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Medicare Handbook misleading

Written by Diane Archer

Axios reports that the Trump Administration’s 2019 Medicare Handbook contains misleading information about Medicare Advantage plans, commercial health plans that contract with the Centers for Medicare and Medicaid Services to offer Medicare benefits. Among other things, the Medicare Handbook wrongly suggests that the out-of-pocket costs in Medicare Advantage plans are low. In truth, the Handbook has been misleading for some time and, in 2019, it will be more misleading.

Consumer advocates are speaking out against the US Department of Health and Human Services’ misleading information in the 2019 Medicare Handbook, claiming it is “distorting and mischaracterizing the facts in serious ways.”

Axios found some troubling changes from this year’s Handbook in the 2019 version. For example, one serious issue with Medicare Advantage plans is that if you need costly care, it is virtually impossible to know whether you will be able to see doctors who can meet your needs or what you will pay out of pocket. You can end up with thousands of dollars in bills. In traditional Medicare, so long as you have supplemental insurance, you have no out-of-pocket costs. But, the Medicare Handbook suggests otherwise.

The Handbook also suggests that you can test a Medicare Advantage plan. The reality is far more complicated. So long as you are relatively healthy, there is not much to test. It is only if you need complex care that you can test a plan, and if it does not meet your needs, it may be too late to switch out and get the care you need in traditional Medicare or another Medicare Advantage plan.

People with Medicare are best served, as are we all, having health insurance coverage that saves us from the stress of worrying about bills. Only traditional Medicare with supplemental coverage offers people that peace of mind. Unfortunately, upfront costs are high and too often unaffordable for the supplemental coverage that many people need to buy when they enroll in traditional Medicare.

The Medicare Handbook suffers and has always suffered from the same issues as the Medicare Plan Finder website, which was just called out for being misleading. The Handbook fails to highlight the potentially high out-of-pocket costs in a Medicare Advantage plan as well as the risk of not being able to see the doctors and hospitals you want and need. It fails to explain that there really is no good way to choose among Medicare Advantage plans, since it appears that not a one of them either offers high value care to people with costly and complex conditions or, if there are ones that do, promotes their high value care.

The changes to the 2019 Medicare Handbook only make a largely unhelpful document even less helpful. The 2019 Handbook will be sent out to everyone with Medicare in September.

Here’s more from Just Care:

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4 Comments

  • Several years ago I tried a Medicare Advantage plan. Big mistake. They promised doctors who had never agreed to the plan, and would not pay for things like a CT scan that I needed. The next year I had enough and switched back to traditional Medicare but… it was extremely difficult to find a plan that would take me with my medical conditions (diabetes, back surgery, knee replacements, frequent UTI’s, etc.). I’m happy with my Medicare and supplement now but it isn’t cheap.

  • Both political parties are captives of the insurance and pharmaceutical industries. There is only one way to rein in outrageous bankrupting health care costs. That is through removing the profit element from health care as most developed nations have already done.

    Health care should not be seen as a commodity! Stop abusing the American people!

  • This website frequently mentions how Medicare Advantage plans can backfire if a patient needs expensive care. I don’t know about other Advantage plans, but Kaiser Permanente’s has a $4,900 yearly maximum out-of-pocket spending limit for covered services.

    • $4,900 sounds like a lot to those of us living with multiple health issues and on pensions. And… some of the doctors may be OK but in my experience many Medicare Advantage doctors are more interested in the bottom line than they are in getting their patients the best care. Recently I lost a good friend who was on a Medicare Advantage plan. She asked her doctor for three years about a lump on her breast. When he finally paid attention she had Stage 3 breast cancer that had metastasized.

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