http://oig.hhs.gov/oei/reports/oei-07-07-00390.pdf

The gentle readers will have to choose whom to believe; a doctor with a master’s degree in healthcare administration & biomechanics, & board certification in insurance consulting, with no financial interest either way, – or – an insurance salesman who sells the very insurance policies that have proven so problematic. Indeed, doing your homework is good advices, BUT trusting a salesman is not the best idea. It is best to compare references with credible consumer advocate sources. Fortunately, the facts in the article are easy to confirm with credible outsides sources. Here is just one:

California Health Advocates and the Medicare Rights Center notes that “Regulatory Oversight of Insurance Companies and Agents are Inadequate to Protect People with Medicare” It can be accessed at: http://www.cahealthadvocates.org/_pdf/advocacy/2007/AfterTheGoldrush.pdf

They note that: “Arguably, agents may take more time marketing and explaining MA products that provide drug coverage and change the way consumers receive Medicare medical benefits. While agents (and plan sponsors) get paid more for MA enrollments, though, there are no corresponding safeguards to ensure that agents actually do engage in more in-depth “service” and “time” necessary to explain MA plans to prospective enrollees, or to confirm that such plans are in fact appropriate for a given individual, such as explaining that one will have to use the plan’s network of doctors.” …“HICAP counselors in California, New York and around the country have handled multiple complaints from consumers who were sold MA products thinking they were enrolling in either a Medigap plan or a standalone PDP offered by the same company. Enrollees switching from fee-for-service Medicare to managed care frequently must change providers and face different and sometimes greater cost-sharing structures often not adequately explained by an agent selling them one of these plans. Without safeguards in place to ensure that the difference in products is adequately explained to prospective enrollees, the linking of higher commissions to enrollments in MA products simply serves as a cover for allowing marketing agents to steer customers to products that generate higher-capitated payments for the company.”

Indeed, SOME Medicare ADVANTAGE recipients will come out ahead financially IF they have limited Healthcare and Drug costs. Those that actually have larger expenses often find many hidden costs and uncovered services. Many seniors with Medicare ADVANTAGE seeking care at many high quality healthcare institutions, such as Mayo Clinic, will be turned away at the door.

Additionally, Medicare ADVANTAGE plans suck an extra 12 to 19 percent in federal funding from the Medicare funds. The corporations get an extra $1,140 of our taxpayer money for each Medicare ADVANTAGE plan enrolled with only 14% ($160) making it to Seniors for healthcare services. That leaves $980 of our tax dollars for insurance corporate profit and overhead, … including salesman Eric’s commission

Best regards,
Dr. Cates

Medicares hospital deductible is $1,132.00 for days 1-60 plus there may be dr. billing covered at 80 percent after another deductible of $162.00, oh but it gets better, if you need to go back in the hospital after 60 days you pay $1,132.00 again and so on. Now if you are in a skilled facility for more than 20 days Medicare charges $141.50 per day for 80 days total charge $11,320.00, staggering!

Medicare Advantage plans offer stop loss protection or the maximum amount you can spend on healthcare cost per year, between $2.500.00 to 5.000.00 depending on the plan.
There is no deductible and in most cases offer a fixed copay on services covered.

Another benefit omitted, if Medicare no longer processes claims then the 80 billion dollars it is estimated per year of fraud in the program is eliminated, not to mention administrative cost, talk about a huge burden.

If Medicare is such a great deal for seniors when they retire, why is it that politicians federal state municipal retirees get to choose from a menu of health plans contracted with the government for their benefits. Hmmmm..

Do your homework for yourself speak to a licensed insurance agent who has experience with these programs. Do not be lead with half truths and omissions.