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Many people not in the low-income "stereotype" choose MA plans over Med Supp. "Its the economy stupid!!"
Medicare Advantage and the Low-Income
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Thank you for bumping the valuable 4 year old post back to the top.
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Honestly, did a third grader write this piece of garbage? The days of houding senior citizens are officially over. MIPPA and the snitch system has taken care of any of that existed. The ONLY plan that a dual eligible should EVER be put in is a SNP for dual eligibles. I've never heard of a dual enrolling into a plan that has copays. Why would they even do it? Th part about the drug gap for duals in an MA is complete phooey.
I don't think that a dual MA is good for everyone, but for some that desperately need the "additional" services, it can make a positive difference in that person's life.
Medicare and Medicaid are two separate entities, so when someone is enrolled in the MSP and decides to enroll in a Medicare Advantage Plan, it does not effect their Medicaid status. Also included in the 2010 CMS Call Letter, there is a section that deals with cost sharing and dual eligibles. Medicare Advantage Plans with dual eligible enrollees must include in their provider contracts that dual eligibles will not be responsible for cost sharing for Medicare Part A and B services when the state is responsible for the costs. Dual eligibles will have the same cost sharing under Medicare Advantage Plans as they do under Original Medicare. In some cases it makes good sense to enroll a dual eligible in a Medicare Advantage Plan, especially when the plan offers an option for Dental, Vision and Hearing which is not covered under Original Medicare or Medicaid. This is old stuff. It's called continuing education for a reason. When the state is responsible for paying cost sharing for Part A and B services, a dual eligible enrolled in a Medicare Advantage Plan cannot be held responsible for cost sharing associated with these services. DUH!!
Who Gets the Advantage? False Promises and Hidden Costs
May 17, 2007
Signing up for Extra Help under Part D enables low-income people with Medicare to get the medicines they are prescribed, medicines they would otherwise be unable to afford.
Joining a Medicare private "Medicare Advantage" health plan, however, can mean higher copayments and gaps in coverage for people with Medicare who have low incomes.
Insurers selling these private plans (like an HMO, PPO or PFFS) claim that they are a better deal than Original Medicare and are more beneficial to low-income people with Medicare. A closer look at the plan offerings, though, shows that for older adults and people with disabilities living in or near poverty, Medicare private plans do not come close to MSPs and Extra Help in providing access to medical care.
Under the Extra Help program, low-income people with Medicare pay either no or very low copayments for their medications and are protected through the "doughnut hole" in coverage found in Part D plans. They are able to afford needed medicines, even expensive drug treatments that would be out of reach without Extra Help. Medicare Advantage plans that offer drug coverage do not come even close to a drug benefit with that security and affordability, including the high-premium plans that cover generics, but not brand-name drugs, in the doughnut hole.
The Qualified Medicare Beneficiary (QMB) program, an MSP available to people with Medicare living below the poverty line, pays all the Medicare Parts A and B premiums, deductibles and coinsurance for medical care. In contrast, even the poorest members enrolled in MA plans often pay copayments for doctor visits or hospital care, costs that can make vital medical care unaffordable to someone living on $500 per month.
Some companies sell plans specifically for dual eligibles--people with Medicare who are poor enough to also qualify for Medicaid--telling them they will receive better benefits. Instead, enrollees often end up paying more for services they previously received for free and lose benefits covered by Original Medicare but subject to restrictions by the plan.
Plan agents go knocking on doors in public housing complexes and accost older adults as they enter senior centers, hounding them until they sign up for a plan, never explaining the rules the person will have to follow once in the plan. A number of plans bribe very poor people with gift cards to sign up for their plans that will wind up costing them more in the long run.
Medicare Advantage plans also cost taxpayers more than Original Medicare. Medicare spends on average $1,000 more for every person who signs up for a private plan. In 2007, overpayments will total $7.5 billion. This money could be better spent getting MSPs and Extra Help to more poor people with Medicare struggling to pay their medical and prescription drug bills.
Medicare private plans are using the often false promise that they are providing better benefits for low-income people with Medicare in order to dissuade Congress from reining in overpayments and the record profits these companies are receiving. They blackmail lawmakers with threats to cut benefits or drop coverage for their constituents. Lawmakers need to see through this scam. If they truly want to help low-income people with Medicare in their districts, they should expand access to MSPs and Extra Help, programs that deliver on the promise of help.[/quote]
Who Gets the Advantage? False Promises and Hidden Costs
May 17, 2007
- Volume 7, Issue 20
Signing up for Extra Help under Part D enables low-income people with Medicare to get the medicines they are prescribed, medicines they would otherwise be unable to afford.
Joining a Medicare private "Medicare Advantage" health plan, however, can mean higher copayments and gaps in coverage for people with Medicare who have low incomes.
Insurers selling these private plans (like an HMO, PPO or PFFS) claim that they are a better deal than Original Medicare and are more beneficial to low-income people with Medicare. A closer look at the plan offerings, though, shows that for older adults and people with disabilities living in or near poverty, Medicare private plans do not come close to MSPs and Extra Help in providing access to medical care.
Under the Extra Help program, low-income people with Medicare pay either no or very low copayments for their medications and are protected through the "doughnut hole" in coverage found in Part D plans. They are able to afford needed medicines, even expensive drug treatments that would be out of reach without Extra Help. Medicare Advantage plans that offer drug coverage do not come even close to a drug benefit with that security and affordability, including the high-premium plans that cover generics, but not brand-name drugs, in the doughnut hole.
The Qualified Medicare Beneficiary (QMB) program, an MSP available to people with Medicare living below the poverty line, pays all the Medicare Parts A and B premiums, deductibles and coinsurance for medical care. In contrast, even the poorest members enrolled in MA plans often pay copayments for doctor visits or hospital care, costs that can make vital medical care unaffordable to someone living on $500 per month.
Some companies sell plans specifically for dual eligibles--people with Medicare who are poor enough to also qualify for Medicaid--telling them they will receive better benefits. Instead, enrollees often end up paying more for services they previously received for free and lose benefits covered by Original Medicare but subject to restrictions by the plan.
Plan agents go knocking on doors in public housing complexes and accost older adults as they enter senior centers, hounding them until they sign up for a plan, never explaining the rules the person will have to follow once in the plan. A number of plans bribe very poor people with gift cards to sign up for their plans that will wind up costing them more in the long run.
Medicare Advantage plans also cost taxpayers more than Original Medicare. Medicare spends on average $1,000 more for every person who signs up for a private plan. In 2007, overpayments will total $7.5 billion. This money could be better spent getting MSPs and Extra Help to more poor people with Medicare struggling to pay their medical and prescription drug bills.
Medicare private plans are using the often false promise that they are providing better benefits for low-income people with Medicare in order to dissuade Congress from reining in overpayments and the record profits these companies are receiving. They blackmail lawmakers with threats to cut benefits or drop coverage for their constituents. Lawmakers need to see through this scam. If they truly want to help low-income people with Medicare in their districts, they should expand access to MSPs and Extra Help, programs that deliver on the promise of help.[/quote]
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Guest
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I would encourage anyone going door to door attempting to sell Medicare Advantage should read the advertising guidelines for MA's abit more careful
Why ?
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Guest
Guest
No offense mate but if you have to ask why then you really don't understand the advertising rules and have no business trying to sell them unless you want CMS to penalize you and the insurance carrier. Better yet if you have a contract with an MA ask them to explain if you do not want take the time to learn their rules.
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The only one that does that around here is some chick named Ricki, we warned her but you know how that goes???
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