by keeping more money floating around that's able to be spent. I know we can debate this until the cows come home and not agree, but that's just the way I see it.