Fact Checking is Not Enough

Medicare Advantage Plans are being advertised 24/7 on TV. They are plans for people with Medicare and a low-income. Are they what they promise?

Fact checking is not enough-

For example: Yes, Medicare Advantage Plans give you the freebies they promise &

AARP summarized the people who prefer original medicare to 5 groups- 1. People who travel often or have more than one residence. 2. People who want flexibility in choosing doctors/providers. 3. People who live in areas with few Medicare Advantage providers. 4. People who do not mind managing multiple insurance policies. It seems like the handful of people who reject them are a small minority of the seniors who are well-to-do and if you are eligible for an advantage plan you will be well served by one.

But there are really important reasons why you may not be best served with one, including AARP’s last point (5) People who prefer to manage their own health care or people who prefer the doctor to determine medical care. If you are very sick, you need your doctor to be making all the calls-whether to go into nursing home or come home from one, whether to have a medical bed, in-home care, types of pain relief. Old medicare puts the doctor in charge-old-fashioned medicine, the kind we assume when we ask for Medicare for All. Medicare advantage makes the insurance company the decision maker. If these are your last months, you don’t want yourself or your family and friends fighting with the insurance company or waiting for decisions. If aggressive or unorthodox treatment might prolong your life, you want your medical care team making decisions not an insurer.

No one is telling the whole truth here, the majority of people want Medicare for All, meanwhile Medicare is being undermined- That is one reason fact checking is not enough- that is why investigative journalism is crucial-that is why doing your own research is crucial- understanding the whole picture- pros, cons, history, context.

My Mom retired at 65 with Social Security and a pension of about 5/6 of her Social Security. She did not have any real health challenges until she neared 80. Despite that, because she was a responsible person who did not wish to burden her children with her medical costs, she kept a full range of supplemental insurance to fill the gaps of Medicare. Over 15 years, this was hundreds of dollars paid out. Her insurance agent encouraged her to sign up with a Medicare Advantage Plan in 2015. Even with the pension, her income was low and she qualified. Shortly, thereafter, she became very ill and frail. Trying to make good decisions was very hard because of the limitations imposed by the insurance company. To coordinate the hospital doctors with nursing home availabilities with the insurance second guessing everything and everyone was very frustrating for all of us. The timing was wrong. She should have been on Medicare Advantage before she was frail. So, she paid out premiums for care that she did not need or use. She did not have the flexibility she needed when she was ill. We learned too late that she could have returned to Original Medicare at any time (but not from her insurance agent.) This is a complicated and confusing system that a single payer system that returns ultimate decision making to patient and doctor would eliminate. In the meantime, do your research!