Sunday, October 12, 2014

Medicare Advantage Warning- Move Over to Traditional Medicare While You Can by Larry Weigel

I just received a phone call from an 80 year old client who is very upset and distraught with her United Health Care Medicare Advantage plan.  The plan, called “Medicare Complete” dropped three of her doctors out of their network in September, and now her doctors are working with her to help pay for her medical treatments the remainder of the year.  She said her doctors were all unaware of being dropped and told her other physicians are being dropped out of networks throughout the country.

Her doctor said the Advantage plan is turning into an HMO (Health Maintenance Organization) to reduce costs for the insurance providers. Fewer doctors’ sign up for HMO’s which limits medical treatment options for seniors. And most seniors don’t want an HMO.  I have a single payer fee for service Medicare Traditional Federal plan which I can use anywhere in the country.  I don’t need a permission slip from an insurance company to tell me which doctors I can use.

This is an example of what would happen if Congress approves the Health Care Compact bill signed into law in Kansas by Governor Brownback in April 2014.  There is a movement in Congress and within our legislature in Kansas to privatize Medicare and change the peace of mind Single Payer fee for service plan (Traditional Medicare) into an insurance sales market called Medicare Advantage.  The politician’s surely must know the insurance companies have made billions of dollars in profits from the Advantage plans.

Those who want to repeal Obamacare are basically saying let’s give back the generous tax payer subsidies to the insurance companies so they can continue to make their guaranteed profits.  President Obama’s Affordable Care Act legislation reallocated about $156 billion in federal tax payer dollars by stopping the corporate welfare gravy train, and he is being nailed to the cross for doing it.

By the way I am a registered Republican so this is not a political statement at all.  It’s about doing the right thing for the seniors I represent. Medicare folks have no voice or no vote and that’s why I am passionate about what I bring to the table for them as their Medicare coach.  I work for them not the insurance industry.

I just saw a T.V. clip a few days ago where Mitch McConnell called in to a Kentucky sports show and said we need to completely strip and repeal Obamacare because Obama took $700 billion out of Medicare. (Now someone just sent me a video on twitter  blasting Obama’s 700 billion alleged theft from Medicare which is a total lie.. and we traced it back to the ruthless and notorious mis- information group called the Heritage Foundation.)  Obama reallocated $156 billion out of the pockets of the insurance companies. The next time you hear a politician tell you I will repeal Obamacare, ask about the $156 billion going back to the insurance industry.

More than $282 billion of tax payer subsidies have been given to insurance companies between the years 1985-2010 unnecessarily simply because some members of Congress want to privatize Medicare. But there is no evidence it provides better care but considerable evidence that during these years tax payers have been fleeced because the private programs cost more to administer and provide no savings as well.   Enough already. 

As a Medicare Coach I support all of the benefits granted to the Medicare folks under Obamacare. I repeat.  I support all of the Medicare benefits granted to the people I represent under Obamacare.  Seniors, please, practice this statement and don’t be afraid to say it out loud and in public. Saying it is your only voice in the matter and maybe those politicians who say they represent you might hear it.  But if you remain silent, you have no voice or no vote.

For all the 450,000 Medicare beneficiaries in Kansas, repeal of Obamacare takes away all those enhanced benefits like closing the donut hole which has already saved seniors billions of dollars.  It’s time to speak up and tell those politicians who want to repeal the Affordable Care Act, it is not going to happen, so please shut up- because talk like that only threatens the enhanced benefits we have already received, and you are trying to take them away from us.

WARNING:  If you are on a Medicare Advantage plan, I recommend you move back to Traditional Medicare fee for service.  This is what my 80 year old client is doing and I told her I would share her story so others don’t get into the mess she is in.  She was sold a Medicare Advantage product and got a real sales pitch, and now that the Affordable Care Act reallocated the billions of subsidies, the insurance providers who sell Advantage plans are pulling the rug out under their members because there is no one in Congress stopping them.

If you are thinking of buying a Medicare Advantage plan in Kansas think again, because Medicare Advantage is not a fit for a rural state like Kansas.  We no longer recommend anyone buying a Medicare Advantage plan because what we have predicted is now coming home to roost.

Once the tax payer gravy train pipeline was shut down with the Affordable Care Act, the companies are dropping doctors, pharmacies and many of their plans to guarantee stockholder share values won’t drop and profits will remain high.

Wait until I tell you what is happening with the Prescription plan renewals.  Only about 13 percent of Medicare members change plans or even look to see if there is a better plan out there.  Insurance companies are dropping pharmacies (I had a client call yesterday from a client almost in tears) to tell me her plan dropped her pharmacy.  Another called to say a real expensive drug I was taking is now no longer available to me.  Formularies change each year, and premiums change. Where there is confusion there is profit.

We have 500 members who renewed their member fee with us and already my assistant is saving our members thousands of dollars. She did an annual Part D prescription review this morning and saved a couple (age 86) more than $1500 dollars. 

So if you are on Medicare have someone review your prescription plan.  The Area Agencies on Aging can help as well as SHICK.  We do much of the same for a first time fee of $295 per person, but we are able to enroll and change plans for our clients on line and do all the follow up and then are here when you need us throughout the year.  A renewal member pays $125, and on average we can save them around $400.  I paid a guy $300 last year to rake my leaves.

We can also move clients out of Medicare Advantage plans which I suspect will be many as more Advantage members learn about changes in their plans.  I hope this helps all Medicare folks and adult children who can relate to the situation my 80 year old client is now facing if it was your mother.   It causes unnecessary stress and worry.

Seniors are drowning in Medicare information and screaming for knowledge. That’s where we can help.

Larry Weigel
1011 Poyntz Ave
Manhattan, KS 66502

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