Type of Medicare Could Influence Cancer Patients' Outcomes

[Northeast Agent]

https://consumer.healthday.com/cancer-treatment-2658727750.html

Key Takeaways

Following cancer surgery, Medicare Advantage patients are less likely to survive than people covered by traditional Medicare

Medicare Advantage enrollees have more limited options for doctors and hospitals, so are less likely to be treated at a top facility

Prior authorization requirements also delay treatment for Medicare Advantage patients

 

[somarco]

Those covered by Medicare Advantage were 1.5 times more likely to die within a month after having their stomach or liver removed, and twice as likely if they had cancer surgery of the pancreas, according to findings published Nov. 21 in the Journal of Clinical Oncology.

Heavy . . .

 

[LostDollar]

but the agents selling MAPD plans are going to swamp you with anecdotal evidence proving exactly the opposite.

 

[LostDollar]

Caveat, not an agent.)
Bolding in quote is mine.

Medicare Advantage enrollees have more limited options for doctors and hospitals, so are less likely to be treated at a top facility

If I am remembering, and interpreting, correctly; more than one MAPD agent recently said, in another thread, this was not an issue because those patients couldn't conveniently get to, or afford to go to, those "top facilities" anyway. I believe those agents felt like their clients got good treatment at their local medical facilities.

 

[somarco]

but the agents selling MAPD plans are going to swamp you with anecdotal evidence proving exactly the opposite.

My post is not anecdotal, quoting the source. Frankly, I don't give a damn about anecdotes when there are scientific studies.

this was not an issue because those patients couldn't conveniently get to, or afford to go to, those "top facilities" anyway.

True . . . as long as they get prior approval from their carrier . . . which is almost always the requirement from the non-par provider.

 

[gregj]

Medicare Advantage enrollees have more limited options for doctors and hospitals, so are less likely to be treated at a top facility

hmmm... pair that with this inaccurate assertion from the article: "People covered by traditional Medicare can go to any U.S. hospital that accepts the public insurance, while Medicare Advantage enrollees can only see doctors and providers in their plan's network and service area."

if they're enrolled in an HMO, sure. In a PPO, different story.... In fact, people can get treated anywhere - it's what portion, if any, of the treatment bill the plan will pay.

 

[Yagents]

I heard from 20 clients that they got a letter from mayo in AZ warning them to be careful this AEP because they don't accept ANY mapd plans.

I had about 5 healthy clients this AEP thank me for saving their lives after being able to get treatment from mayo after an unexpected serious illness.

PPO does not mean u can go anywhere. I prefer to not play doctor roulette with clients health

 

[gregj]

they don't accept ANY mapd plans.

to confirm: is it your understanding Mayo will not provide non-emergency treatment to Medicare beneficiaries enrolled in a MAPD PPO?

Because the Mayo AZ exec's quotes in this MedPage Today article muddy that picture somewhat

 

[Fisher]

I have a client-to-be bring in a letter from his Mayo doc stating that he (the doc) is no longer accepting Medicare at all. No supp, no Advantage - straight cash, homie.

 

[Yagents]

to confirm: is it your understanding Mayo will not provide non-emergency treatment to Medicare beneficiaries enrolled in a MAPD PPO?

Because the Mayo AZ exec's quotes in this MedPage Today article muddy that picture somewhat

I don't get your question. It clearly states, non emergency care. Cancer is not emergency care.

"Asked about the reasoning behind the letters, Mayo communications manager Kevin Punsky replied that they are intended to serve as "a courtesy reminder" at the start of the annual Medicare re-enrollment window that began Oct. 15. They are intended to notify those eligible for Medicare that if they want coverage for non-emergency care at the Mayo Clinic in those two states, they should enroll in "Original Medicare (Parts A, B and D) as well as Medicare supplements."

And the letter from Mayo AZ is written differently. It states:

"We want to remind you that Mayo AZ is not currently in network with ANY MA plans, even when the plan indicates you can be seen at any facility that accepts Medicare"

I presume they are referring to the MA PPO plans[/QUOTE]