Disadvantage plans

Medicare Advantage Plans are a huge rip-off for taxpayers and purchasers alike. These HMO health insurance plans for seniors are aggressively marketed every fall by giant, profit-first insurance corporations and their obscenely paid executives, only because they are extremely lucrative.

Since the early 1970s, the government has permitted private insurers to corrupt what was originally a highly efficient, simple, health insurance program that covered every adult 65 and over. Now, being on Medicare is an unnecessary nightmare of complexity and annual worry over whether one is in the “right” plan. When all seniors were in the same risk pool, the healthier could easily cover the expenses for the severely ill. But when the population is carved up into smaller and smaller groups, that basic principle of insurance crumbles.

Because financing illness isn’t really a profitable venture, private insurers have learned to game the system. They receive a government lump sum per member based on that member’s risk score. So, they cherry pick as healthy a group as possible, artificially inflate the risk scores by making members appear sicker than they are, lobby for ever higher payments while raising co-pays, require time consuming preauthorizations in an effort to deny care, and shift network doctors and formulary medications around to frustrate the sicker members so that they voluntarily lemon drop and change companies or switch to Traditional Medicare, where the sickest are always welcome. Then they accuse the government of inefficiencies after skimming off the cream of the risk pool!

Be informed.

Cris M. Currie

Mead