Medicare Advantage insurers incentivize brokers to mislead people about their Medicare choices. A number of Medicare Payment Advisory Commission (MedPAC) Commissioners want to stop Medicare Advantage insurers from paying brokers more to steer people into their Medicare Advantage plans than to steer people into Traditional Medicare, Joyce Frieden writes for MedPage Today.
Medicare insurance brokers have no financial incentive to help people understand why Traditional Medicare might better meet their needs, providing easy access to care from doctors and hospitals across the US. They are not paid to do so. MedPAC Commissioner Lynn Barr called out the reality that these insurers are capitalists and said we need to “stop pretending they’re going to do things out of the goodness of their heart.”
In a series of 24 focus groups, MedPAC staff learned that few people use independent informed sources to make their Medicare choices. Many rely on insurance brokers, who are biased, or friends and family, who might not understand the tradeoffs between Medicare Advantage and Traditional Medicare. Few contact their State Health Insurance Assistance Program (SHIP), which provides free unbiased advice.
Brokers are often not paid to enroll people in standalone Part D drug plans that people with Traditional Medicare use. But, they earn over $600 to enroll a person in a Medicare Advantage plan and $300 if the person stays in the plan. Insurers pay brokers only a fraction of that amount to enroll people in a Medicare supplemental insurance plan (“Medigap”), and in cases where the person has a disability, they sometimes pay no commission at all.
The MedPAC Commissioners recognize that people need much more help choosing between Traditional Medicare and a Medicare Advantage plan. They also expressed concern that Medicare Advantage provider directories tend to include a lot of misinformation, making it impossible to know which physicians are in the insurers’ network.
Also keep in mind: You have no good way to distinguish the good Medicare Advantage plans from the bad ones. Medicare’s five-star rating system should steer you away from plans with fewer than five stars. But, even the five-star plans could have high rates of inappropriate delays and denials of care, high mortality rates, and large administrative and financial obstacles to care. The government doesn’t factor delays and denials into the star ratings. You are forced to gamble with your health.
Here’s more from Just Care:
- It’s Medicare open enrollment season, here’s what to do and not do
- Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
- Medicare Advantage: Expect lots of care denials
- Louisiana: Medicare Advantage denials harm patients, while gouging taxpayers
- Seven questions you should be asking this Medicare Open Enrollment period
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