UnitedHealth is rethinking its Medicare Advantage strategy. To maximize profits, it is ending its Medicare Advantage plans in certain communities and narrowing the number of PPOs it offers. Six hundred thousand enrollees will lose coverage, reports Susan Morse for HealthCare Finance.
It’s still not known which Medicare Advantage markets UnitedHealthcare will exit or which Medicare Advantage PPOs it plans to shut down. UnitedHealth is also cutting some of its Medigap offering and Part D stand-alone plans.
UnitedHealth says that its medical costs are rising faster than they had assumed, particularly for outpatients services, but also inpatient care, orthopedic services and pharmacy infusions. Providers are charging for more intense visits.
What is clear is that insurers in Medicare Advantage are moving towards ever more restrictive coverage. If people cannot join a PPO–a Medicare health plan that covers a portion of your care outside the community–they will not have coverage for non-emergency and non-urgent health care services when they are living or traveling away from their primary residence.
If people cannot buy Medigap or Part D stand-alone plans, they are hard-pressed to enroll in Traditional Medicare, their only option that covers their care anywhere in the US, from most doctors and hospitals and without prior authorization.
Neither Congress nor the President can make for-profit Medicare Advantage insurers provide coverage if they do not want to. The needs of older adults and people with disabilities do not factor into insurers’ decision-making. Only profits.
UnitedHealth reported lower than expected profits in the second quarter of this year. It was $3.4 billion dollars. Not enough. Profits were $4.2 billion last year.
Here’s more from Just Care:
- UnitedHealth deprives members of critical rehabilitation care
- Justice Department investigating UnitedHealth for Medicare Advantage fraud
- Senator Grassley takes on UnitedHealth Medicare Advantage overpayments
- Medicare Advantage inappropriate denials of care abound
- Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
