Medicare (Dis)Advantage
This is not medical or financial advice.
There’s also (In)Humana, Tri (and) Care, Cartel Unidas…Oh, by the way, what is the difference between Cartel Unidas and drug cartels?
At least the drug cartels provide health insurance…
I now have readers across the pond, so I should explain how Medicare Advantage works.
In Team America, we basically have two options for medical insurance, once we reach the age of 65. One is to have what we call straight Medicare, which will cover 80% of medical expenses, and then most people buy a supplement from a private company. If someone is disabled, they may qualify for Medicaid to cover the other 20%.
The other popular option is to allow a private company to oversee your Medicare allowance, called Medicare Advantage, and disperse your allowance as they see fit. I’m sure nothing nefarious would happen, when a for profit company listed on Wall Street, oversees someone’s Medicare allowance.
Now I’m not saying this is definitively wrong. Straight Medicare with a 20% copay can also be substancial. But I do think people need to do their own homework and research. Research the number of lawsuits that states have against a particular company, for starters.
Read the fine print
Many people assume that the supplemental insurance will cover what Medicare does not. Sometimes what the policy actually states, is that the supplement will cover 20% of what Medicare agrees to cover. That is a big discrepancy. Make sure you find that description in writing.
Don’t believe the phone call
Find your policy description in writing. You can call someone at the company to help you find that policy in writing. If they can’t find it, or don’t want to give the location to you, isn’t that a red flag? Don’t be surprised if the company representative doesn’t understand their companies’ own policies.
The Big Picture
I used to own a clinic, where we routinely received excuses for non payment of claims from Medicare (public) and these companies (private).
I can best sum it up this way, although this is an oversimplified explanation,
The public option will screw you over due to incompetence, the private option will screw you over for profit.
These private companies have publicly traded stock. They have to make money. They make more money, if they deny your claims. Humana and United stock were trading at $50/share before the (Un)Affordable Care Act. They now trade in the $500 range.
I saw a recent statistic that 60% of bankruptcy is from medical expenses, yet 70% of us have some form of medical insurance.
One other bit of evidence of the private sectors’ shadiness is the fact that many people have 2 insurances, and a co pay and deductible on the 2nd insurance. Give me a break. How much can you nickel and dime a customer? Are you covering medical care, or are you not?
We’ve done it to ourselves
Who’s to blame? Mitt Romney said corporations are people, implying they must be ok. While that is true they are people like us, what he failed to explain is that corporations bring out the collective worst behaviors in all of us. And we give them our business. And our mutual funds and retirements fund their Wall Street worth.
I don’t know what’s best for your health insurance needs. But I would research the companies and options first, and try to be a customer/patient as little as possible.
