Senior advocates say new draft guide to Medicare distorts facts. Here’s what you need to know

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Senior advocates say new draft guide to Medicare distorts facts. Here's what you need to know

Medicare & You is the government’s seminal guide to all things Medicare, and is a primary resource used by consumers in each year’s annual enrollment season beginning Oct. 15. As such, it is or should be the gold standard of reliable information for more than 65 million people already enrolled in Medicare and the millions of people who newly enroll each year.

According to three leading senior advocacy groups, however, the 2019 draft version of Medicare & You has unfairly tilted the playing field. After reviewing the draft, the three groups – the Center for Medicare Advocacy, Justice in Aging, and the Medicare Rights Center – said it contained false statements that appear designed to convince people that private Medicare Advantage (MA) insurance plans are superior to original Medicare.

In several comparative discussions of the two approaches to Medicare, CMS downplays the possible shortcomings of getting care from a limited network of health providers in an MA plan, which involve not only a limited number of providers but also geographic limitations of where a plan provides coverage. At the same time, the draft handbook fails to emphasize that users of original Medicare can use any Medicare-licensed providers anywhere in the nation.
 
I wonder if this push towards MA is based on DC wanting to shift as much of the cost of care away from original Medicare and into the pockets of the insurance carriers and beneficiaries.

CMS wants to move away from FFS and go in the direction of Pay for Performance. They also are moving to shift as many Part B drugs over to Part D.

The seniors who make up my client base want freedom of choice when it comes to doctors and want to direct their own care. We rarely have a discussion about premiums or OOP maximums, they want to keep their doctor(s) and that is primary to them.

The linked article is interesting, and we may see more discussions like that from DC in the future. But the gray panthers very much resent being told what is best for them.
 
People justify their position once a position is taken. I've had lots of people say "I haven't had a problem" and be reluctant to change. This seems to be especially true for those who shop for insurance like they do groceries. They calculate or at least estimate the lowest cost per oz and buy that item even though something else may be higher quality and value.

As it relates to MA, they don't pay a premium and get free gym membership under Silver Sneakers. Higher OOP and provider restrictions be damned. They invariably ask whether they can change back to regular Medicare when they come down with something like cancer.
 
Its become very obvious that the current administration, HHS and the GOP are pushing MAPD. Speaker Ryan has spoken out about how great they are, too.

Which I don't get. I may be the most liberal person on the boards, but I'm in TEXAS. I have gotten yelled at for bringing up AARP Part D, because those "commie a**holes" supported that son of a bitch and Obamacare. I deal with Tea Party members every day. They KNOW who the Freedom Caucus is and send them money. I say the words "HMO" or "Managed Care" and they go ballistic. Probably 90% of the time I do Medicare 101, I am told "You can skip this part. I am not going on an HMO" when I get to the Part C section.

So...someone want to clue me in? When did the GOP decide to push HMO's. I just don't get it.
 
Its become very obvious that the current administration, HHS and the GOP are pushing MAPD. Speaker Ryan has spoken out about how great they are, too.

Which I don't get. I may be the most liberal person on the boards, but I'm in TEXAS. I have gotten yelled at for bringing up AARP Part D, because those "commie a**holes" supported that son of a bitch and Obamacare. I deal with Tea Party members every day. They KNOW who the Freedom Caucus is and send them money. I say the words "HMO" or "Managed Care" and they go ballistic. Probably 90% of the time I do Medicare 101, I am told "You can skip this part. I am not going on an HMO" when I get to the Part C section.

So...someone want to clue me in? When did the GOP decide to push HMO's. I just don't get it.
Difference between people who have to use it and politicians lining their pockets from carriers.
 
I'm in PA and in my county there's a high percentage of MA, although I know a lot of people with Med Supp and Part D. I offer both, although I much prefer Med Supp. When I sit down with beneficiaries I go really in depth with the pros and cons of both. Going forward, if they want MA, I'm really going to start pushing Medico's HIP as they offer reimbursement for physical therapy, which is something seniors scream about if they start needing it a few times a week. It's a $45-$50 co-pay here, with the exception of one carrier's PPO where it's $15 per visit.

A few months back I attended a local networking event where a local Congressman was the guest speaker. At the end of his spiel I asked for an update about Part D and negotiating drug prices. He looked at my name tag and said, "Lisa, I would love to have you help me work on something. Give your card to my aide and he'll call you." So I did and the next day I received a smooth email from his office. Of course nothing after that and when I read his Bio it said he's a supporter of MA. He said that to shut me up and move on to the next question.
 
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"I haven't had a problem" are the most frequent words I hear.

"No, I haven't been sick" is invariably the response to my next query.

I never have health problems except for when I do. The next one will cost me $10,000 - unless i can stay clean until Medicare.
 
"I haven't had a problem" are the most frequent words I hear.

"No, I haven't been sick" is invariably the response to my next query.

I never have health problems except for when I do. The next one will cost me $10,000 - unless i can stay clean until Medicare.

"When's the last time you had a car accident? You don't buy insurance for what you need today. You buy it for what you need tomorrow."
 
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