Make it stop!
Even readers not “of a certain age” have seen the inescapable Medicare Advantage ads on TV promising seniors more health care for less. Why, they’ll even add money to your Social Security check every single month!
It sounds too good to be true. You know why.
Consumer complaints about the ads have doubled in just the last year, reports Forbes. A Senate committee found “evidence that beneficiaries are being inundated with aggressive marketing tactics as well as false and misleading information.”
Congressman Mark Pocan, Democrat of Wisconsin and former co-chair of the congressional progressive caucus (CPC), has seen enough. He may be in the House minority, but he’s playing “the long game.” On Wednesday, he will reintroduce the Save Medicare Act aimed at reinforcing traditional Medicare. It may go nowhere this session, but he’s building support for when Democrats regain a House majority (The Guardian):
The bill targets Medicare Advantage plans, which Pocan and his allies say the plans have turned into a cash grab for insurance companies. The program, in which healthcare coverage options from private insurance companies serve as an alternative to traditional Medicare, was initially designed as a cost-cutting measure to encourage insurance companies to provide seniors with healthcare coverage at a competitive price. Nearly half of Medicare-eligible Americans are now enrolled in a Medicare Advantage plan.
But multiple lawsuits have documented how private insurance companies seek to overdiagnose Medicare Advantage enrollees to receive more money from the federal government, according to a recent New York Times analysis. The Times found that eight of the ten biggest Medicare Advantage providers have submitted inflated bills to the government. Estimates of the cost of Medicare Advantage overbilling in 2020 alone range from $12bn to $25bn.
That explains why insurers market these plans so heavily. As health care industry whistleblower Wendell Potter says, the only “advantage” to these HMO-style networked plans is for the insurers.
Pocan wants advantage plans curtailed.
“This has become an additional profit center for these companies, when that could have actually gone towards enhancing Medicare,” Pocan said. “This is a program that doesn’t benefit most seniors.”
The Save Medicare Act would prohibit insurance companies from using the word “Medicare” in plan titles, helping seniors to distinguish between traditional Medicare and private offerings. The bill would also fine companies who attempt to engage in the marketing practice.
Pocan’s own mother, in her early 90s and not especially mobile, was once unable to receive care because her Medicare Advantage plan required her to travel to a doctor’s office in her local community. Traditional Medicare would have allowed a medical provider to come directly to her assisted living facility.
They don’t mention those minor details in the hard-sell.
“Many seniors don’t know the difference between Medicare and Medicare Advantage. They don’t understand that it’s not really the government program they paid into,” Pocan said. “I think a lot of seniors are getting ripped off.”
Some seniors with limited retirement funds find these pitches enticing because they cannot afford more per month. But on these plans they may pay more later. As Potter told a pre-pandemic audience here, insurers know what you’ll buy.
Don’t.