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Post by sunny225 on Apr 5, 2024 1:45:12 GMT
www.breitbart.com/politics/2024/04/03/joe-biden-moves-to-slash-medicare-advantage/Joe Biden Moves to Slash Medicare Advantage The Biden administration has finalized its move to slash Medicare Advantage as the 46th president has claimed former President Donald Trump seeks to slash entitlement programs. The Biden administration on Monday will cut base payments for Medicare Advantage plans by an average of .16 percent despite pressure from Republicans and healthcare experts. This follows Biden making controversial moves in the risk adjusting coding system to allegedly make Medicare Advantage payments more accurate. Biden’s move would impact more than half of Medicare enrollees, as many American seniors now look to Medicare Advantage for their healthcare needs. American seniors enrolled in Medicare Advantage could see their supplemental benefits reduced or cost-sharing increased by $33 a month in 2025, according to experts. Chris Meekins, an analyst, said, “President Biden’s team is gambling that MA beneficiaries won’t realize before the election the benefits Biden’s team is causing them to lose come January 2025.” Biden’s move to slash Medicare Advantage comes as Trump told Breitbart News he will never touch Social Security or Medicare. This runs contrary to claims from Biden and Democrats that he would cut entitlement programs. “I will never do anything that will jeopardize or hurt Social Security or Medicare,” Trump explained. “We’ll have to do it elsewhere. But we’re not going to do anything to hurt them.” more at link www.freedomworks.org/press/freedomworks-condemns-medicare-advantage-cuts/www.axios.com/2024/04/02/medicare-advantage-insurer-pay
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Post by farmrbrown on Apr 5, 2024 2:08:09 GMT
From the link above:
I don't know if y'all have experienced or seen the same thing as I have over the last 10 years or so, but my advice to anyone about to retire is stick with original Medicare and buy an affordable supplemental policy for any "extras" according to your needs. And I say this as someone who was never too impressed with the Medicare coverage of some people I knew, but as time passed they got 5 star treatment compared to what I see now from those who opted for an Advantage Plan instead - including my wife. When our DIL asked about my mom's insurance at the beginning of last year's struggle, when we told her she said, "She has a friggen Platinum American Express then! Good anywhere for anything." Slightly exaggerated but she manages a large nursing home in Florida so I figured she'd seen the best and the worst in her job.
It goes back farther than Obamacare, but I now realize that this whole scheme is designed to get seniors on private insurance rather than stay on the gov't financial books with original Medicare. Be careful whatever you choose, because once you leave the SS system and go with an "Advantage Plan", you have a snowball's chance in Hell of ever changing your mind and getting back in. A word to the wise....
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Post by arabianknight on Apr 5, 2024 4:47:16 GMT
www.breitbart.com/politics/2024/04/03/joe-biden-moves-to-slash-medicare-advantage/Joe Biden Moves to Slash Medicare Advantage The Biden administration has finalized its move to slash Medicare Advantage as the 46th president has claimed former President Donald Trump seeks to slash entitlement programs. The Biden administration on Monday will cut base payments for Medicare Advantage plans by an average of .16 percent despite pressure from Republicans and healthcare experts. This follows Biden making controversial moves in the risk adjusting coding system to allegedly make Medicare Advantage payments more accurate. Biden’s move would impact more than half of Medicare enrollees, as many American seniors now look to Medicare Advantage for their healthcare needs. American seniors enrolled in Medicare Advantage could see their supplemental benefits reduced or cost-sharing increased by $33 a month in 2025, according to experts. Chris Meekins, an analyst, said, “President Biden’s team is gambling that MA beneficiaries won’t realize before the election the benefits Biden’s team is causing them to lose come January 2025.” Biden’s move to slash Medicare Advantage comes as Trump told Breitbart News he will never touch Social Security or Medicare. This runs contrary to claims from Biden and Democrats that he would cut entitlement programs. “I will never do anything that will jeopardize or hurt Social Security or Medicare,” Trump explained. “We’ll have to do it elsewhere. But we’re not going to do anything to hurt them.” more at link www.freedomworks.org/press/freedomworks-condemns-medicare-advantage-cuts/www.axios.com/2024/04/02/medicare-advantage-insurer-pay I love my Humana Advantage program. Now I do not have drug coverage with Humana I get my drug program from a WI. plan called Senior Care. Only 30 bucks a Year and co pay very low. That way my Humana Advantage program cost me Zero premium. Now I had both eyes in for cataract surgery and it only costs me 300 Dollars co-pay for each eye. The entire Hospital Bill was 24,567. For One Eye and co-pay like I said I only paid $300. Love Humana Advantage.. I have had Humana Advantage program now for over 10 years. Great going Humana and I also get OTC meds like 25 dolls a month free from Humana. Great going.
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Post by farmrbrown on Apr 5, 2024 6:03:04 GMT
Humana is the plan my wife has and she's watched them change the drugs they cover to make it harder to get, same with the medical treatment/surgical coverage. Meanwhile the premiums increase so that there's not much difference than having mediocre health insurance from an employer. It's taken about 3 years of haggling, a few appeals with subsequent tests and retesting before they finally approved a generic form that didn't have a $3,000 a month copay to cure her Hepatitis C. I'm not saying it's useless, but it's nothing to write home about either. I thank God for my good health and will continue to do so. So far I haven't seen anybody beat His coverage - 24/7 emergency service, house calls, miraculous treatments....and never a bill for services rendered. *Check out His retirement plan sometime too. It's awesome!
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Post by arabianknight on Apr 5, 2024 6:40:18 GMT
Just don't forget when talking about ANY Medicare Advantage Program from ANY company. Not only are ALL States have different plans each County in said state have different programs under the same company like Humana. It is the States that issue different rules for any said Advantage program In Fact a person in one county can have the same program and in another county from the same company and each will have a different cost, because it is each county that can administer a different outcome with that same program, and even not have the same number of choices either to choose from. Counties count big time in figuring out how much or how little one might have to pay for said coverage by any of the health companies out there.
Case In Point: I moved from one county to one next door. I have 4 choices to choose from Humana in my county. When I moved that same Humana Advantage program I only had 3 Choices to choose.~!!!
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Post by farmrbrown on Apr 5, 2024 7:05:48 GMT
Just don't forget when talking about ANY Medicare Advantage Program from ANY company. Not only are ALL States have different plans each County in said state have different programs under the same company like Humana. It is the States that issue different rules for any said Advantage program In Fact a person in one county can have the same program and in another county from the same company and each will have a different cost, because it is each county that can administer a different outcome with that same program, and even not have the same number of choices either to choose from. Counties count big time in figuring out how much or how little one might have to pay for said coverage by any of the health companies out there. Case In Point: I moved from one county to one next door. I have 4 choices to choose from Humana in my county. When I moved that same Humana Advantage program I only had 3 Choices to choose.~!!! I know all that, but why would I move to chase the bait some insurance company threw out as a lure? Especially if I like where I'm at and move to a place I don't like, just so they pull a bait-and-switch 2 years later. Now you're getting to the fundamental point I figured out after listening to those TV ads, ad nauseum. Ready? Original Medicare is the same - in every square inch of the U.S.A. Same coverage - no denials because it's company policy. Same premium cost whether New York or New Mexico. And if you do move or just go on cross country vacation - you are ALWAYS "in network". Understand that I've studied this little scam for years. The real kicker is when I looked at the date when these "Plan C's" were invented. Ever wonder why they had Plan A, B, and D all the way back in the 1980's when Reagan and Tip O'Neil "overhauled" Social Security to save it? That's right. Mom had A & B (original medicare) with a plan D supplement for prescription drugs, although Aspirin was about all she ever took or needed. BUT......why didn't they go in alphabetical order when they added the prescription drug requirement? Why was it D instead of C? These Advantage Plans C weren't even invented until 1997! Or so it would seem anyway. Listen, I know there aren't enough brain cells in Congress to blow your nose, but ABC's? You think that was just a mistake or the fix was in to make big profits for the private insurance companies, when Obama was still in his diapers? Ok, that's all. I gotta red eye flight to Jamaica to catch...........
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Post by woolybear on Apr 5, 2024 13:23:14 GMT
farmrbrown, I always thought that "D" letter in Plan D stood for "Drug". So D is a drug plan. BUT I am reasonably sure that the government bigwigs weren't thinking the same as I. I started my medicare coverage last year. I spent the whole previous year (2022-23) studying the different plans and watching Utubes from different sources that explained the differences between supplemental and advantage plans. I chose original medicare with supplemental because of the "across the country" coverage. I didn't know if I would be traveling around the country and I didn't want to be tied down to an In Network system. I had previous experience with the in network stuff when DH was working or when we were on Marketplace insurance. When DD was working in Ohio one summer I talked with the insurance person about if DD had any type of medical issue. I was informed that they would cover an emergency but anything beyond that she had to come back into the state for any coverage. I used an insurance broker to help me find and sign up for a supplemental and part D plan. They had better access to info and could explain it better to me than I could find on my own. My Part D is from Wellcare. Last year it cost around $1/month, this year it's .49c/month plus my co-pay.
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Post by Tricky Grama on Apr 5, 2024 13:26:54 GMT
We both have United Health Care advantage plan. B/4 signing up we checked w/our docs & they all took it so that's what we did. Been totally happy w/it. & every year it gets BETTER for $ off drugs. Many have gone to 0 pay, none have gone up in co-pay. MAY have cost DH a little more in hosp fees but if you add all the years we didn't pay a monthly premium I'm sure we're ahead.
I DID make a huge mistake when signing up at age 65. Did NOT sign up for drug plan. I was under the impression it cost a monthly fee & didn't take any drugs except my asthma daily inhaler & our Doc friend supplied me w/his samples. What was I thinking??? That I'd never have to take anything my whole life??? Sheesh. (brings me to the fact that I FREQUENTLY have to say: "I ARE a college grad-U ate".) b/c I do so many dumb things. (birthday ipad comes to mind here as an example. Ha) So now I pay $22.30/mo for part 'D' that woulda been free if I'd signed up at 65.
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Post by woody on Apr 5, 2024 16:14:30 GMT
I have Medicare and Aetna health insurance plan. The past few months my pharmacy can’t get three of my scripts. I called three different CVS’s and finally the last call had them. Never had a problem with Aetna and getting meds since I’ve been with them for about 7 years.
It’s very frightening when I can’t get my prescriptions that I’ve been taking for years.
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Post by arabianknight on Apr 5, 2024 21:18:13 GMT
We both have United Health Care advantage plan. B/4 signing up we checked w/our docs & they all took it so that's what we did. Been totally happy w/it. & every year it gets BETTER for $ off drugs. Many have gone to 0 pay, none have gone up in co-pay. MAY have cost DH a little more in hosp fees but if you add all the years we didn't pay a monthly premium I'm sure we're ahead. I DID make a huge mistake when signing up at age 65. Did NOT sign up for drug plan. I was under the impression it cost a monthly fee & didn't take any drugs except my asthma daily inhaler & our Doc friend supplied me w/his samples. What was I thinking??? That I'd never have to take anything my whole life??? Sheesh. (brings me to the fact that I FREQUENTLY have to say: "I ARE a college grad-U ate".) b/c I do so many dumb things. (birthday ipad comes to mind here as an example. Ha) So now I pay $22.30/mo for part 'D' that woulda been free if I'd signed up at 65. Yes I know what you are saying. I did the same thing when I first went on Medicare at the age of 56. But then at the age of 65 that fine went away. But if you get it after age 65 as you know now that fine stays with you the rest of your life. Now I found out because I read at lot... Not what is on the internet, or different misinformed message boards, but what is on the Federal Medicare site itself. Now I have been on Medicare for nearly 20 years so I have read a lot over all those years, believe you me. I have changed companies 4 times from United Health and 2 others before I settled on Humana.
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Post by farmrbrown on Apr 5, 2024 21:43:57 GMT
farmrbrown , I always thought that "D" letter in Plan D stood for "Drug". So D is a drug plan. BUT I am reasonably sure that the government bigwigs weren't thinking the same as I. I started my medicare coverage last year. I spent the whole previous year (2022-23) studying the different plans and watching Utubes from different sources that explained the differences between supplemental and advantage plans. I chose original medicare with supplemental because of the "across the country" coverage. I didn't know if I would be traveling around the country and I didn't want to be tied down to an In Network system. I had previous experience with the in network stuff when DH was working or when we were on Marketplace insurance. When DD was working in Ohio one summer I talked with the insurance person about if DD had any type of medical issue. I was informed that they would cover an emergency but anything beyond that she had to come back into the state for any coverage. I used an insurance broker to help me find and sign up for a supplemental and part D plan. They had better access to info and could explain it better to me than I could find on my own. My Part D is from Wellcare. Last year it cost around $1/month, this year it's .49c/month plus my co-pay. Yep. "D" doesn't stand for drugs any more than "C" stands for Advantage. You chose the same thing as my mom did years ago and the same thing my daughter-in-law who runs a nursing home said was a 5 star ***** GOLD plan. I can't speak for anybody else, we all have our own lives to lead but it's not uncommon for retirees/grandparents to take a trip to visit the kids, see the Grand Canyon or whatever. No one plans to slip on the ice or trip over a toy on the stairs but then you also don't need to worry if you're covered when you get to the ER, 500 miles from home. All you wanna do is get a cast on your wrist and get the heck outta there, lol.
Anyway, I'm still a few years away from all of that it never hurts to have as much info as possible before making an important decision. Even more so if that decision is irreversible. I don't mind having a choice, but I ask myself, "If these Advantage Plans are so much better than Original Medicare, why do they not let you go back to it once you leave?"
Hard to come up with an answer for that other than the one I stated.
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Post by David! on Apr 5, 2024 23:24:45 GMT
I don’t think it would hurt one bit to look hard at reigning in MA plans and marketing claims. .16 cutting is hardly slashing and probably wouldn’t even get rid of the fat. I’ve been known to travel far and wide at the spur of the moment and have some pretty costly issues so I will be on regular Medicare with a supplement in just a few months. I’ve had to deal with doctors and hospitals leaving networks in the past and I’d rather avoid that. I have friends on MA that love the no cost and benefits and have other friends who wish they could get back on regular Medicare. To each his own.
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Post by Ozarks Tom on Apr 5, 2024 23:27:06 GMT
We started out with an advantage plan that was tied in with the major medical systems in our area, but good nationwide also. The Cox Medical System, where all our doctors are decided not to honor them anymore. Not good. So, Sweet Bride checked around and we went with Humana. They had the same cost, zero, as we're in a supposed "depressed" area. But Humana turned out to be a PITA, constantly calling and wanting to do an "in home" visit. Sorry, that ain't happening, but they persisted seems like monthly even after being told in no uncertain terms we didn't want them out here. As it happens, and not by accident I'm sure, Cox Medical Systems came out with their own insurance plan, which is also coordinated nationwide, for the same zero cost.
Co-pays are minimal, drugs are covered as before, and nobody calling wanting to walk through the house.
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Post by themotherhen on Apr 6, 2024 1:44:23 GMT
I won't have to worry about any Medicare plans for 20 years but it's good information to have! Also, having county by county differences between plans is the silliest thing that I have ever heard of, and totally wasteful of everyone involved's time and effort.
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Post by Jolly on Apr 6, 2024 11:42:49 GMT
I dunno, but Medicare sez Plan D is for drugs... www.medicare.gov/drug-coverage-part-dI remember the original debate...It was a push by W, and Hastert (Republican SOTH) was the sponser...The Bill www.congress.gov/bill/108th-congress/house-bill/1As for Medicare Advantage... Remember, TINSTAAFL!. Medicare Advantage (depending on the plan) can work very well for some people, particularly those people that fall in that gap between the people who have Medicare + Medicaid, and the people who have Medicare + Supplemental Plan. Medicare Advantage can limit out of pocket expenses, particularly for relatively healthy people. But you are essentially working with a HMO in many respects...Most make you stay within network for doctors, hospitals, prescriptions, etc. And they can change from year to year. Case-in-point...My wife spent almost an hour trying to explain to my 84 year-old MIL yesterday, why her husband had no bill for his xrays in December, but her xrays at the same imaging center cost her $100 in February. They had the same policy with Humana they've had for over 5 years! Well, yes and no...The Humana rep said the old policy had changed some of the benefits and this other policy they offered was most similar to what the had, so they switched. It's close, but it's not the same policy. Deductibles are slightly increased and it doesn't always pay 100% after deductibles on all outpatient procedures. The problem I have with all this, is that we're talking mostly seniors here, many with limited medical knowledge, limited insurance knowledge and some with mild cognitive problems. Medicare Advantage is an insurance product and it can be very confusing, even for the best of us.
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