Thursday, February 4, 2016

Medicare Advantage

Should you sign up for a Medicare Advantage plan?

No. No. A thousand times NO! The most important reason is that you lose the ability to get a test done very quickly.
An example:  your doctor sees a mass on your chest x ray. He would like to get a CT scan of your lungs.  If you had traditional Medicare you could go right away and have it done.  If you have a Medicare advantage plan (it should be called disadvantage)  your doctor has to have an employee try to get authorization from the insurance company you decided to trust with your health.  The employee may begin it that day, it might be several days.  If the employee calls, and goes through many prompts, it may begin the case, then 4 days later they send a fax asking that records be faxed to a certain fax line (that they will not give you ahead of time).  It can take from one to 21 days to get approval.  At times the request is denied.

Some companies have the doctor call and speak to another doctor (usually some one with no background in the organ system being treated. )  

Some companies say the authorization can be done online. The web pages change 4 times a year, and many times don't work.

You lose the ability to get prompt diagnostic testing and your treatment can be delayed.

You lose the ability to go where you want for the treatment. Mayo clinic does not accept medicare advantage plans (probably because it is so costly to try to get approvals and at times they refuse payment for services.)  They will not even see you for cash.  

You have created a great deal  of extra work for your doctor.  You have given a company an opportunity to make money by creating obstacles to you receiving medical treatment. .You end up being the loser. Ask yourself, how does this company make money?  The answer is not pretty.

If you keep traditional Medicare and buy a supplemental plan (BCBS, Mutual of Omaha, my favorite)  you have no authorizations to obtain, everything is paid for.  No lengthy phone calls and frustration for your physician or you.

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