Sunday, February 03, 2008

Erickson Tribune discusses Medicare Advantage

The Erickson Tribune, a small newspaper for seniors, is now promoting, in the February 2008 issue, its “Erickson Advantage” program – that is, a Medicare Advantage program. I summarized this topic on this blog Dec. 20, here. The article, by Lisa M. Davila, is titled, “A better way to spend Medicare’s money.”

According to the article, a Medicare Advantage plan is set up by a private insurance company that makes a contract with Medicare to make benefits available to its own policyholders and acts as a carrier (the other term is “intermediary”), under a theory that a private company can provide better health care service for a given amount of money than can the federal government. Yes, it sounds like a neocon idea.

Erickson claims it is trying to provide a better deal by bundling primary care with traditional Medicare supplementary insurance, which often costs well over $200 a month. The Advantage policy, when a senior buys such a policy, must cover all of the medical expenses since the senior then no longer can use Medicare (since Medicare has paid the insurance company). A policy obviously must be carefully structured and a senior must look at the costs and benefits (deductibles, etc) very carefully in consideration of his or her own circumstances. Major media outlets claim that there have been serious problems with coverage of some procedures in the plans, where seniors have bought them and then certain procedures that Medicare would have covered were not covered in the Advantage plan. Presumably, Medicare would carefully regulate these plans, but according to media reports, this hasn’t always worked. Some people make a living selling these plans and earning commissions on the sales, so there are issues with integrity, conflict of interest, and other problems common in insurance sales.

The Erickson Advantage fact sheet is here.

Its main website is here. There is some detail as to the individual plans. Visitors who know these products (including insurance agents) are welcome to comment here as to how they work and as to their effectiveness. I try to keep this blog as “objective” as possible.

1 comment:

Nancy b said...

Bill, thanks for your blog on this. I just want to clarify that the Medicare Advantage plan is only available to those people who live on an Erickson Campus. Erickson got a waiver to do this because it was a closed campus as a demonstration project. That is why they are able to provide and cover more preventive assessments then traditional Medicare. And they have proven that they can reduce hospital stays. As a disclaimer, I do not work for this plan but I do work for Erickson.