It is that time of year again. The time of the year when many people are choosing their health insurance plan for the next year. People really need to pay attention to more than just the premium rates.
“I’m seeing more and more patients in my clinic with Medicare Advantage insurance plans. They’re stunned when they find out it’s not the same as traditional Medicare. Not all procedures and medicines are covered,” says Dr. Edward Hughes, Medical Director of First Dayton Cancer Care. Dr. Hughes’ experience is not the exception. Medicare Advantage plans have doubled in the past 9 years and now cover over 15 million seniors.
Medicare Advantage is run by private companies, unlike traditional Medicare, which is run by the federal government.
A recent study by the Wharton School of the University of Pennsylvania asked the question and was titled, “Who benefits When the Government Pays More? Pass-through in the Medicare Advantage Program.” Mark Duggan, a Wharton professor and co-author of the study, said “We’re talking about billions of dollars in additional government spending … I was somewhat surprised to see so little benefit passing through to consumers in the form of better benefits. We see more people enroll and we see more advertising expenditures. But we actually don’t see much better quality when you pay plans more.”
Rather than respond with a Congressional hearing, Congress instead gave Medicare Advantage a 0.4% increase in lieu of a planned 1.9% cut.
What’s the senior to do? Dr. Hughes recommends that “before you sign up for Medicare Advantage, look carefully and read your policy’s coverage for major illnesses that are likely to happen to seniors, like diabetes, heart disease, cancer, and COPD. Your quality of life and financial health depend on it.”