Thank you for sharing this. I know I continue to read things like this but still, 4 years into this with Medicare Advantage, this has not been my experience.

Maybe mine is a "better" plan, or maybe I haven't needed some of the care that they withhold. I am in good health generally. I think I may put some to the test as I have been experiencing some strange leg issues that we can't figure out and I suspect I will be needing more testing.

I will report back in the next months about my expeirence.

Just like other plans offered by insurance companies - they vary by company. Some make you jump through more hoops than others and I'm sure they have different strategies for making money. Logic would indicate that if you're paying less, they're making up the difference somewhere and it's not transparent to the healthcare consumer. Requiring an x-ray before a CT isn't unique to Advantage plans. My last individual plan required that as well.

I haven't been denied anything with my current Advantage Plan, which I've had for years. If any of these companies are overcharging the government, I hope they have to repay the money plus penalties and interest.

sushipup, that's an odd article. It conveys outrage and concern of those involved but little in the way of facts and background.

Congressional hearings are staged political events anyway. Maybe there's an issue, a fire to be concerned with somewhere but from this article I see only smoke. Is it real smoke or a smokescreen?

Two statements in the article caught my eye "Seniors in their last year of life had dropped out of Medicare Advantage plans at twice the rate of other patients leaving the plans" and "she said 3.5 million members didn’t have any records of getting care for medical conditions diagnosed during those health assessment visits.". By themselves they sound alarming.

Without an explanation of when in the last year of their lives the plans were dropped the droppage may be self-evident.

The second often can mean the patient was told the pro's and con's of the treatment and decided against it. I have a couple of things that I have been told could be treated or left alone to heal themselves or if operated on could cause other problems.

I do not have any Medicare Advantage or Supplement as I kept my employer insurance but those of you who do have those types of plans I thought every year you could switch plans during open enrollment. The article makes it sound like switching even at that time of the year would require passing a medical exam so have things changed that much since I was looking at those plans?

The article makes it sound like switching even at that time of the year would require passing a medical exam

Perhaps my understanding is not correct, but what I have gathered is that while one can switch back and forth without a medical exam during those enrollment periods, in some states switching back to Medicare and then requesting an application for an additional medigap policy after having an Advantage policy for a certain amount of time may indeed require an exam just for the medigap policy and depending on the results might be a higher price or not offered at all.

https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap

You can switch Plan D Rx plans every year. I do not know about switching between MAPs and regular Medicare. And as for switching supplement plans, I don't know, except that you cannot go to a higher level plan without passing underwriting. Your local free medicare advisor should know (not sales person/agent.)

From the AARP article that I linked to above:

*But there’s a catch: If you don’t get the policy within a certain time frame, insurers in most states can reject you or charge more because of preexisting conditions. This limitation no longer exists for other kinds of health insurance.*

There is a wealth of information about Medicare and the problems of Medicare Advantage plans here. And there are a lot of problems with MA, denial of care being only one of them.

You can switch MAPS once a year, no exam required.

laceyveil, the person behind the website you linked seems to dislike all Medicare Advantage Plans for some reason. To me, the site seems unbalanced with all negative "information", and nothing positive. She claims her goal is to educate people about healthcare options, so shouldn't that include all information, not just one side?

As I've said before, my experience with MAPs has been positive, no problem seeing doctors I needed to see, hospital visits, tests, prescription costs, etc.. The only complaint I can think of is that they didn't cover a medication I was prescribed, but I assume all health insurance providers have a formulary of covered drugs, MAP or otherwise.

I believe that the point of the site is to make clear problems with all the areas it covers. There are in fact a very large number of problems with Medicare Advantage. The only real plus is that it's cheap up front.

Worked in the Medical field all my adult life. My husband was a doctor and I handled the billing for his private practice. I can't express how difficult Medicare Advantage is so difficult to work with, how little they cover. After a few years, my husband decided he would no longer accept it.

Straight Medicare is so much better from the medical providers end. I rarely had to contact them but MA was a constant struggle. We felt sorry for those patients but it just wasn't worth dealing with them and would have had to require hiring another biller to just deal with them.

My husband offered patients (many he had seen for many, many years) a discount if they paid cash rather than deal with MA. His discount was generous because some of these people had been patients for so many years.

Personally, I have straight Medicare with AARP/UHC as secondary. I have never had a problem and all our doctors accept it. I can travel anywhere in the Country and see any doctor without getting permission, etc. Yes, it costs more, but as you get older, it is money well spent, in my opinion as a patient and a person who worked in the medical field.

Jane