If you have type 2 diabetes, you are likely better off in traditional Medicare than in a Medicare Advantage plan. A new study published in JAMA Internal Medicine finds that Medicare Advantage plans do not deliver better health outcomes for people with type 2 diabetes than traditional Medicare, even though the government spends more on people enrolled in Medicare Advantage. Suzanne Blake reports for Newsweek on some of the reasons why people should think twice before enrolling in a Medicare Advantage plan.
One big issue with Medicare Advantage plans is that they too often do not cover the medical and hospital care people need. They attract enrollees with offers of grocery allowances, dental coverage and gym memberships. But, as soon as you need costly inpatient care, you are likely to face prior authorization hurdles and inappropriate delays and denials of care.
Medicare Advantage plans frequently overrule treating physicians about the care their patients need, leading to poor quality care and endangering people’s health and well-being.
Researchers tracked roughly 35,000 people with type 2 diabetes over the course of three and a half years. They then looked at whether switching into Medicare Advantage improved their diabetes management and health outcomes. They studied people’s A1C levels and blood pressure.
A large cohort of people did not see health improvements. Researchers believe that people are not getting a lot of the “extra” benefits. The researchers’ conclusion is compelling: “[D]on’t let a grocery card, gym membership or dental allowance make the Medicare decision for you. Doctors, prescriptions, networks, prior authorization and your ability to change coverage later matter more.” Keep in mind that it can be very hard to switch from Medicare Advantage to traditional Medicare because, in many states, insurers can deny you supplemental coverage or charge you a high price for it.
Kevin Thompson, CEO of 9i Capital Group and host of the 9innings podcast, told Newsweek: “Beneficiaries should know that much of the shiny marketing that comes with Medicare Advantage plans often comes with restrictions and barriers. You may feel like you are getting a better deal, but additional prior authorizations can delay access to care, while restricted networks can limit where and from whom you receive that care.”
Because you can never know whether a Medicare Advantage plan will cover the care you need, you’re gambling with your health when you enroll. Overall, the “extra” benefits that Medicare Advantage plans offer are not improving people’s health outcomes. Yet, taxpayers are now spending roughly 14 percent more on people enrolled in Medicare Advantage than traditional Medicare, which is eating into the Medicare Trust Fund and driving up people’s Medicare premiums.
Here’s more from Just Care:
- Diabetes is common among older adults: Know the symptoms
- Medicare covers diabetes prevention program
- Medicare coverage for people with diabetes
- If you have prediabetes, Medicare can help
- Reduce your risk of diabetes, eat healthy
