Are any of you following this new legislation to reform Medicare that the Senate Democrats are proposing? I'm NOT trying to start any kind of political discussion here. I'm just wondering what you all think the future of MAPD will be if the Democrats are successful in adding dental, vision and hearing to basic Medicare.
Democrat Bill to Reform Medicare
- Thread starter Nikita
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Too often, people get into this tit for tat argument because we take incomplete information and try to fill in the gaps. Then it kind of takes a life of its own.
Medicare Advantage isn't just dental and vision and adding routine care to Original Medicare doesn't take away from the "selling point" of managed care... lower premiums.
In order for Original Medicare to truly cause a dent, they'd have to close all loopholes and make Medicare Supplements completely unnecessary.
All in all though, I'm a wait and see kind of guy. You don't really know what expanding Medicare means until you have a bill up for a vote.
IMO this is being oversold just like Obamacare.
My opinion is talk about DVH is another campaign promise for 2022 and possibly 2024.
Looking back . . .
A House bill introduced last week by Rep. Lloyd Doggett, D-Texas, would include things such as dentures, preventive and emergency dental care, refractive eye exams and eyeglasses, and hearing aids and exams.
The expanded coverage also was included in a broader health-care-related bill that cleared the House in 2019 but was not taken up by the Senate. Under that proposal, beneficiaries would have chipped in the standard 20% for some dental coverage. Major treatments — i.e., bridges, crowns, root canals — would have cost more. Dentures also would have been covered, within limits. And routine eye and hearing exams, as well as hearing aids, contact lenses and eyeglasses, also would have been included.
https://www.cnbc.com/2021/07/14/med...al-vision-hearing-under-democrats-budget.html
Many will hear the sales pitch and think "Oh boy, free dental, vision & hearing".
Those same folks, IF it comes about will most likely be very disappointed, just like Part D that roughly 15 years later it is misunderstood by most beneficiaries (and quite a few agents). A high percentage of INFORMED beneficiaries have no clue how to use their plan and end up overpaying both premium and copay.
The few who DO understand Part D rarely use it.
I think DVH will suffer the same fate.
Several folks ASK about SilverSneakers but UHC decided to drop the program because “over 90 percent of policyholders who are eligible for SilverSneakers® “never step foot in a gym.”
I see no reason to believe a DVH plan will be any different. The final result will most likely bear no resemblance to the sales pitch and will be a source of complaint more than praise.
My opinion is talk about DVH is another campaign promise for 2022 and possibly 2024.
Looking back . . .
A House bill introduced last week by Rep. Lloyd Doggett, D-Texas, would include things such as dentures, preventive and emergency dental care, refractive eye exams and eyeglasses, and hearing aids and exams.
The expanded coverage also was included in a broader health-care-related bill that cleared the House in 2019 but was not taken up by the Senate. Under that proposal, beneficiaries would have chipped in the standard 20% for some dental coverage. Major treatments — i.e., bridges, crowns, root canals — would have cost more. Dentures also would have been covered, within limits. And routine eye and hearing exams, as well as hearing aids, contact lenses and eyeglasses, also would have been included.
https://www.cnbc.com/2021/07/14/med...al-vision-hearing-under-democrats-budget.html
Many will hear the sales pitch and think "Oh boy, free dental, vision & hearing".
Those same folks, IF it comes about will most likely be very disappointed, just like Part D that roughly 15 years later it is misunderstood by most beneficiaries (and quite a few agents). A high percentage of INFORMED beneficiaries have no clue how to use their plan and end up overpaying both premium and copay.
The few who DO understand Part D rarely use it.
I think DVH will suffer the same fate.
Several folks ASK about SilverSneakers but UHC decided to drop the program because “over 90 percent of policyholders who are eligible for SilverSneakers® “never step foot in a gym.”
I see no reason to believe a DVH plan will be any different. The final result will most likely bear no resemblance to the sales pitch and will be a source of complaint more than praise.
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Reform means doing it better either in quality or in cost. I dont see any of that here. We dont have the political will to make medical care cost effective in our current political system. Usually Democrats expand coverage and claim it does not cost anything and Republicans cut back coverage saying it will lead to savings. Both of them are not true but work very well for our political cycle.
MW60
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They still want to lower eligibility age requirement but looks like this won't make it to the table this round. I have read various information regarding this.. Do Insurance Companies feel this will be a plus for them as those under 65 are most likely healthier but then again there are other complications involved, medicaid eligible, ACA premiums vs Medicare, etc.. and of course I am assuming they will charge more than the $140 a month. As for the dental, vision, hearing as usual it's very vague.. I have a feeling we are looking at dentures, low cost hearing aids. Most vision procedures are already covered so I am not sure what is up with that one..
Probably . . .
When Obamacare was being "sold" to the public DC was also selling it to the carriers. Mandated health insurance with "government" (actually taxpayer funded) subsidies was viewed as a windfall. This came with an added bonus of government (taxpayer) reinsurance against losses for picking up sick people without underwriting.
But as 2014 approached a significant number of carriers bailed on the U65 individual health insurance market. By the time we got to 2016 all but a handful of carriers remained active in that market.
In Georgia, as late as 2013 we had roughly 25 - 30 carriers writing U65 major med coverage. By 2016 we had 5 still playing that game including two that only wrote coverage in a handful of zip. PPO's all but disappeared and some zips offer you a choice of Blue Cross or Blue Cross.
Carriers were greedy and stupid about Obamacare. No reason to believe this will be different.
Hopefully, comprehensive dental will be added to Medicare. I write a good bit of dental, and hear the stories about the "nice dentist" that lets them pay by the month an inflated price for a root canal or crown, at a high rate of interest. So sick of those greedy money grubbing assholes, taking advantage of elderly people, and everybody else.
MOST medical providers participate in ORIGINAL Medicare but the drop off is significant for MAPD plans.
About half the providers (exclusive of hospitals) do not participate in any MAPD plans. Others will accept carrier A and B but not C & D.
Roughly 80% of dental providers do not participate in dental insurance or discount plans. Similar results for opticians.
Reminds me of a poster I had on my wall in college.
Suppose they gave a war and nobody came . . .
About half the providers (exclusive of hospitals) do not participate in any MAPD plans. Others will accept carrier A and B but not C & D.
Roughly 80% of dental providers do not participate in dental insurance or discount plans. Similar results for opticians.
Reminds me of a poster I had on my wall in college.
Suppose they gave a war and nobody came . . .
I assure you if original Medicare adds dental it will be very limited like for basic . I noticed a few mapd carriers for 2022 reduced their dental and even on the comprehensive they cover crowns but not root canals and don’t cover denture realignment
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Personally, if I had any say (obvs I don't)
I'd be happy with catastrophic coverage like a HDHP with access to an HSA, but unlike the way its set up, private could cover more routine care.
I'd be happy with catastrophic coverage like a HDHP with access to an HSA, but unlike the way its set up, private could cover more routine care.
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