By Patty Harvey
North Coast Journal (Humboldt County, Calif.), Letters, October 19, 2023
It’s that time again. If you’re thinking goblins and scary monsters, think again. Humboldt County seniors are being inundated with slick ads, mailers and presentations designed to lure them into the private health insurance plans known as Medicare Advantage (MA). (“California Says No to Privatizing Medicare,” Sept. 21.)
These plans are fraught with pitfalls and misconceptions, the first being you are not joining Medicare. You may, in fact, save money at the outset but there are long-term deficits. It is important if you choose such a plan to ask questions first. For example, you may want to know:
- In workshops you ask that I decide how much health care I am going to need in the future in order to determine my plan’s parameters. How can I be expected to anticipate the future?
- What local doctors and hospitals can I access? (It turns out there are only 12 physicians and two hospitals here in the program network.)
- Which of the many perks you offer are actually available here and how much does the plan pay for each?
- Can I return to traditional Medicare with a Medigap policy after being on Medicare Advantage after one year?
- What is the maximum out-of-pocket I would have to pay in one year, in network and out?
- If I need care in a specific hospital or from a specific specialist of my choice will I be covered?
- Publicity around MA details massive fraud and abuse by these companies that overcharge the Medicare trust fund by billions of dollars every year. Hospitals and physicians are refusing to accept MA patients due to repeated delays and denials of treatments and layers of paperwork. Does this plan ever deny treatment and for what reasons?
What seemsĀ too good to be trueĀ often is neither good nor true. Being prepared means not being blindsided.