JustCare

Tag: Medicare

  • Proposed Medicare Advantage rule aims to limit bad insurer behavior

    Proposed Medicare Advantage rule aims to limit bad insurer behavior

    Last week, the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare, proposed a new rule intended to limit some of the many insurance company bad acts, reports Rebecca Pifer for HealthcareDive. Unfortunately, Medicare Advantage plans all too frequently inappropriately delay and deny people’s care notwithstanding CMS rules. To protect MA enrollees, the government should penalize insurers who violate their obligations severely enough to deter bad acts; without strict penalties, more rules are unlikely to be of much help.

    The CMS proposed rule strives to address five of the biggest concerns with Medicare Advantage. The Trump administration will have the power to decide which, if any, of these proposals will be finalized.

    • Insurers’ use of artificial intelligence to deny care without consideration of patient needs. The rule is designed to make transparent to MA enrollees their insurers’ coverage policies. Insurers sometimes use artificial intelligence to engage in across-the-board denials of care, even when care is urgently needed. The  MA insurers use AI particularly to deny care for people with costly and complex conditions, such as people with cancer and people needing rehabilitation services. New CMS data reveals that more than 80 percent of denials are overturned on appeal, but only four percent of people appeal. The proposed rule also would require insurers to notify enrollees about their appeal rights.
    • Insurers’ publication of inaccurate provider directories that misrepresent which physicians and hospitals are in network. The rule strives to ensure that the provider directories do not mislead enrollees as they are wont to do.
    • Insurers’ misleading marketing. The rule strives to protect enrollees from misleading marketing.
    • Insurers’ coverage of supplemental benefits. The rule aims to ensure that enrollees are fully aware of these benefits and their limitations.
    • Insurers’ reporting of how much money they spend on patient care rather than administration and profits. Insurers are legally required to spend at least 85 percent of the money they are paid to cover enrollees on patient care. But, many appear to find ways to spend a lot less.

    In addition, if finalized, the proposed rule would for the first time require Medicare to cover weight-loss drugs for people who are obese, even if they don’t have other health conditions.

    Here’s more from Just Care:

  • Turning 65? When to enroll in Medicare

    Turning 65? When to enroll in Medicare

    Turning 65 is fraught for all kinds of reasons, one of which is that you will need to consider whether you should enroll in Medicare. Here’s what I just explained to a friend.

    Should you enroll in Medicare at 65? If you’re not actively working or you do not have health insurance coverage through your job or your spouse’s current job, you will need to enroll in Medicare when you turn 65. And, if you have insurance through your job or through your spouse’s job but the employer has fewer than 20 employees, you also should enroll in Medicare at 65. If you do not, you will pay a penalty for each year you delay enrolling.

    You can enroll before your 65th birthday. You can and should enroll in the three months before your 65th birthday to ensure you are covered on the first day of your birthday month. Contact your Social Security office to enroll. You do not have to sign up for Social Security at that time. In fact, if you can afford to delay taking Social Security, you should, in order to earn larger benefits down the road.

    What choices do you need to make? You need to choose between traditional Medicare, which you should get automatically (but you should confirm) and a Medicare Advantage plan. Traditional Medicare gives you coverage for care from almost all doctors and hospitals across the US, without administrative barriers to care like prior authorization. You pay for supplemental coverage, sometimes called Medigap, to fill coverage gaps–about $2,500 a year for a comprehensive policy–but then you have few out-of-pocket costs; almost all your care is covered in full.

    Medicare Advantage restricts your access to care to its network of providers and has administrative barriers to care such as prior authorization requirements, which can cause undue delays. Medicare Advantage plans also have been found to engage in widespread and persistent inappropriate denials of care and coverage. But, Medicare Advantage plans have an out-of-pocket cap so they save you money if you do not need a lot of care.  If you do, you could spend as much as $9,350 out of pocket in 2025 for in-network care alone. You cannot buy supplemental coverage to cover these costs. If you opt for Medicare Advantage, you will need to choose your Medicare Advantage plan carefully. Do not trust an insurance agent or broker to help you because they generally work on commission. You can compare options online here. You can call your State Health Insurance Assistance Program for free guidance.

    N.B. If you opt for Medicare Advantage when you first enroll in Medicare, you could be locked in. You can always enroll in traditional Medicare, but you might not be able to buy supplemental coverage. It will depend upon where you live. Your federally guaranteed right to Medicare supplemental coverage, sometimes called Medigap, ends one year after you first enrolled in a Medicare Advantage plan, with some limited exceptions. Only four states–NY, CT, ME and MA–require Medicare supplemental insurers to sell you coverage after your initial enrollment period.

    How about prescription drug coverage? With traditional Medicare, you will need to enroll in a Medicare Part D prescription drug plan. You can compare your options online. With Medicare Advantage, prescription drug coverage is almost always included. If you go with a Medicare Advantage plan, to save money, you should choose a Medicare Advantage plan that covers the drugs that you use at the lowest cost. That said, the drugs these plans cover and your out-of-pocket costs can change at any time. Moreover, it can sometimes be cheaper to get your drugs through Costco or another pharmacy. 

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  • What are your Medicare premiums in 2025?

    What are your Medicare premiums in 2025?

    Medicare only covers about half of a typical person’s health care costs. People with Medicare generally pay a monthly Medicare Part B premium, about 16 percent of their medical and inpatient costs out of pocket (or through supplemental coverage: Medigap, Medicaid or retiree insurance) as well as some or all of the cost of dental, vision, hearing and long-term care services. Medicare Part B premiums and other out-of-pocket costs are rising in 2025. Here’s what you need to know.

    Part B premiums in 2024:
    In 2025, people whose modified adjusted gross income from two years ago as reported on their federal tax return is $106,000 or less pay a monthly Part B premium of $185, an increase of $10.30.

    People with incomes above $106,000–about eight percent of the Medicare population–pay a Medicare Part B premium of:

    • $259 a month, if their income is above $106,000 and no more than $133,000.
    • $370 a month, if their income is above $133,000 and no more than $167,000.
    • $480.90 a month, if their income is above $167,000 and no more than $200,000.
    • $591.90 a month, if their income is above $200,000 and less than $500,000.
    • $628.90 a month, if their income is $500,000 or more.

    For couples with combined incomes of $400,000 or less two years ago, filing a joint tax return, the premium amount doubles. Couples filing jointly with annual incomes above $400,000 and less than $750,000 each pay a $591.90 monthly premium. And, couples with annual incomes of $750,000 and above each pay a $628.90 monthly premium. Visit this CMS web site for your Part B premium amount if you are filing separate returns.

    Medicare Part B annual deductible: $257, an increase of $17 from the annual deductible of $240 in 2024.

    For more than four decades, the Medicare Part B premium (medical insurance) was the same for everyone regardless of income, geography or health status, a quarter of the cost of Part B services. (Medicare Part A, hospital insurance, is premium-free if you have contributed into Social Security for at least 40 quarters.)  In 2007, wealthier people with Medicare began paying higher premiums.

    Here are 2025 Medicare Part A costs:

    • There is no Medicare Part A premium if you or your spouse are among the 99 percent of people with Medicare who have at least 40 quarters of Medicare-covered employment.
    • The Medicare Part A inpatient hospital deductible is $1,676, in 2025, and  coinsurance for hospitalizations after day 60 is $419 a day in a benefit period; coinsurance for lifetime reserve days is $838 a day.
    • The Medicare Part A daily coinsurance for skilled nursing facility stays after day 20 is $209.50.

    Extra Help paying your Medicare premiums and out-of-pocket costs: People with low incomes and assets have help paying these costs through Medicaid and the Medicare Savings Program. You should apply through your Medicaid office, if you think you might be eligible.

    Here’s more from Just Care:

  • Insurers focus on Medicare Advantage Special Needs Plans to maximize profits

    Insurers focus on Medicare Advantage Special Needs Plans to maximize profits

    Laura Beerman writes for HealthLeaders about how Medicare Advantage insurers are making out like bandits from offering care to people in Medicare Advantage “Special Needs Plans” or SNPs. Insurers like the Medicare Advantage program because they profit more from Medicare Advantage plans than from other insurance they offer. Providing Medicare coverage to people who have both Medicare and Medicaid in D-SNPs is even more lucrative than providing Medicare coverage to people who have only Medicare.

    Medicare Advantage Special Needs Plans are intended to cover people with Medicare and Medicaid, people with chronic or disabling conditions, including people with diabetes, HIV/AIDS, and dementia, as well as people living in a nursing home or requiring nursing care at home. But, it is not clear that most of the SNPs actually provide people with good Medicare benefits from high quality providers. People eligible for SNPs should seriously consider traditional Medicare, which makes it easy to get care from the providers you want to see anywhere in the US. People with Medicare and Medicaid generally have no out-of-pocket costs in traditional Medicare.

    Insurers are getting an increasing number of SNP enrollees. The number of SNP enrollees has doubled in the last five years. Insurers are also offering more SNP plans. Insurers make twice the profits from SNPs covering people with Medicare and Medicaid than they do from people without Medicaid in Medicare Advantage plans.

    It’s not clear whether people in SNPs understand what they are giving up when they opt for a SNP instead of traditional Medicare. People with Medicare and Medicaid in SNPs tend to be especially vulnerable, in poor health and living on small incomes, struggling to make ends meet. They also often struggle to keep their Medicaid eligibility.

    The Biden administration made it a little harder for the Medicare Advantage insurers to run away with as many taxpayer dollars as they’d like. As a result of some reforms that rein in Medicare Advantage payments a little, the Medicare Advantage market is changing somewhat. Insurers want big profits. So, some insurers have ended some Medicare Advantage plans that are less profitable.

    More than half of people in D-SNPs (people with Medicare and Medicaid) are in either a UnitedHealth Medicare Advantage plan or a Humana Medicare Advantage plan.

    Here’s more from Just Care:

  • Trump reelected: What happens to health care?

    Trump reelected: What happens to health care?

    With Donald Trump on his way back to the White House, we can be sure that our health care system will change dramatically over the next four years. Sarah Owermohle reports for StatNews on ways in which Trump could restructure US health care.

    As Trump said in his victory speech, Robert F. Kennedy Jr. is likely to be in charge of “mak[ing] America health again.” It’s not at all clear what that means. Americans appeared less focused on health care this election and more focused on the economy. However, health care costs are part of the economy and have always been a large concern for Americans.

    This go round, Trump claims he won’t try to end the Affordable Care Act. He says he simply wants to reduce costs. That could mean lower costs for healthy people and higher costs for people who need care. It could also mean health insurance options that are not comprehensive, for example, insurance that does not cover prescription drugs.

    Tax credits that help people with low incomes afford insurance premiums could not be extended at the close of 2025, when they expire. Republicans in Congress don’t support them.

    Trump says he will not support a law that bans abortion in American. He intends to prevent funding for gender-affirming care and prohibit it for minors entirely. He will protect employers’ right to refuse to cover birth control based on their religion.

    What will Trump do with Medicare? During his last presidency he ultimately decided not to support lower drug prices. Will he try to undo Medicare drug price negotiation for high-cost drugs?

    Both Medicare and Medicaid are on the table. He might try to do away with traditional Medicare. Although Medicare Advantage has cost the Medicare program significantly more than traditional Medicare, Republicans in Congress still look to the corporate insurers offering Medicare Advantage plans to contain costs. Trump left open the possibility that he would cut spending on Medicare and Medicaid. In his first presidency, he gave states permission to put work requirements on some people with Medicaid.

    Trump says he wants a commission to look at the growth of chronic illnesses in America. Who knows what that will lead to. To date, he has not embraced RFK Jr.’s notion that vaccines are responsible for chronic diseases. RFK Jr. will not lead the Department of Health and Human Services, according to a Trump spokesperson, but he still could have significant authority over recommended vaccines.

    On a brighter note, Trump has said he will ensure access and insurance coverage of in vitro fertilization.

    Trump says he supports tax credits to help with the costs of  America’s 53 million plus caregivers. He has yet to offer details as to what that would look like. Health savings accounts, which tend to be of little help to people when they need costly care, is one way he might go.

    Here’s more from Just Care:

  • Lower income Medicare cancer patients less likely to get optimal care

    Lower income Medicare cancer patients less likely to get optimal care

    A new study of Medicare cancer patients published in the Journal of Clinical Oncology finds that patients with lower incomes who receive a Medicare Part D Low-Income Subsidy (LIS) through the Extra Help program, are less likely to get optimal care, reports Medscape. These lower income individuals too often do not get systemic cancer therapy as compared to individuals with higher incomes not in the LIS program. People in the LIS program are more likely to get treatment that is not recommended.

    The goal of the Medicare Low-Income Subsidy or Extra Help program is to promote health equity. However, many people with low incomes who qualify for the program either do not know it exists or face too many barriers applying for it. As a result, around half of all people eligible are not enrolled in it.

    To qualify for Extra Help, you must apply through your state Medicaid office. However, you will be automatically enrolled if you have Medicaid, receive Supplemental Security Income benefits or are enrolled in a Medicare Savings Program.

    This new observational study of cancer patients suggests that those who are enrolled in the LIS program still face financial barriers to care that prevent them from getting the systemic cancer treatment they need. The LIS program helps offset the cost of oral prescription drugs under Medicare Part D for people with incomes up to 150 percent of the federal poverty level. The LIS program does not help offset the costs of drugs administered by physicians under Medicare Part B.

    However, many people in the LIS program also qualify for a Medicare Savings Program. There are a few programs to help with Medicare Part A and Part B out-of-pocket costs, depending upon your income. Some pay the deductibles and coinsurance. To apply, contact your state Medicaid office.

    Also, as of January 1, 2023, a new Medicare prescription drug law could help offset coinsurance costs for some drugs and biologicals under Medicare Part B.

    Of the group studied, more than 40 percent did not receive systemic therapy for their cancer. Those who did not receive systemic therapy were more likely to be among those in the LIS program. Moreover, of those who did receive systemic therapy, those in the LIS program were more likely to receive inferior care.

    The study authors posit that the inferior care for the LIS cohort stems from financial barriers.

    Here’s more from Just Care:

  • What happens to Medicare if Trump wins?

    What happens to Medicare if Trump wins?

    Older adults and people with disabilities have no warning to avoid enrolling in Medicare Advantage plans–plans run by corporate health insurers–that likely will deny them care. And, they have no good protections. If Donald Trump becomes President again, everyone could be forced into a Medicare Advantage plan, reports Jessica Glenza for The Guardian.

    Today, traditional Medicare, the government-administered alternative to Medicare Advantage, has become a luxury for the wealthy. People enroll in Medicare Advantage because the upfront costs are lower. And, they are then locked in. They can’t switch to traditional Medicare because it lacks an out-of-pocket cap, and they can’t afford supplemental insurance to protect themselves against catastrophic costs.

    Problems abound in Medicare Advantage for people who get sick and need costly care. Millions of people in Medicare Advantage struggle to figure out how they are going to stay with their treating physicians because their Medicare Advantage plan is leaving their area or their physicians are leaving their Medicare Advantage plan networks. Or, they wonder how they will travel tens of miles to get the care they need because their local hospital is no longer in-network. Or, they struggle to deal with Medicare Advantage denials of care their treating physicians says they need.

    Joe Namath and William Shatner might tell you how much they like Medicare Advantage, but dollars to donuts, they are in traditional Medicare. Traditional Medicare is a luxury for the wealthy because it actually covers the care you need from the physicians and hospitals you want to use.

    Trump and his supporters in Congress want to privatize Medicare and end traditional Medicare. They want you to believe that you will have all the choices you need in Medicare Advantage. The fact is that you will have a bunch of meaningless choices because you won’t be guaranteed the choice of a Medicare Advantage plan that will meet your needs if you are in an accident or are diagnosed with cancer or heart disease. Only traditional Medicare guarantees you coverage for all your needs.

    The ten big insurers offering Medicare Advantage have been charged with fraud many times. In 2022, eight of them were defending themselves in court.

    While Medicare Advantage plans might not meet your needs, they meet the needs of the biggest health insurers, who are able to profit wildly. Nearly half of United Healthcare’s total revenue came from Medicare Advantage. But, Medicare Advantage enrollees represent only 15 percent of all its enrollees, according to Accountable.US.

    Trump and his supporters in Congress appear to prefer a Medicare program in which health insurers have the financial incentive to stint on care and profit wildly at taxpayer expense, to a more cost-effective world in which people can get the care they need and the government is in charge.

    Here’s more from Just Care:

  • Even with Medicare, older adults struggle to afford their care

    Even with Medicare, older adults struggle to afford their care

    Maggie Shaw writes in AJMC  about new findings reported in the Annals of Internal Medicine that many older adults struggle to pay the $1,600 Medicare Part A deductible. These findings corroborate a slew of earlier findings that cost is a barrier to care for people with Medicare, be they in traditional Medicare or Medicare Advantage.

    Most people in traditional Medicare have supplemental coverage to pick up those costs, either through Medigap, insurance they buy to fill coverage gaps, Medicaid, if their income is low, or retiree coverage from their jobs. How many people in Medicare Advantage can afford their care?

    Cost is a barrier to care for far too many people with Medicare, whether they are in traditional Medicare or Medicare Advantage. Traditional Medicare needs an out-of-pocket limit so that people who cannot get supplemental coverage still have financial protection. Usually, they sign up for Medicare Advantage, thinking they have protection because it does have an out-of-pocket cap.

    But, in Medicare Advantage, people are too often denied the care they need or forced to go through too many hoops to get their Medicare Advantage plan to cover their care. Moreover, when it is covered, they can have high out-of-pocket costs and they can’t get supplemental coverage to fill cost gaps. We have only a limited understanding of how often that leads Medicare Advantage enrollees to forego needed care.

    The AJMC study found that between a third and a half of all people with Medicare lack financial stability. Black and Hispanic adults with Medicare are particularly at risk financially; many do not have supplemental coverage. An NBER study a few years back found that even a $10 copay increase for prescription drugs under Medicare Part D led many to stop filling their prescriptions.

    The people most at risk in Medicare have incomes too high to qualify for Medicaid, up to 400 percent of the federal poverty level. Some of them qualify for Medicare Savings Programs that help with their costs. But, this help is not automatic and too often they do not apply for these programs. It’s a hassle.

    Instead, people with Medicare are left without needed care. The authors recommend that policymakers either make it easier for people with low incomes to qualify for help with their out-of-pocket costs or add an out-of-pocket maximum to Medicare.

    Here’s more from Just Care:
  • 2024: What to know this Medicare Open Enrollment Period

    2024: What to know this Medicare Open Enrollment Period

    During this Medicare Open Enrollment Period, here’s the most important thing you need to know: You gamble with your health if you are in the Medicare Advantage program. Your upfront costs are lower in Medicare Advantage than if you enroll in Traditional Medicare and need to buy Medicare supplemental coverage. But, you could pay a much bigger price in Medicare Advantage when you need costly care. 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.

    If you can afford it, choose Traditional Medicare over a Medicare Advantage plan. Enroll in Traditional Medicare to ensure you have good and speedy coverage when you need it. Most older adults will develop a serious condition at some point. 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 specialists 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.

    Get advice from your SHIP about your Medicare options and not from an insurance agent. Unfortunately, most insurance agents are paid to give you biased advice and 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. 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).

    Assume you will get worse care in Medicare Advantage than Traditional Medicare. In Traditional Medicare you get all medically necessary care your doctor recommends without having to go through any hoops. Every Medicare Advantage plan is different, some good and some to avoid at all costs. But, there’s no good information to tell you which plans to avoid. Overall, in Medicare Advantage you are very likely to get less home care, less rehab care, less nursing care, less hospital care if you need it than in Traditional Medicare. Medicare Advantage plans must technically cover the same benefits as Traditional Medicare, but they tend to cover many fewer services, taking the view that care your doctors say you need is not medically necessary. They often overrule your treating physician or delay treatment when you most need care. Moreover, there’s mounting evidence that you will see lower quality physicians and might not get access to specialty hospitals in Medicare Advantage. Bottom line: You cannot know whether your MA plan will refuse to cover the care you need or delay needed care.

    Don’t rely on friends or the government’s star-rating system to pick a good Medicare Advantage plan. Even if your friends say they are happy with their Medicare Advantage plan right now, they are gambling with their health care in a Medicare Advantage plan. Everything can change at any time. 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. Providers leave Medicare Advantage networks all the time. Moreover, you can’t count on getting ready access to the care your doctors say you need. If you are choosing among Medicare Advantage plans, choose a five-star plan. But keep in mind that 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.

    Don’t count on seeing the physicians listed in the Medicare Advantage network, much less the physicians you need to see if you develop a complex condition. Unfortunately, provider networks in Medicare Advantage plans are limited and can change at any time. This year, 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. Also, MA network directories are usually inaccurate.

    Know that the government can’t ensure that Medicare Advantage plans deliver the same benefits as Traditional Medicare. 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.

    If you’re dissatisfied with a Medicare Advantage plan, you can’t 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 financial risk. If you can, it might be very expensive. What’s worse, you could incur thousands of dollars in out-of-pocket costs in Medicare Advantage or be forced to forgo needed care.

    If you have Medicare and Medicaid, you should seriously consider Traditional Medicare. 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).

  • Health insurers successfully gouge Medicare

    Health insurers successfully gouge Medicare

    Fred Schulte and Holly Hacker report for KFFHealthNews on the power of the health insurance industry to reap extra billions from Medicare with near impunity. Millions of dollars in lobbying money and campaign contributions have helped the biggest health insurers to continue to collect and keep tens of billions of dollars in Medicare overpayments. The government appears unwilling or unable to recoup these funds.

    Anyone who doesn’t trust government to do the right thing should recognize that the government can’t control the health insurance industry to do the right thing. And, unlike the government, big health insurers have the money, the power and the financial incentive to put their profits ahead of the needs of older adults and people with disabilities with Medicare. A combination of political contributions large enough to oust members of Congress when they are up for re-election if they don’t support the health insurers, huge investments in marketing and lobbying Congress, and money to outspend the government in any lawsuit, put the health insurers in control.

    When you couple insurer control over policymakers with a gameable Medicare Advantage payment system, limited government dollars for oversight and enforcement of the insurers, and 4,000 different Medicare Advantage plans, it’s to be expected that the big losers in the long run will be our nation’s older adults and people with disabilities and taxpayers.

    Working alongside many experts and advocacy organizations, I’ve spent more than two decades trying to reform Medicare Advantage to little if any effect. Overpayments are projected to be as much as $1.4 trillion over the next 10 years and inappropriate denials of care and coverage are on the rise. Whatever people believe to be the deficiencies of Traditional Medicare, it is far more cost-effective and it is far easier to oversee than Medicare Advantage.

    Here’s more from Just Care: