One health insurer admits that Medicare Advantage is broken

In its latest advertising campaign, the SCAN Group, an insurer that offers non-profit Medicare Advantage (MA) plans, admits that the Medicare Advantage program is broken, reports Paige Minemyer for Fierce Healthcare.

Scan’s ad campaign is literally titled “Health Insurance is Broken.” Denials of care happen too often. Prior authorization is a headache, frustratingly time-consuming, and delays treatment. Drugs you need aren’t covered. Even signing up for an MA plan can be a pain.

The ad ends with: “Health insurance is clearly broken,” which we all know by now, but few in Congress are prepared to do anything meaningful about.

Older adults and people with disabilities are beyond frustrated when they need timely care in a Medicare Advantage plan. So long as the government pays insurers upfront and allows them to keep the money they don’t spend, they will always have a powerful incentive to delay and deny care. That’s why, when it comes to expensive treatments–you get fewer benefits in Medicare Advantage than in traditional Medicare.

Here are some ways Medicare Advantage is broken:

• No meaningful choice. No good data distinguishing among the MA plans. Some are deadly and not avoidable. We know more about restaurants than MA plans
• Misleading marketing and sales: insurange agents and brokers, online tools, ads
• Star-rating system is a farce
• Provider networks are often inadequate, false and misleading directories, often no access to cancer centers of excellence, top specialists, rehab treatment, skilled nursing treatment and more
• Prior authorization is broken, denying necessary care or delaying it
• Access to care in rural communities is broken
• Out-of-pocket costs for complex care can be prohibitive

Traditional Medicare covers all the medically necessary care your treating physicians say you need. You don’t have to deal with prior authorization. And, you have coverage from most physicians and hospitals across the US, wherever you are, whenever you need it.

Here’s the ad:

Here’s more from Just Care:

• Ten ways Medicare Advantage plans differ from traditional Medicare
• Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
• Medicare Advantage needs serious fixes; $88 billion in government overpayments must end
• Medicare Open Enrollment: Don’t trust insurance agents
• Prior authorization: How dangerous is it?