Thursday, December 20, 2007

ABC News covers Medicare Advantage

ABC News, on both the Good Morning America and World News Tonight shows, warned senior consumers about private Medicare Advantage programs which some insurance agents have marketed aggressively to seniors, sometimes to seniors with dementia. The Medicare Advantage program is sold to replace Medicare (including Medicare premiums; it's a little hard to fathom the Part A since those eligible for full social security benefits don't pay Part A premiums; they do pay Part B and D (prescriptions). Chris Cuomo (himself an attorney) reported this morning in detail with a seven minute video. The video is called "Senior Citizens Battle Insurance." In some cases, insurance companies have refused to cover conditions that Medicare would have covered. While some Medicare Advantage plans give better benefits, the patients are at the mercy of the discretion of the insurance company.

To find the video, go to and search for "Medicare".

The video did relate a story where United Healthcare paid over $1 million in benefits for quadruple bypass surgery, but the patient was asked to lobby for Medicare advantage.

I did vet for the possibility of becoming an insurance agent in the spring of 2005. Medicare was not mentioned, but I suppose it could have been. Insurance agents always have to walk a fine line on ethics and can feel pressured to meet quotas.

Medicare's explanation for the plans is here.

Update: 12/21

I checked with my own ex-employer from whom I get pension and retiree health insurance. I asked what happens when I turn 65 in July. Since I am "not grandfathered" it would automatically convert to the Prescription Drug Only Plan once I am eligible for Medicare. But the premium for the quasi Part D is more than the premium I have now. I don't understand why this would be. If anyone understands how the age 65 conversion works (or what grandfathering means) I'd love to see a comment.

Update: Dec. 29: "No Premium Medicare supplements"

Another topic is supplemental Medicare coverage, which may include drug plans. Humana is advertising its Humana Gold HMO, and PPO plans that appear to be inexpensive. I have no idea how good the coverage is in practice, given these reports. The link is here.
I don't see how the premiums and benefits really match up and make sense. Comments are welcome.

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