JustCare

Tag: Disenroll

  • Seven questions you should be asking this Medicare Open Enrollment period

    Seven questions you should be asking this Medicare Open Enrollment period

    During this Medicare Open Enrollment period, ask yourself these seven questions. And, please know that you can always call the Medicare Rights Center at 1-800-333-4114 or your SHIP (State Health Insurance assistance Program) for free, unbiased advice on any of your Medicare questions.

    1. Q. What’s the biggest difference between traditional Medicare and a Medicare Advantage plan? To ensure you have good coverage for both current and unforeseeable health needs, you should enroll in traditional Medicare. In traditional Medicare, you and your doctor decide the care you need, with no prior approval. And, you have easy access to care from almost all doctors and hospitals in the United States with no incentive to stint on your care. In a Medicare Advantage plan, a corporate insurance company decides when you get care, often requiring you to get its approval first. Medicare Advantage plans also restrict access to physicians and too often second-guess your treating physicians, denying you needed care inappropriately. The less care the Medicare Advantage plan provides, the more the insurance company profits. You will pay more upfront in traditional Medicare if you don’t have Medicaid and need to buy supplemental coverage, but you are likely to spend a lot less out of pocket when you need costly care. Regardless of whether you stay in traditional Medicare or enroll in Medicare Advantage, you still need to pay your Part B premium.
    2. Q. Should I trust an insurance agent’s advice about my Medicare options? No. Unfortunately, insurance agents are paid more to steer you away from traditional Medicare and into a Medicare Advantage plan, even if it does not meet your needs. While some insurance agents might be good, you can’t know whom to trust. Keep in mind that while Medicare Advantage plans tell you that they offer you extra benefits, you still need to pay your Part B premium, and extra benefits are often very limited and come with high out-of-pocket costs; be aware that many Medicare Advantage plans won’t cover as much necessary medical and hospital care as traditional Medicare. For free independent advice about your options, call the Medicare Rights Center at 1-800-333-4114 or a State Health Insurance Assistance Program (SHIP).
    3. Q. Why can’t I rely on my friends or the government’s star-rating system to pick a good Medicare Advantage plan? Unlike traditional Medicare, which gives you easy access to the physicians and hospitals you use from everywhere in the US and allows for continuity of care, you can’t count on a Medicare Advantage plan to cover your care from the health care providers listed in their network or to cover the medically necessary care that traditional Medicare covers. Even if your friends say they are happy with their Medicare Advantage plan right now, they are gambling with their health care. The government’s five-star rating system does not consider that some Medicare Advantage plans engage in widespread inappropriate delays and denials of care, and other Medicare Advantage plans engage in different bad acts that can endanger your health. So, while you should never sign up for a Medicare Advantage plan with a one, two or three-star rating, Medicare Advantage plans with four and five-star ratings can have very high denial and delay rates.
    4. Q. If I’m enrolled in a Medicare Advantage plan, can I count on seeing the physicians listed in the network and lower costs? Unfortunately, provider networks in Medicare Advantage plans can change at any time and your out-of-pocket costs can be as high as $8,300 this year for in-network care alone. You can study the MA plan literature, and you can know your total out-of-pocket costs for in-network care. But, you cannot know whether the MA plan will refuse to cover the care you need or delay needed care for an extended period. This year alone, dozens of health systems have canceled their Medicare Advantage contracts, further restricting access to care for their patients in MA, because MA plans make it hard for them to give people needed care.
    5. Q. Doesn’t the government make sure that Medicare Advantage plans deliver the same benefits as traditional Medicare? No. The government cannot protect you from Medicare Advantage bad actors. The insurers offering Medicare Advantage plans can decide you don’t need care when you clearly do, and there’s no one stopping them; they are largely unaccountable for their bad acts. In the last few years there have been multiple government and independent reports on insurance company bad acts in Medicare Advantage plans.
    6. Q. If I join a Medicare Advantage plan, can I disenroll and switch to traditional Medicare? You can switch to traditional Medicare each annual open enrollment period. However, depending upon your situation, where you live, your income, your age and more, you might not be able to get supplemental coverage to pick up your out-of-pocket costs and protect you from high costs. What’s worse, you could incur thousands of dollars in out-of-pocket costs in Medicare Advantage.
    7. Q. If I have traditional Medicare and Medicaid, what should I do? If you have both Medicare and Medicaid, traditional Medicare covers virtually all your out-of-pocket costs. You will get much easier access to physicians and inpatient services in traditional Medicare than in a Medicare Advantage plan if you need costly health care services or have a complex condition.

    For free independent advice about your options, call the Medicare Rights Center at 1-800-333-4114 or a State Health Insurance Assistance Program (SHIP).

    Here’s more from Just Care:

  • 2023: Four things to know if your income is low and you have Medicare

    2023: Four things to know if your income is low and you have Medicare

    Today, 12.3 million older adults and people with disabilities are enrolled in both Medicare and Medicaid.  Almost three out of four of them (71.1 percent) are eligible for full Medicaid benefits, the remaining 28.9 percent are enrolled in a Medicare Savings Program. While Medicare is an earned health care benefit for people over 65 and people with disabilities, Medicaid is a means-based benefit for people with limited incomes and savings. Medicare and Medicaid work together to provide a more comprehensive set of benefits for people with low incomes.

    1. Medicaid picks up many health care costs that Medicare does not cover: Depending upon your income and assets, along with which state you live in, you might qualify for full Medicaid benefits in addition to Medicare. Medicaid would be your secondary insurance, paying after Medicare.  It generally covers the gaps in Medicare, including the Part B premium, the Part D drug premium, deductibles and coinsurance. It sometimes covers routine dental care and travel to and from the doctor’s office and some long-term care. No matter where you live, if you meet state-specific criteria, you will have coverage for nursing home care.  Depending which state you live in, and your care needs, you might also be eligible for home or community-based care.  In addition, there are several Medicaid/Medicare demonstration projects underway testing new ways to deliver home care for people with Medicare, in one project with the help of therapists, nurses and handymen.
    2. Your state Medicaid office or SHIP program can help you know whether you qualify for full Medicaid or other low-income assistance.  Even if your income or assets are over the limit, many states have what are called “spend-down” programs that allow you to qualify for Medicaid after you have spent some of your own money for health care.  If you own a home, Medicaid does not count your home as an asset. To contact your state Medicaid office, click here and to learn about free and low-cost resources, including the State Health Insurance Programs (SHIP), click here.
    3. Some states enroll people with Medicaid and Medicare in commercial managed care plans: These Medicare Advantage plans might create obstacles to care through limited networks and inappropriate delays and denials of care. But, no matter what state you live in, you should have the right to disenroll and switch to traditional Medicare if you’d like. If you have both Medicare and Medicaid, your out-of-pocket costs in traditional Medicare should be very little or nothing. Contact your state Medicaid office to learn about options in your state.
    4. Even if your income or assets are too high to qualify for full Medicaid benefits, Medicare Savings Programs, (administered by state Medicaid programs), may cover some of the gaps in Medicare. Four different Medicare Savings Programs fill different Medicare coverage gaps, depending upon your income and assets. For example, in 2023, the Qualified Medicare Beneficiary Program, QMB, picks up the cost of Part A premiums; Part B premiums, deductibles, coinsurance, and copayments. To qualify, your individual monthly income cannot exceed $1,235 (married $1,663) and assets $9,090 (married $13,630) plus $1,5oo for burial funds. To learn more about these programs and which health care costs they pick up, click here.

    In addition to Medicaid and Medicare Savings Programs, there are thousands of government and charitable programs that provide free and low-cost services across the country.

    Here’s more from Just Care:

  • Medicare Advantage plans have little reason to address people’s long-term health needs

    Medicare Advantage plans have little reason to address people’s long-term health needs

    Nearly half of all Medicare Advantage members leave their Medicare Advantage plans within five years of enrolling, according to a recent study by David Meyers et al. at the Brown University School of Public Health published in the JAMA Network. Most of them are locked out of traditional Medicare because they are unable to get supplemental coverage, so they switch to other Medicare Advantage plans. Because insurers offering Medicare Advantage plans know they are not likely to hold on to their members over the long-term, they have little reason to address people’s long-term health care needs.

    The government pays Medicare Advantage (MA) plans a fixed rate per enrollee, regardless of the amount of money the MA plans spend on each enrollee. The thought is that these generous payments would lead the insurers offering MA plans to invest in the long-term heath and care outcomes of their members. But, the data suggests otherwise. The researchers suggest that their findings provide a strong reason for looking at long-term MA disenrollment rates when measuring MA performance as a means of helping to ensure MA plans do not disregard their members’ long-term health care needs.

    Researchers studied 82 377 917 individuals enrolled in a Medicare Advantage plan any time from 2011 to 2020. Of those, overall, nearly half (48 percent) left their MA plan within five years of joining. One-third left their MA plan within three years of joining. Disenrollment rates varied substantially by Medicare Advantage plan.

    These findings adds support to the case that Medicare Advantage plans are likely not invested in the long-term health and care management of their members, as hoped. Data on inappropriate denial rates in Medicare Advantage, particularly for people in hospital and people in need of post-hospital care also suggests that Medicare Advantage plans, as a whole, have little or no interest in ensuring the health and well-being of their members. Rather, the denial data suggests that once their members get sick and need costly care, the MA plans want them to leave.

    The researchers at Brown have found that people enrolled in Medicare Advantage plans who have complex and costly needs disenroll from their plans at higher frequency than people who are in relatively good health. Now, these researchers find that, over time, half of people disenroll from their Medicare Advantage plans. The researchers did not study why, but there’s a compelling argument that these people disenrolled because they were dissatisfied with their plans.

    The researchers further found that Black Medicare Advantage enrollees disenrolled from their Medicare Advantage plans at higher rates than enrollees of other races. Nearly 15 percent of them disenrolled from their Medicare Advantage plans within one year of enrolling.

    Of note, a smaller portion of people enrolled in plans with five-star ratings disenrolled within five years as people enrolled in four- and three-star plans.

    In sum, the researchers report three key findings from their work, in addition to their finding that 48.3 percent of people enrolled in Medicare Advantage plans who do not also have Medicaid left their Medicare Advantage plans within five years.

    1. Black enrollees in Medicare Advantage left their Medicare Advantage plans at higher rates than people of other races.
    2. Different Medicare Advantage plans had very different rates of disenrollment, though the researchers do not disclose which Medicare Advantage plans have the highest disenrollment rates over the five-year period. Disenrollment rates over one year did not correlate with disenrollment rates over five years.
    3. Medicare Advantage plans with five stars had lower disenrollment rates than those with fewer stars.

    The researchers conclude that Medicare Advantage plans “may financially benefit by increasing coding intensity in a short period while avoiding interventions to address chronic conditions in which potential benefits may take time to materialize and accrue to competing insurers.”

    Here’s more from Just Care:

  • Medicare open enrollment: Don’t be misled by ads

    Medicare open enrollment: Don’t be misled by ads

    When it comes to Medicare, every corporate health insurer seems to have an offer you can’t refuse, often from one of your favorite heroes paid to push their products. Don’t be misled by the TV ads and other promotional hype; get impartial information from your State Health Insurance Assistance Program. And, if you are misled, please know that you now have special rights to disenroll.

    Millions of older adults and people with disabilities are receiving misleading information from insurance companies offering Medicare Advantage. These insurers are not telling you the whole story about the health plans they are offering. Medicare Advantage plans offer you coverage from a limited number physicians and hospitals–generally far fewer than it appears from their provider directories–and often with large out-of-pocket costs if you need costly care. And, you are likely to need prior approval for your care, as well as to face delays and denials of care.

    So many people are signing up for these health plans based on misleading information that the Centers for Medicare and Medicaid Services (CMS) has threatened to penalize Medicare Advantage plans if they or the insurance brokers selling their products mislead people, reports Susan Jaffe for California Healthline. Under federal law, they are not allowed to engage in deceptive marketing practices, but that has not stopped them. And, since marketing is always deceptive–highlighting benefits but not costs–what exactly constitutes deceptive marketing?

    CMS is seeing a lot of complaints. Does the punishment CMS is threatening fit the crimes the health plans are committing? The Medicare Advantage plans make so much money off of each enrollee that it can be highly profitable for them to try to sell people a free lunch. When asked, CMS could not name one instance in which it had fined or suspended enrollment in a Medicare Advantage plan for deceptive marketing.

    The good news is that CMS has added new protections for people who are misled into joining a Medicare Advantage plan. You have additional rights to disenroll beyond the first three months of the year. According to CMS, enrollees have a “special enrollment period” if you want to disenroll because of deceptive sales tactics, including “situations in which a beneficiary provides a verbal or written allegation that his or her enrollment in a MA or Part D plan was based upon misleading or incorrect information … [or] where a beneficiary states that he or she was enrolled into a plan without his or her knowledge.”

    Most important: Never give a stranger your Medicare or Social Security number. In some cases, insurance agents are calling people, asking for their Medicare number and enrolling them in a Medicare Advantage plan without telling them.

    If you want health insurance that will meet your needs if you take a bad fall or are diagnosed with a serious condition, traditional Medicare gives you the freedom to see the doctors you want to see and use the hospitals you want to use anywhere in the country, generally with no bureaucratic hassle. The tradeoff is that you will need supplemental coverage, either through Medicaid, a former employer or a Medigap plan in order to protect yourself from out-of-pocket costs that have no cap. But, the cost of Medigap can be as low as $1,500 a year, far lower than the out-of-pocket cap in Medicare Advantage, which averages around $5,000 a year and can be as high as $7,550 for in-network care alone.’

    Here’s more from Just Care:

  • People living in rural communities disenroll from Medicare Advantage at a high rate

    People living in rural communities disenroll from Medicare Advantage at a high rate

    Sungchul Park, David Meyers et al. report in Health Affairs that people living in rural communities have far higher rates of disenrollment from Medicare Advantage into traditional Medicare than people living in urban and suburban communities. The disenrollment rate from Medicare Advantage to traditional Medicare is high in rural communities, and particularly high for people with complex and costly conditions.

    People don’t tend to switch from traditional Medicare into Medicare Advantage, be they people living in rural or metropolitan communities. But, for people living in rural communities, the converse is not true. They had high rates of switching out of Medicare Advantage and into traditional Medicare, and higher rates than people in Medicare Advantage living in cities. People living in rural communities who needed expensive treatments were especially likely to switch to traditional Medicare from Medicare Advantage.

    The authors hypothesize that people in rural communities leave Medicare Advantage because these health plans restrict their access to care and keep them from getting the care they need. But, they cannot say so with certainty. What we know is that rural Americans have higher levels of dissatisfaction with the quality and cost of care available to them through Medicare Advantage than other people with Medicare.

    Differences in health status did not explain why people in rural communities were more likely than other Medicare Advantage enrollees to switch to traditional Medicare. The authors did not find that people living in rural communities in Medicare Advantage plans were in worse health than people living in urban communities. Out-of-pocket costs also did not seem to be a larger driver of disenrollment in rural communities than in urban communities.

    Policymakers should take note that rural Medicare Advantage enrollees are not happy with the access to doctors and hospitals Medicare Advantage plans offer them. Congress might want to consider imposing more robust standards for network adequacy in rural communities so that rural Americans have access to more physicians and other providers. Congress also should consider ways to lure more providers to practice in rural communities and improve quality of care in Medicare Advantage in rural communities. Right now, Medicare Advantage plans do not appear to offer as good quality care in rural communities as they do elsewhere.

    The authors do not indicate whether some Medicare Advantage plans are better than others at meeting the needs of rural residents or whether all Medicare Advantage plans do an equally poor job. It is important that people understand that there can be substantial differences among Medicare Advantage plans, differences that can lead to poor or excellent health outcomes. But, as of now, some thirty years into the government’s experiment with private Medicare plans, people cannot know key differences.

    Here’s more from Just Care:

  • The wrong choice of Medicare Advantage plan could kill you

    The wrong choice of Medicare Advantage plan could kill you

    Older adults and people with disabilities have the choice of private health plans that offer Medicare benefits, sometimes called Medicare Advantage plans. Through an analysis of mortality rates at different Medicare Advantage plans, Jason Abaluck, Associate Professor of Economics, Yale University and colleagues at Brown University, University of Chicago and Northwestern University, found that the wrong choice of Medicare Advantage plan could kill you. The government would save thousands of lives if it terminated contracts with Medicare Advantage plans that have high mortality rates.

    After studying mortality rates in hundreds of Medicare Advantage plans with 15 million enrollees over five years, the researchers determined that people who choose the wrong Medicare Advantage plan have a much higher risk of dying. Put differently, your choice of health insurer affects how long you will live, along with other health outcomes.

    The researchers suggest that giving people the ability to choose between a plan that has their primary care doctor in network and one that saves them money is crazy. And, who knows which of these plans will prolong people’s lives and which will shorten them?

    They recognize that people cannot make good choices. They further recognize that the private health insurance market is broken. The Medicare Advantage plans have very little reason to put money towards keeping people healthier. In fact, some have mortality rates as high as eight percent–one in twelve of their members die each year; others have mortality rates of two percent.

    The researchers looked specifically at what happened to people’s mortality rates when they switched out of one Medicare Advantage plan and into a different Medicare Advantage plan. They found that a Medicare Advantage plan’s mortality rate had a direct effect on whether a person lived or died.

    To be clear, people have no clue what the mortality rate is for a given Medicare Advantage plan. That data is not publicly reported. And, star-ratings of Medicare Advantage plans are of no help.

    The researchers say that Medicare Advantage plans with higher premiums and better drug coverage tend to have better health outcomes. But, these two factors alone will not tell you whether you have a better chance of survival in a particular Medicare Advantage plan.

    What’s the solution? The researchers recommend that the government terminate contracts with Medicare Advantage plans that have the highest mortality rates. By so doing, the government could save around 10,000 lives a year. The better solution: Terminate all Medicare Advantage plans, eliminate out-of-pocket costs in traditional Medicare and move everyone into traditional Medicare or, better still, Medicare for All.

    Here’s more from Just Care:

  • Could you pay more in Medicare Advantage than traditional Medicare?

    Could you pay more in Medicare Advantage than traditional Medicare?

    Many people with Medicare opt for a Medicare Advantage plan, a commercial insurance plan that contracts with Medicare to deliver Medicare benefits, because they believe it will save them money over traditional Medicare. But, you could pay more in a Medicare Advantage plan than traditional Medicare.

    These days, the Trump Administration makes the commercial Medicare Advantage plans look more enticing than ever. The message is “All the benefits of Medicare and more.” But, what does that really mean and what do you trade away?

    It’s not at all clear that you will spend less for your care in a Medicare Advantage plan. According to the Kaiser Family Foundation, average out-of-pocket costs for people with Medicare in 2013 were $5,503 (41% of the average individual’s Social Security annual income.) Kaiser’s analysis does not distinguish between people in traditional Medicare and people in Medicare Advantage plans. The Medicare Advantage plans don’t disclose this data.

    Why don’t the Medicare Advantage plans reveal this data? What are they hiding? Are people spending more out-of-pocket than their advertisements suggest? If people are spending as much or more in Medicare Advantage plans as in traditional Medicare, it is hard to believe many people would opt for a Medicare Advantage plan and restrict their access to doctors.

    If people are paying less out of pocket in a Medicare Advantage plan than in traditional Medicare, it may be because they are not getting the care they need, delaying or skipping care. They may choose to go without care to avoid paying the deductible and copays. Or, their Medicare Advantage plan may not authorize care they need. Since the data is not available, we don’t know whether the cost of getting care in a Medicare Advantage plan or the health plan’s refusals to cover care is affecting people’s health and well-being.

    The data do show that people who need costly services disenroll from Medicare Advantage plans when they can and switch to traditional Medicare at far higher rates than people in good health. Unfortunately, the cost of Medicare supplemental insurance or, in some cases, the lack of access to supplemental coverage, can be a barrier to enrollment in traditional Medicare. Congress needs to fix that as soon as possible.

    Here’s more from Just Care:

  • People with Medicare and Medicaid in Special Needs Plans at extra risk

    People with Medicare and Medicaid in Special Needs Plans at extra risk

    A paper in Health Affairs by Marc A. Cohen et al. explains that people with Medicare and Medicaid, “dual-eligibles,” enrolled in commercial Medicare Special Needs Plans, a type of Medicare Advantage plan, are now at extra risk. A new guideline by the Center for Medicare and Medicaid Services (CMS) severely restricts their right to disenroll from these plans. Yet, the data show that dual-eligibles with complex conditions may need to leave Special Needs Plans in order to get appropriate care.

    Dual-eligibles with complex conditions have been disenrolling at high rates from Special Needs Plans. And, it’s likely it’s because they are not getting the care they need. It’s hard to believe that dual-eligibles are jumping at the chance to leave their SNPs if they are getting the care they need. Changing health plans is never fun, always involves time and energy, and usually also stress and frustration.

    Keeping enrollees who choose to leave SNPs from disenrolling is not in these enrollees’ best interests. As of January 1, 2019, however, dual-eligibles may not leave their Special Needs Plan any month of the year, a protection they have always had. They must remain in their SNPs for at least three months, except during the Medicare Advantage Open Enrollment Period, between January and March of each year. Many states limit the disenrollment rights of dual-eligibles even further.

    The new guideline from the Centers for Medicare and Medicaid Services (CMS) supports the financial interests of Special Needs Plans (SNPs) that fail to provide good care to their enrollees. Cohen et al. explain that there is a high correlation between enrollees with complex conditions disenrolling from SNPs and low-quality SNPs. Another recent study showed high rates of disenrollment from Medicare Advantage plans for dual-eligibles with complex conditions.

    The new policy compromises the health of low income older adults and people with disabilities. It gives SNPs the ability to count on additional Medicare and Medicaid income that they previously had not been able to count on, even when they deliver poor care. Supporters of the new policy claim that it gives enrollees more time to adjust to the SNPs. Of course, if the SNPs are not serving their needs, it’s unclear why forcing enrollees to remain in the SNPs is helpful to them.

    To determine whether disenrollment from SNPs was associated with poor SNP performance, the paper’s authors looked at SNP quality measures. They found that the SNPs with poor performance were far more likely to see high disenrollment rates. Unfortunately, dissatisfied enrollees will no longer be able to leave as quickly as they had been able to.

    Here’s more from Just Care:

  • People with serious health needs more likely to disenroll from Medicare Advantage plans

    People with serious health needs more likely to disenroll from Medicare Advantage plans

    A new study by David Meyers, Brown University School of Public Health, et al., of people enrolled in Medicare Advantage plans, published in JAMA Internal Medicine, shows that people with high health care needs disenroll from these commercial Medicare health plans into traditional Medicare at higher rates than people in better health. Their findings suggest that commercial health plans, overall, are not in business to meet the needs of people with complex conditions.

    Medicare Advantage plans have financial incentives to attract healthy members and steer less healthy members out of their plans. The federal government pays these plans a fixed rate per member. The less care each member receives, the more money the health plan gets to keep.

    The study’s authors find that rates of disenrollment from Medicare Advantage plans increase after people experience a serious health condition. The Government Accountability Office also has studied this issue and found that a high proportion of people disenroll from Medicare Advantage plans when they have serious health care needs.

    We have little clue how poorly the people with complex conditions who remain in their Medicare Advantage plans fare. Some evidence is concerning. In May 2018, Just Care reported on another study showing that enrollees in Medicare Advantage plans are more likely to end up in poorer quality skilled nursing facilities than people in traditional Medicare. More recently, a judge in Northern California found that UnitedHealth illegally denied necessary care to tens of thousands of enrollees with mental health needs.

    Poor treatment by commercial health plans of people with costly conditions is one reason why proponents of Medicare for All support improving and expanding Medicare to everyone. Medicare for all would fill gaps in traditional Medicare coverage, eliminating premiums, deductibles and coinsurance and adding vision, hearing, dental and long-term care. Medicare for All would also end commercial health insurance, including Medicare Advantage plans, which drive up costs and differ dramatically from traditional Medicare.

    The study’s authors looked at data of 13.9 million people enrolled in Medicare Advantage plans over a two-year period. They found a disenrollment rate of 4.6 percent for people with high needs as compared to a disenrollment rate of 3.3 percent for people without high needs. They infer from the data that Medicare Advantage plans are less likely to meet the preferences of people with complex conditions than people with fewer health care needs.

    The authors’ findings confirm what we already know. People with complex conditions are often hard-pressed to see the doctors they want to see and get the care they need when enrolled in a commercial Medicare Advantage plan.

    Of course, not all Medicare Advantage plans are alike. The study’s authors suggest that the ones with low star ratings are likely less well-equipped to meet the needs of people with costly conditions. But, the Medicare Advantage plans with five-star ratings could be ones that are engaged in wrongful delays and denials of care; the five-star ratings do not say enough about a plan’s performance to rely upon.

    The authors do not disclose the names of the Medicare Advantage plans with the disproportional disenrollment among enrollees needing costly care. Generally, Medicare Advantage plans only allow researchers to use their data on the condition that the researchers not call out particular health plans; in some cases, the researchers do not know which data belongs to which health plans. Keeping this information confidential is a particular disservice to the public.

    The authors categorized people as having a high health need if they have two or more “complex chronic conditions such as heart failure, chronic obstructive pulmonary disorder, and depression” or “six or more chronic conditions.”  They also looked at dual-eligibles–people with Medicare and Medicaid.

    Dual-eligibles with costly health needs disenrolled from Medicare Advantage plans to traditional Medicare at higher rates than others. But, the authors did not explore whether this is because others may not be able to buy the supplemental coverage they need to fill coverage gaps if they switch to traditional Medicare. The ability to buy supplemental coverage is not guaranteed in many states, except when people initially enroll in Medicare at 65.

    If you support Medicare for All, please tell your members of Congress. Please sign this petition.

    Here’s more from Just Care: